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Ann Rehabil Med. 2016 Jun;40(3):373-82. doi: 10.5535/arm.2016.40.3.373. Epub 2016 Jun 29.

Factors Associated With Upper Extremity Functional Recovery Following Low-Frequency Repetitive Transcranial Magnetic Stimulation in Stroke Patients.

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Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.
Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea.
Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.; Department of Nanobiomedical Science, BK21 Plus NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Korea.; Institute of Tissue Regeneration Engineering, Dankook University, Cheonan, Korea.



To investigate the factors related to upper extremity functional improvement following inhibitory repetitive transcranial magnetic stimulation (rTMS) in stroke patients.


Forty-one stroke patients received low-frequency rTMS over the contralesional hemisphere according to a standard protocol, in addition to conventional physical and occupational therapy. The rTMS-treated patients were divided into two groups according to their responsiveness to rTMS measured by the self-care score of the Korean version of Modified Barthel Index (K-MBI): responded group (n=19) and non-responded group (n=22). Forty-one age-matched stroke patients who had not received rTMS served as controls. Neurological, cognitive and functional assessments were performed before rTMS and 4 weeks after rTMS treatment.


Among the rTMS-treated patients, the responded group was significantly younger than the non-responded group (51.6±10.5 years and 65.5±13.7 years, respectively; p=0.001). Four weeks after rTMS, the National Institutes of Health Stroke Scale, the Brunnstrom recovery stage and upper extremity muscle power scores were significantly more improved in the responded group than in the control group. Besides the self-care score, the mobility score of the K-MBI was also more improved in the responded group than in the non-responded group or controls.


Age is the most obvious factor determining upper extremity functional responsiveness to low-frequency rTMS in stroke patients.


Age factors; Recovery of function; Stroke; Transcranial magnetic stimulation; Upper extremity

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