Abstract

A review of the literature was done to investigate whether the evidence indicates that repetitive transcranial magnetic stimulation (rTMS) combined with physical therapy (PT) is more effective than therapy alone for improving functional mobility in persons over the age of 50 recovering from a stroke with hemiparesis. Four articles were identified from searches of PubMed, Physiotherapy Evidence Database (PEDro), and the Cochrane Library. All of the studies were double-blind randomized controlled trials and level 2 on the Oxford Centre for Evidence-Based Medicine (OCEBM) scale. The 4 articles were critically analyzed to identify an answer to the clinical question. All 4 of the studies concluded that rTMS combined with PT was more effective than PT alone for improving the functional mobility of patients in the early stages of stroke recovery. Three of the studies investigated 1-Hz and/or 3-Hz rTMS and 1 included 10-Hz rTMS; lower frequencies and contralesional rTMS were the most effective. Based on the evidence, rTMS with PT is more effective than PT only but more research is required to establish optimal rTMS and therapy protocols.

Keywords: Transcranial magnetic stimulation; rTMS; Stroke; Stroke recovery