Six-month effectiveness of low-frequency repetitive transcranial magnetic stimulation and intensive occupational therapy in upper limb hemiparesis after stroke

Abstract

There has been increasing recognition of combination therapy of low-frequency repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) in upper limb hemiparesis. But few studies have reported on the long-term effect. We report the long-term effect of this therapy in upper limb paralysis in chronic stroke patients. Twenty-two patients with chronic hemiparesis, who received combination therapy of low-frequency rTMS and OT were enrolled (age: 55.4 ± 14.8 years; time after onset: 1522 ± 1332 days). Patients underwent 15 days therapy while Wolf Motor Function Test (WMFT) and Action Research Arm Test (ARAT) were recorded before, after, and 6-month after the therapy. Differences in scores were tested for statistical significance by using ANOVA and Tukey. All patients completed the therapy without any adverse effects. All of the score improved significantly between before and after the therapy (WMFT time: from 722 to 590 s, P < 0.05; WMFT FAS: from 37.7 to 42.5 points, P < 0.05; ARAT: from 15.7 to 20.9 points, P < 0.05). The differences between before and 6-month after the therapy were also significant (WMFT time: from 722 to 553 s, P < 0.05; WMFT FAS: from 37.7 to 42.9 points, P < 0.05; ARAT: from 15.7 to 22.5 points, P < 0.05). But there was no significant difference between after and 6-month after the therapy. A combination therapy of low-frequency rTMS and OT enhances motor recovery of the upper limb paralysis in chronic stroke patients. These results suggest that the effect lasts for 6 months after the therapy. This is an area of ongoing research and further studies are needed.