Effects Of Different Frequency Repetitive Transcranial Magnetic Stimulation On Motor Function In Children With Spastic Hemiplegia Cerebral Palsy

Objective: To study the effects of conventional rehabilitation training combined with lowor high-frequency repetitive transcranial magnetic stimulation(LF-rTMS or HF-rTMS)on motor function and muscle tone in children with spastic hemiplegia cerebral palsy(CP),to select a suitable and effective rehabilitation method for children with spastic hemiplegia CP.Methods: Forty-five patients with CP of spastic hemiplegia who were outpatient and hospitalized at the Pediatric Cerebral Palsy Prevention and Treatment Center In Heilongjiang Province were selected from December 2016 to December 2017.According to the numerical table method,there were segmented into three groups: pseudo-stimulus group,LF-rTMS group,HF-rTMS group,15 patients in each group.Routine rehabilitation training includes: physical therapy(40min/time),occupational therapy(30min/time),speech therapy(30min/time),massage therapy(30min/time),acupuncture(1h/time).All rehabilitation training programs were performed once a day,5 times a week for 12 weeks.Gross motor function test scale(GMFM),fine motor function test scale(FMFM)and modified Asthworth classification(MAS),respectively,by the same rehabilitation therapists to assess the three groups of children before and after the treatment,comparative analysis of the gross motor function of the hemiplegic limb,the fine motor function of the upper extremities,and the scores of the elbow flexors and carpi flexors of the affected upper limbs before and after treatment in the three groups of patients.Results: The scores of the three groups were improved after 8 weeks of treatment than before,which was statistically significant(P<0.05).The ability of D-zone,E-zone,the upper limb fine motor function and muscle tension in LF-rTMS group and HF-rTMS group improve better than those in control group(P<0.05).MAS scores of elbow flexor and wrist flexor of the affected upper limbs in both groups were significantly lower than those in control group(P<0.05).There were no significant differences in D-zone,E-zone and fine motor function score,elbow flexor and wrist flexor MAS score between LF-rTMS group and HF-rTMS group(P>0.05).There was no significant difference in the functional improvement between LF-rTMS group and the HF-rTMS group after 12 weeks compared with 8 weeks treatment(P>0.05).Conclusions: On the basis of routine rehabilitation training combined with LF-rTMS or HF-rTMS can both improve the gross motor function,the fine motor function of upper limbs and hemiparesis upper limb muscle tension in children with spastic hemiplegia cerebral palsy,the combination of two modes of treatment is superior to conventional rehabilitation,and there is no significant difference between the two combined treatment effect,the appropriate course of the treatment is two months.