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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neurorehabilitation
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1439904
This article is part of the Research Topic Transcranial Magnetic Stimulation (TMS) in Motor Control and Motor Rehabilitation: Current Trends and Future Directions View all 3 articles

Effect of Short-Term 10Hz Repeated Transcranial Magnetic Stimulation on Postural Control Ability in Patients with Mild Hemiparesis in Acute Ischemic Stroke: A Single-Blinded Randomized Controlled Trial

Provisionally accepted
Jiangping Ma Jiangping Ma 1Nuo Ma Nuo Ma 1Lu Zhang Lu Zhang 1Siyu Qian Siyu Qian 1Linghao Xu Linghao Xu 2Xueyuan Liu Xueyuan Liu 3*Guilin Meng Guilin Meng 1
  • 1 Department of Neurology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
  • 2 Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, Shanghai Municipality, China
  • 3 Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

The final, formatted version of the article will be published soon.

    Background: Previous studies have demonstrated that repetitive transcranial magnetic stimulation (rTMS) can improve postural control in subacute and chronic ischemic stroke, but further research is needed to investigate the effect of rTMS on acute ischemic stroke. Objective: We compared the therapeutic effects of rTMS and conventional rehabilitation on postural control in patients with mild hemiparesis in acute ischemic stroke. Methods: Eighty-six patients with acute ischemic stroke were randomly assigned to either the experimental group or the control group within 1-7 days of onset. Patients in both groups received conventional rehabilitation for 2 weeks. Patients in the experimental group received rTMS treatments lasting for 2 weeks. Before and after the 2-week treatment, patients were assessed based on the Timed up and Go (TUG) test, Dual-Task Walking (DTW) test, Functional Ambulation Category (FAC), Tinetti Performance Oriented Mobility Assessment (POMA), gait kinematic parameters, Barthel Index (BI), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and National Institutes of Health Stroke Scale (NIHSS). Additionally, TUG and single-task gait velocity were assessed at 2 months after the start of treatment, and independent walking recovery was also followed up. Results: After 2 weeks of treatment, compared to conventional rehabilitation, participants who underwent rTMS treatment exhibited notable enhancements in TUG, FAC, POMA, and some gait parameters [single-task gait velocity, gait stride length, gait cadence, gait cycle]. Changes in cognitive function partially mediated the improvement in single-task gait velocity and gait stride length by rTMS. Generalized Estimating Equation (GEE) analysis showed that the trend of improvement in single-task gait velocity over time was more pronounced in the experimental group than in the control group. The results of the Kaplan-Meier curve indicated a median gait recovery time of 90 days for patients in the experimental group and 100 days for the control group. Multifactorial Cox regression analyses showed that rTMS promoted faster recovery of independent walking compared with conventional rehabilitation. Conclusion: rTMS outperformed conventional rehabilitation in improving postural control in patients with acute ischemic stroke. Improvements in cognitive function may serve as a mediating factor in the favorable treatment outcome of rTMS for improving postural control.

    Keywords: ischemic stroke, repetitive transcranial magnetic stimulation, Rehabilitation, Postural control, gait Registration: no. ChiCTR1900026225  Introduction

    Received: 31 May 2024; Accepted: 26 Jul 2024.

    Copyright: © 2024 Ma, Ma, Zhang, Qian, Xu, Liu and Meng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xueyuan Liu, Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China

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