A Clinical Randomized Controlled Study of Low-Frequency rTMS Therapy on Lower Limb Motor Dysfunction after Stroke

Abstract

Objective: To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation (rTMS) for the treatment of lower limb motor dysfunction after stroke. Methods: A total of 96 patients with stroke and lower limb motor dysfunction were enrolled in this study, and were randomly divided into the experimental group and the sham stimulation group using the method of calculator-generated random numbers. Both groups received conventional medication and rehabilitation therapy. The experimental group received 4 weeks of 1 Hz rTMS treatment in the primary cortical motor area (M1) of the healthy side, with the treatment coil tangent to the skull surface; the sham stimulation group underwent the same procedures as the experimental group, but the treatment coil was perpendicular to the skull surface instead. Lower-extremity subscale of the Fugl-Meyer Assessment (FMA-LE), Berg Balance Scale (BBS), gait analysis, and lower-extremity surface electromyography (LESEM) were performed in both groups before and after rTMS treatment. Results: All 96 patients completed the test with no shedding and no adverse reactions. After treatment, the FMA-LE score and BBS score of the 2 groups of patients were significantly improved as compared with the pre-treatment (P < 0.05), and the TUG test time was reduced as compared with the pre-treatment (P < 0.05). The true stimulation group had greater improvement in all assessment indexes than that of the sham stimulation group (P < 0.05). After treatment, the electromyographic activity of the tibialis anterior and rectus femoris muscles in the true simulation group improved significantly. The step length, step speed, and step frequency were also significantly improved in both groups after treatment, and the symmetrical ratio of step length and support time was reduced (P < 0.05). Comparison between the groups revealed that the true simulation group significantly improved after rTMS treatment as compared to the sham stimulation group (P < 0.05). Conclusion: 1Hz rTMS treatment safely and effectively improved motor and balance function in patients with post-stroke lower limb motor dysfunction.