Abstract
Background: After stroke the unaffected hemisphere is dis-inhibited, due to reduction in trans-callosal inhibition from the damaged hemisphere this in turn may increase inhibition of the affected hemisphere and could impair functional recovery. Objective: Low rate rTMS assumed to help gait rehabilitation as well as EEG synchronization after stroke. Are these two variables correlated? Methods: Thirty stroke patients were treated by conventional physical therapy program as well as rTMS at 1 Hz three sessions per week. The following parameters including quantitative electroencephalogram (QEEG), timed up and go test (TUG), Fugl- Meyer scale (FMS), Cadence and gait Speed were measured before and after six weeks of the treatment program. Compared to 15 stroke patients received physiotherapy program only. Results: All gait evaluation tests were improved after treatment in both groups, however the study group showed significant improvement than the control one. In the study group; there was significant improvement of the relative alpha band power spectrum over the treated as well as the untreated hemisphere. The relative theta/beta ratio over the central regions shows significant improvement as well. There were no significant correlations between the EEG power spectrum and the improvement of the gait evaluation tests. Conclusion: Although rTMS for the unaffected hemisphere after stroke improves the gait ability of the patient as well as the fast frequency band of the EEG yet they are not correlated to each other.
Highlights
Impaired walking is one of the main functional problems that the physiotherapist encounters in caring for neurologically impaired patient
Many factors could affect the ability to walk such as range of motion (ROM), posture, bony alignment, muscle power, motor control, coordination, sensation and balance [1]
The temporal aspects of the hemiplegics gait are characterized by increased cycle time, reduced walking velocity, and reduced cadence and altered stance and swing phase periods [2,3]
Summary
Impaired walking is one of the main functional problems that the physiotherapist encounters in caring for neurologically impaired patient. Many factors could affect the ability to walk such as range of motion (ROM), posture, bony alignment, muscle power, motor control, coordination, sensation and balance [1]. The two cerebral hemispheres are functionally coupled and balanced as the motor cortex trans-callosal interactions are mainly inhibitory [5]. This in turn may increase inhibition of the affected hemisphere and could impair functional recovery [6]. After stroke the unaffected hemisphere is dis-inhibited, due to reduction in trans-callosal inhibition from the damaged hemisphere this in turn may increase inhibition of the affected hemisphere and could impair functional recovery
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