A Randomized Controlled Trial of Repetitive Peripheral Magnetic Stimulation applied in Early Subacute Stroke: Effects on Severe Upper-limb Impairment.

ABSTRACT

OBJECTIVES: Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive method that activates peripheral nerves and enhances muscle strength. This study aimed to investigate the effect of rPMS applied in early subacute stroke on severe upper extremity impairment. DESIGN: Randomized controlled trial. SETTING: Rehabilitation department of a university hospital. SUBJECTS: People aged 30-80 years with no practical arm function within four weeks of a first stroke. INTERVENTIONS: Participants were randomly assigned to either the rPMS group (n = 24, 20Hz and 2400 pulses of rPMS to triceps brachii and extensor digitorum muscles daily for two weeks in addition to conventional physiotherapy) or the control group (n = 20, conventional physiotherapy). MAIN MEASURES: The primary outcome was the upper extremity motor section of Fugl-Meyer Assessment after treatment. Secondary outcomes included Barthel Index and root mean square of surface electromyography for muscle strength and stretch-induced spasticity of critical muscles of the upper extremity. Data presented mean (SD) or median (IQR). RESULTS: The rPMS group showed more significant improvements in the Fugl-Meyer Assessment (12.5 (2.5) vs. 7.0 (1.4), P < 0.001), Barthel Index (15 (5) vs. 10 (3.7), P < 0.001), and strength-root mean square (biceps brachii 20.5 (4.8) vs. 6.2 (2.7), p < 0.001; triceps brachii 14.9 (5.8) vs. 4.3 (1.2), p < 0.001; flexor digitorum 5.1 (0.8) vs. 4.0 (1.1), p < 0.001) compared with the control group. CONCLUSION: In patients with no functional arm movement, rPMS of upper limb extensors improves arm function and muscle strength for grip and elbow flexion and extension.