Objective:The aim of this study was to compare the effects of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) applied to the lesioned hemisphere with those of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) applied to the contralesional hemisphere on lower-limb motor function and gait in individuals with subacute stroke.Design: A single-blind, parallel-group randomized controlled trial was conducted.Methods: Twenty-eight individuals with unilateral subacute stroke registered at community-based rehabilitation centers were randomly assigned to either the HF-rTMS group (n = 14) or LF-rTMS group (n = 14).HF rTMS (5 Hz) was delivered over the lesioned primary motor cortex and LF rTMS (1 Hz) was applied over the contralesional primary motor cortex.Each session consisted of 1,200 pulses at 100% of the resting motor threshold, administered 5 times per week for 4 weeks.Both groups received identical conventional physical therapy.Outcome measures included the Fugl-Meyer Assessment of Lower Extremity (FMA-LE) and spatiotemporal gait parameters.Between-group differences were analyzed using analysis of covariance adjusted for baseline values.Results: : Both groups showed significant improvements in lower-limb motor function and gait parameters after the intervention.After adjusting for baseline values, the HF-rTMS group demonstrated greater improvements than the LF-rTMS group in FMA-LE scores, step length, step time, double support time, and weight-bearing symmetry.Conclusions: In individuals with subacute stroke, HF-rTMS applied to the lesioned hemisphere resulted in greater improvements than LF-rTMS applied to the contralesional hemisphere in lower-limb motor function and selected gait parameters.
Nam et al. (Mon,) studied this question.