title: Anti-spastic effect of low-frequency rTMS applied with occupational therapy in post-stroke patients with upper limb hemiparesis.
abstract: OBJECTIVE
  To determine the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with occupational therapy (OT) on the spasticity of the hemiparetic upper limb after stroke.
  
  
  METHODS
  The study subjects were 39 post-stroke patients with spastic upper limb hemiparesis (age: 56.5 ± 16.0 years, time after onset: 50.3 ± 37.8 months). At admission, the severity of hemiparesis was categorized as Brunnstrom stage 3-5 for hand-fingers. During 15-day hospitalization, each patient received 22 sessions of low-frequency rTMS applied to the non-lesional hemisphere and OT (one-to-one training and self-training). The spasticity of finger and wrist flexors of the affected upper limb was evaluated using the modified Ashworth scale (MAS) on the day of admission and discharge and 4 weeks after discharge. Each subject underwent Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test (WMFT).
  
  
  RESULTS
  The low-frequency rTMS/OT protocol significantly decreased the MAS scores for both finger and wrist flexors at discharge and at 4 weeks after discharge. In addition, the low-frequency rTMS/OT protocol significantly increased the FMA score and shortened the WMFT performance time.
  
  
  CONCLUSIONS
  The 15-day in-patient protocol of low-frequency rTMS/OT is potentially suitable for reducing spasticity as well as improving motor function on the affected upper limb after stroke.
authors: Department of Rehabilitation Medicine, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato, Tokyo, Japan.
authors: Wataru
authors: W
authors: Kakuda
authors: Masahiro
authors: M
authors: Abo
authors: Kazushige
authors: K
authors: Kobayashi
authors: Ryo
authors: R
authors: Momosaki
authors: Aki
authors: A
authors: Yokoi
authors: Akiko
authors: A
authors: Fukuda
authors: Hiroshi
authors: H
authors: Ito
authors: Ayumi
authors: A
authors: Tominaga
authors: Takuma
authors: T
authors: Umemori
authors: Yumi
authors: Y
authors: Kameda
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000517:prevention & control / Q000534:rehabilitation*; D009788:Occupational Therapy / Q000379:methods*; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome