S5-5. Effects of repetitive transcranial magnetic stimulation with repetitive facilitation exercise in post-stroke patients

Abstract

Repetitive magnetic stimulation (rTMS) induces functional and structural plasticity, while repetitive facilitation exercises (RFEs) promote the functional recovery of the hemiplegic upper limb and hand to a greater extent than the conventional therapy. The aim of this study was to investigate whether multiple sessions of 1-Hz rTMS facilitated the effect of RFEs on hemiplegic upper-limb function in chronic post-stroke patients. The study design was a randomized double-blinded crossover study. Eighteen patients with hemiplegia of the upper limb, were assigned to two groups: the motor-before-sham rTMS group, which performed motor rTMS sessions for two weeks followed by sham rTMS sessions for two weeks; or the motor-following-sham rTMS group, which performed sham rTMS sessions for two weeks followed by motor rTMS sessions for two weeks. Patients received 1-Hz rTMS to the unaffected motor cortex for four minutes and performed RFEs for 40 min during motor rTMS sessions. The Fugl-Meyer assessment, Action Research Arm test and simple test for evaluating hand function were used to evaluate upper-limb function. Motor function improved significantly during the motor, but not sham, rTMS sessions. We concluded that multiple sessions of 1-Hz rTMS facilitated the effect of RFEs in improving the motor function of the affected upper limb.