Effectiveness Of Different High-frequency RTMS On Upper-limbs Motor Function And ADL In Patients With Cerebral Infarction

ObjectiveThe 3Hz and 10 Hz rTMS were applied to ischemic stroke patients respectively,observed the change of the excitability of the contralesional cortex,the spasticity and Fugl-Meyer scores of the affected upper-limbs,and ability of daily living.To evaluated the effect of 3Hz and 10 Hz rTMS on the upper-limbs motor function and the activity ability in patients with stoke,provide reference for clinical select the better therapy parameter of high frequency rTMS.MethodRecruited 60 inpatients that conformed the inclusion criteria from rehabilitation apartment of the second affiliated hospital of guangzhou medical college.Randomly divided into group A,B and C.Three groups received routine training and basic drug therapy,group A received 3Hz rTMS,group B received 10 Hz rTMS and group C received shamed rTMS(parameters same with the group B)respectively.All patients received those treatments once per day,5 times a week for 2 weeks.The FMA,MAS,MBI scores were assessed before,after treatment and then after one month.The RMT of contralesional cortex was assessed before and after treatment.Result1.There were no significant differences between the three groups regarding the baseline clinical assessment of scales(P>0.05),the data was comparable.2.After treatment,the RMT of group A and B was significant increased(P<0.05),group C was no significant differences(P>0.05).There were no significant differences between the three groups in RMT and its improvement(P>0.05).3.There was a significant decreased in the MAS score of the elbow flexor muscle after treatment in group B(P<0.05),and the other two groups improved,but nosignificant difference(P>0.05).Compared with the before and after treatment,the three groups showed significant improvement in the follow-up(P<0.05),group A and group B scores better than group C(P<0.05).The MAS score of the wrist flexor muscle was significantly improved after treatment and follow-up in group A and group B(P<0.05),and no significant improvement in group C(P> 0.05).There was no significant difference between the three groups during after treatment and follow-up(P > 0.05).4.The FMA scores(proximal upper-limbs,hand and total scores)were significantly improved in the three groups after treatment and follow-up than before treatment(P<0.05).Group A and group B were significantly better than the group C(P<0.05)in the FMA(upper-limbs proximal,hand,total scores)improvement between before,follow-up and after treatment.The FMA(upper-limbs proximal,total scores)improvement between the after treatment and follow-up of group A and group B was better than that of group C(P<0.05),while the hand function was no significant difference between the three groups(P>0.05).5.After treatment and follow-up,the MBI score was significantly improved in the three groups(P<0.05),and there was no significant difference between the MBI score and the improvement(P > 0.05).Conclusion1.3Hz and 10 Hz rTMS applied to the ipsilesional can reduce the excitability of the contralesional cortex.2.3Hz and 10 Hz rTMS can reduce the muscle tension and promote the affected upper limbs movement function recovery in patients with cerebral infarction that affected upper-limbs was in Brunnstrom?-? stage.3.High frequency rTMS and conventional rehabilitation training can significantly improve the activity of daily living in patients with cerebral infarction.4.The efficacy of 3Hz and 10 Hz rTMS was similar,but the treatment time of10 Hz rTMS was significantly shorter than 3Hz,and the clinical application was more advantageous.