Effect of Repetitive Transcranial Magnetic Stimulation Pulses on Muscle Spasticity of Cerebral Palsy Children

Abstract

Background: Spasticity is a common contributor to the quality of life of children with CP as it leads to musculoskeletal problems; however, it had been proved that removal of spasticity can improve motor functions in these children; thus, several invasive and non-invasive approaches are applied. Repetitive Transcranial magnetic stimulation (rTMS) is one such non-invasive brain stimulation approach that can induce motor functions in children with movement disorder depending on stimulation intensity and pulses. Objective: This study was aimed to evaluate the effect of different rTMS pulses on muscle spasticity of spastic cerebral palsy (CP) children. Method: Thirty spastic CP children participated in this study which was divided equally into three groups P15, P20 and P25 on the basis of stimulating pulses of 1500, 2000 and 2500 respectively. Modified Ashworth Scale (MAS) was employed for assessing the degree of muscle spasticity and prior to start of rTMS therapy, pre assessment of MAS was performed on selected muscles of both lower and upper limbs. rTMS therapy was administered at 10 Hz frequency to each of the participants for 15 min duration for 20 days followed by physical therapy (PT) of 30 min duration daily for 20 days. After completion of the therapy sessions, post-assessment of MAS on exactly the same muscles were recorded. Result: Statistically significant result (p<0.5) was found on different muscles that responded to different rTMS pulses between groups along with reduction in muscle spasticity. Conclusion: The result demonstrated that rTMS pulse of 1500 and 2000 was effective in both upper and lower limb muscles of spastic CP children but pulse of 2500 was effective in children with severe muscle tightness falling in higher age group range.