Effect of Transcranial Magnetic Stimulation with Rehabilitation Program on Motor Function and ADL in Upper Extremity Ischemic Stroke: A Randomized Controlled Trials

Abstract

Ischemic stroke becomes the reason why some neural networks as well as cortico-subcortical excitability change either in the evidently spared contralateral hemisphere of the upper extremity or in the affected area. The processes are modulated through recent non-invasive brain stimulation techniques. In particular, a rehabilitation program and non-invasive instrument called transcranial magnetic stimulation (TMS) has already been implemented to examine the changes in brain plasticity caused by stroke and used as a therapeutic modality to securely increase the function of motor and activities of daily living (ADL). This study investigated the effect of low-frequency TMS with rehabilitation programs in post-ischemic stroke patients to improve the upper extremity's motor function. Randomized controlled trial was conducted in this study by dividing 11 patients into two groups which fulfilled the present inclusion criteria. Wolf Motor Function Test (WMFT) and Upper Extremity Fugl Meyer Assessment (UEFMA) were used to ADL of day 7 and to measure the levels of motor function, respectively. The study results showed a considerable difference in TMS with the rehabilitation program which was achieved on day seven on both groups. The total score of UEFMA and WMFT considerably increased from the condition before intervention (UEFMA intervention-control: 19.83-6.00; WMFT intervention-control: 20.67–4.00, p < 0.001). Therefore, low-frequency TMS with a rehabilitation program is recommended since it shows a considerable increase in the motor function of the upper extremity and ADL among the patients with post-ischemic stroke.