The effecicacy of repetitive transcranial magnetic stimulation on rehabilitation of mild hemiplegic gait after ischemic stroke:a randomized,single-blind,parallel-controlled,multicenter study
Objective To explore the efficacy of high-frequency repetitive transcranial magnetic stimulation(rTMS)in assisting the rehabilitation of gait in patients with mild hemiplegia after ischemic stroke.Methods A total of 23 patients with mild hemiplegic gait after ischemic stroke were selected from Zhongshan Hospital,Shanghai Xuhui District Central Hospital,and Huadong Hospital.There were 19 males and 4 females aged 35 to 75 years.The patients were randomly divided into an active stimulation group(n=11,receiving rTMS treatment)and a sham stimulation group(n=12,only receiving sound without effective rTMS treatment).Active and sham rTMS treatments were given for 4 consecutive weeks.The stimulation target was the primary motor cortex of the lower limb(Leg-M1)on the side of the stroke,with a frequency of 10 Hz.The patients in both groups received gait training simultaneously.The duration of follow-up was 8 weeks.The Tinetti balance and gait scale was used to assess the gait and balance status before treatment and at 4,8,and 12 weeks after treatment.The mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),Hamilton depression scale(HAMD),and instrument activities of daily living(IADL)were used to assess the cognitive function,emotions,and daily living abilities before treatment and at 4 and 12 weeks after treatment.Adverse events during treatment and follow-up period were recorded.Results There were no statistically significant differences in the age,gender composition,or infarct location between the two groups(all P＞0.05).Tinetti balance score,gait score,and total Tinetti score at 4,8,and 12 weeks after treatment were significantly higher than those before treatment in both groups(all P＜0.05).Tinetti balance score in the active stimulation group was significantly higher than that in the sham stimulation group at 4 weeks after treatment(P＜0.05).There were no statistically significant differences in the Tinetti balance score between the two groups before treatment,at 8 and 12 weeks after treatment(all P＞0.05).There were no statistically significant differences in the Tinetti gait score or total Tinetti score between the two groups before treatment,at 4,8,and 12 weeks after treatment(all P＞0.05).There were no statistically significant differences in the MMSE,MoCA,HAMD or IADL score between the two groups before and after treatment(all P＞0.05).The patients in both groups had lower HAMD score and IADL score at 4 and 12 weeks after treatment than before treatment(all P＜0.05).No adverse events occurred during treatment and follow-up in either group.Conclusion High-frequency rTMS targeting the Leg-M1 on the side of ischemic stroke may improve the rehabilitation efficiency and promote balance function recovery in a short term.It has no significant impact on the cognitive function or emotions of stroke patients.
Repetitive transcranial magnetic stimulationIschemic strokeRehabilitation
维普
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