Effects and Possible Mechanisms of Repetitive Transcranial Magnetic Stimulation on Lower Limb Spasticity in Subjects with Stroke

• Main Authors: Fei-Lin Lee, 李斐琳
• Other Authors: Ray-Yau Wang
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/29335878812689861091

碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 98 === Spasticity is a consequence of upper motor neuron syndrome characterized by muscle overactivity. It is one of the common symptoms in patients with stroke. Spasticity, especially around lower limb, can affect functional abilities such as walking and motor performance. Recently, repetitive transcranial magnetic stimulation (rTMS) emerges as a new direction for treating spasticity. However, such effects have not been established for patients with stroke, not to mention understanding the underlying mechanisms. The purpose of this study was to investigate the effects of rTMS on lower limb spasticity in patients with chronic stroke. Participants were recruited and randomly allocated to 5 Hz rTMS (experimental) group or sham rTMS (control) group to investigate the effects of rTMS and possible mechanisms for such effects. The rTMS was delivered once a day, 5 days per week, for 2 weeks. The outcome measures for comparison include neurophysiological measures – both on cortical level and spinal level, spasticity, and the walking speed. Our results showed that after 10 sessions of rTMS, subjects in the experimental group demonstrated decrease in motor threshold, decrease in soleus H-reflex, decrease in spasticity and increase in walking speed as compared with sunjects in the control group. Our results indicated the 5 Hz rTMS applied over the ipsilesional hemisphere of subjects with chronic stroke can decrease spasticity and increase the walking speed. The possible underlying mechanisms of rTMS for spasticity involve the activation of cortical excitability, reduce spinal reflex and thus improve gait speed.