Effect of cTBS magnetic stimulation over contralateral premotor areas on post-stroke spastic gait in severe hemiplegia patients

Nie Lijing; Deng Qian; Zhang Huifang

doi:10.3969/j.issn.1009-0126.2024.09.014

Abstract：Objective To determine the effects of continuous θ burst stimulation of contralateral premotor areas on post-stroke spasticity gait in patients with severe hemiplegia.Methods A pro-spective trial was conducted on 186 stroke patients with severe hemiplegia admitted to our depart-ment from January 2019 to January 2024.They were randomly into control group(93 cases,con-ventional rehabilitation training)and observation group(93 cases,continuous θ burst transcranial stimulation).In 4 weeks after treatment,gait parameters,Fugl-Meyer assessment of lower ex-tremity(FMA-LE)score,Berg balance scale(BSS)score,clinic spasticity index(CSI)score,lower limb sensation,spasticity improvement,and total effective rate were compared between the two groups.Results After treatment,both the 2 groups had significantly higher hip flexion,knee flex-ion,stride length,step frequency,step speed,FMA-LE score,BSS score,CSI score,and H wave latency,and lower two-point discrimination perception and H/M ratio when compared with the levels before treatment(P＜0.01).What's more,all above indicators were obviously better in the observation group than the control group(P＜0.01).The observation group had 1(1.1％),11(11.8％),48(51.6％),31(33.3％)and 2 cases(2.2％),respectively,of spasticity improvement grades 1,1+,2,3,and 4,and the control group had 0,7(7.5％),29(31.2％),44(47.3％),and 13 cases(14.0％),respectively,with statistical differences between the two group(P＜0.01).The total effective rate was notably higher in the observation group than the control group(96.8％vs 77.4％,x2=15.500,P＜0.01).Conclusion For severe hemiplegia patients,continuous θ burst stimulation can improve muscle spasm,restore gait,and better improve lower limb sensory and motor function.