Effects of high-frequency repetitive transcranial magnetic stimulation combined with Physiotherapy in Rehabilitation of Functional outcomes, Balance, Quality of life and depression in stroke patients: A randomized controlled trial

Abstract

Stroke is the most common and disabling neurological injury in adults, and more than 50% of patients who survive develop long-term disabilities. Movement disorder reduces patients' quality of life and daily life activities and has a noteworthy social impact by reducing productivity. The present study aimed to determine the effect of the combined high-frequency repeated transcranial magnetic stimulation (rTMS) and rehabilitation compared to rehabilitation treatment alone on balance, functional independence, quality of life, and depression in stroke patients. Methods: The current study was a randomized clinical trial on 36 stroke patients referred to the Physigo Center. Patients were randomly assigned to intervention and control groups. The intervention group received ten sessions of high-frequency rTMS treatment along with the usual stroke rehabilitation methods. The control group received only rehabilitation treatments. To measure balance, depression, functional independence, and quality of life, the Berg Balance Scale (BBS), Beck Depression Scale, Standard Daily Activities Questionnaire, and 36-item SF-36 Quality of Life Questionnaire were used, respectively. The research data was statistically analyzed using SPSS version 16 software. Results: Among 36 people, 23 (63.09%) men and 13 (36.01%) women, with an average age of 64.81 ± 5.29, participated in this study. The changes in the average balance score in the intervention group (from 39.33±3.07 before the intervention to 49.17±1.85 four weeks after the intervention) are significantly more than the control group (from 39.17±4.44 before the intervention, it was up to 45.39±1.91 (p<0.001). The changes in the average score of functional independence in the intervention group (from 7.55±2.95 before the intervention to 10.55±2.12 four weeks after the intervention) were significantly more than the control group (from 6.89±3.21 before the intervention, it was 8.72±3.07 (p=0.008). The changes in the mean Beck depression score in the intervention group (from 33.33±4.23 before the intervention to 25.56±3.09 four weeks after the intervention) were significantly more than the control group (from 67.67±4.60 33 before the intervention to 32.44±4.30) (p<0.001).