ObjectiveTo investigate the efficacy of transcranial combined with peripheral repetitive magnetic stimulation on motor dysfunction after stroke.MethodsA total of 40 patients after stroke who were hospitalized in the Department of Rehabilitation Medicine, the Second Affiliated Hospital of Xi’an Jiaotong University between January and December 2019 were selected. The patients were divided into the trial group and the control group by random number table method, with 20 cases in each group. Both groups received conventional rehabilitation and medicine treatment, on that basis, the trial group received repetitive transcranial magnetic stimulation (rTMS) combined with repetitive peripheral magnetic stimulation (rPMS), while the control group received rTMS combined with fake rPMS, both lasted for 2 weeks. Before treatment and 2, 4, 12 weeks after the initiation of treatment, the Fugl-Meyer Assessment (FMA) [including FMA-Upper Limb (FMA-UL), FMA-Lower Limb (FMA-LL)], National Institute of Health Stroke Scale (NIHSS), and Modified Barthel Index (MBI) were used to evaluate the efficacy of rTMS combined with rPMS.ResultsFive patients fell off, and 35 patients were finally included, including 18 in the trial group and 17 in the control group. No adverse reaction occurred during the study. Before treatment, there was no significant difference in FMA, FMA-UL, FMA-LL, NIHSS or MBI scores between the two groups (P>0.05). After treatment, the FMA score of the trial group changed from 36.44±28.59 to 75.56±19.94, and that of the control group changed from 39.05±29.85 to 54.64±23.25; the between-group difference was statistically significant at the end of the 4th and 12th weeks (P<0.05). The FMA-UL score of the trial group changed from 21.39±22.14 to 46.94±15.84, and that of the control group changed from 20.82±20.47 to 31.29±16.98; the between-group difference was statistically significant at the end of the 4th and 12th weeks (P<0.05). The FMA-LL score of the trial group changed from 15.06±9.10 to 28.61±5.69, and that of the control group changed from 18.23±10.33 to 23.35±8.20; the between-group difference was statistically significant at the end of the 12th week (P>0.05). The NIHSS score of the trial group changed from 6.83±4.54 to 2.78±2.05, and that of the control group changed from 6.35±3.67 to 3.94±2.56; the MBI score of the trial group changed from 53.33±17.90 to 83.06±12.50, and that of the control group changed from 60.88±25.45 to 78.82±15.67; there was no statistically significant difference in NIHSS or MBI between the two groups at any timepoint (P>0.05). Except for the FMA-LL of the control group, the other outcome indicators in each group were significantly different after treatment compared with those before treatment (P<0.05).ConclusionsBoth rTMS and rTMS combined with rPMS can improve the limb motor function and activities of daily living of stroke patients. The treatment mode of rTMS combined with rPMS has better effect on motor dysfunction after stroke, which is of great significance for improving the overall rehabilitation effect.
Stroke has the characteristics of high incidence rate, high mortality rate and high disability rate. Most patients may have some motor dysfunction after stroke, which greatly affects the normal life of patients. As a common sequela after stroke, foot drop seriously affects the walking gait of patients, limits the activities of patients, and reduces their quality of life. In recent years, repetitive peripheral magnetic stimulation (rPMS) has been used more and more in the rehabilitation of various diseases. Because rPMS is noninvasive, affordable and effective, it is accepted by many patients. This article reviews the research progress of rPMS for foot drop after stroke.
Post-stroke spasticity, a common sequelae of upper motor neuron lesions, results in motor control deficits and pathological hypertonia that not only reduce patients’ activities of daily living but may also cause impairment of adaptive neuroplasticity. Repetitive peripheral magnetic stimulation (rPMS), as a novel non-invasive neuromodulation technique, demonstrates unique clinical potential through targeted modulation of electromagnetic coupling effects in the peripheral neuromuscular system. Although current international studies have validated the therapeutic potential of rPMS for spasticity, significant heterogeneity persists in elucidating its mechanisms of action, optimizing parameter protocols, and standardizing outcome assessment systems. This review innovatively synthesized recent randomized controlled trials (RCTs) and mechanistic evidence, systematically summarizing rPMS-mediated multidimensional intervention paradigms for upper- and lower-limb spasticity. It rigorously examined the correlations between stimulation frequency parameters (low-frequency vs. high-frequency), anatomical targeting (nerve trunk vs. motor point), and clinical outcomes including spasticity severity, motor function, and quality of life. Crucially, the analysis reveals that rPMS may ameliorate spasticity through dual mechanisms involving local neuroelectrophysiological modulation and central sensorimotor network reorganization, thereby providing a theoretical foundation for developing individualized rPMS clinical protocols and establishing precision treatment strategies.