Effect of low-frequency repetitive transcranial magnetic stimulation combining task-oriented training on upper limb motor function recovery after stroke

Abstract

Objective To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with task-oriented training on the recovery of upper limb motor function of stroke patients. Methods A total of 42 patients with hemiplegia after stroke were randomly divided into control group (N = 20) and treatment group (N = 22). Control group received routine rehabilitation training and task-oriented training, and treatment group received low-frequency (1 Hz) rTMS over the contralesional cortex addition to routine rehabilitation and task-oriented training. Fugl-Meyer Assessment Scale for Upper Extremity (FMA-UE) and Wolf Motor Function Test (WMFT) were used to evaluate upper limb motor function of all patients before treatment, after 4-week treatment and 3 months after treatment. The latency and central motor conduction time (CMCT) of motor-evoked potential (MEP) in the contralesional cortex were recorded and analyzed. Results Compared with control group, FMA-UE score ( P = 0.006) and WMFT score ( P = 0.024) were significantly increased in treatment group. There was significant difference in FMA-AUE score ( P = 0.000) and WMFT score ( P = 0.000) at different time points. Compared with before treatment, FMA-UE score ( P = 0.000, for all) and WMFT score ( P = 0.000, for all) of patients in both groups were all significantly increased after 4-week treatment and 3 months after treatment. Besides, FMA-UE score ( P = 0.000, for all) and WMFT score ( P = 0.000, for all) 3 months after treatment were higher than those after 4-week treatment. There was no statistically significant difference between 2 groups on the latency ( P = 0.979) and CMCT ( P = 0.807) of MEP before and after treatment, and so was the difference on the latency ( P = 0.085) and CMCT ( P = 0.507) of MEP in the contralesional cortex at different time points (before treatment, after 4-week treatment and 3 months after treatment). Conclusions Low-frequency rTMS over the contralesional cortex combined with task-oriented training could greatly promote upper limb motor function of patients after stroke, and should be recommended to clinical application. DOI: 10.3969/j.issn.1672-6731.2017.04.004