Effects of repetitive transcranial magnetic stimulation combined with functional electrical stimulation on hand function of stroke: A randomized controlled trial.

Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that has been widely used for hand function recovery in patients with subacute and chronic stroke.

Objective: To observe the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with functional electrical stimulation (FES) on hand function recovery during convalescence of stroke.

Methods: Patients were divided into3 groups of 20 patients in each. All patients received routine training. rTMS group was treated with low-frequency repetitive transcranial magnetic stimulation (rTMS). FES group received functional electrical stimulation (FES) therapy. Observation group was treated with low-frequency rTMS and FES. The changes of TMS-MEP in the 3 groups were observed at the time of enrollment and after 2 courses of treatment, respectively, and the total active activity of fingers (TAM) and Fugl-Meyer assessment (FMA) rating scale were evaluated in wrist and hand parts.

Results: The amplitude of TMS-MEP was significantly higher than that of FES group. FMA score and TAM score in the observation group were significantly better than that of rTMS group and FES group.

Conclusion: Low-frequency rTMS combined with FES treatment can effectively improve the range of motion of fingers, and significantly improve the grasp, pinching and other functions of hands.