Effect of low frequency rTMS on stiffness of joints of the upper limbs in hemiplegic patients

Disabilities of the upper limbs due to stroke can lead to more prolonged functional problems in comparison to lower limb disabilities, and fewer numbers of investigations have been performed on this problem. Use of magnetic stimulation to produce induction currents in the brain for therapeutic purposes is a new method. The aim of this study was to determine the effects of rTMS plus routine rehabilitation on hand stiffness, and compare them with pure routine rehabilitation program in hemiplegic patients. Method and material: 12 hemiplegic patients were assigned randomly to two groups. Control group, received rehabilitation program with placebo magnetic stimulation, and experimental group, received magnetic stimulation with routine rehabilitation program, 3 times/week for 10 sessions. Using Wrist Robo Hab,we assessed joint stiffness during flexion-extension of the wrist, and supination-pronation of forearm before and after treatment. In the control group we did not find any significant decrease in the resistance of flexor (p=0.207) and pronator (p=0.291) muscles. But in the experimental group the resistance of flexor (p=0.009) and pronator (p=0.035) muscles decreased significantly. rTMS can decrease stiffness of the upper limb joints and can be used in chronic hemiplegic patients, when conventional treatments are not effective.