A Randomized Controlled Trial of Repetitive Peripheral Magnetic Stimulation applied in Early Subacute Stroke: Effects on Severe Upper-limb Impairment

Abstract

Objectives Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive method that activates peripheral nerves and enhances muscle strength. This study aimed to investigate the effect of rPMS applied in early subacute stroke on severe upper extremity impairment. Design Randomized controlled trial. Setting Rehabilitation department of a university hospital. Subjects People aged 30–80 years with no practical arm function within four weeks of a first stroke. Interventions Participants were randomly assigned to either the rPMS group ( n = 24, 20Hz and 2400 pulses of rPMS to triceps brachii and extensor digitorum muscles daily for two weeks in addition to conventional physiotherapy) or the control group ( n = 20, conventional physiotherapy). Main measures The primary outcome was the upper extremity motor section of Fugl-Meyer Assessment after treatment. Secondary outcomes included Barthel Index and root mean square of surface electromyography for muscle strength and stretch-induced spasticity of critical muscles of the upper extremity. Data presented: mean (SD) or median (IQR). Results The rPMS group showed more significant improvements in the Fugl-Meyer Assessment (12.5 (2.5) vs. 7.0 (1.4), P < 0.001), Barthel Index (15 (5) vs. 10 (3.7), P < 0.001), and strength-root mean square (biceps brachii: 20.5 (4.8) vs. 6.2 (2.7), p < 0.001; triceps brachii: 14.9 (5.8) vs. 4.3 (1.2), p < 0.001; flexor digitorum: 5.1 (0.8) vs. 4.0 (1.1), p < 0.001) compared with the control group. Conclusion In patients with no functional arm movement, rPMS of upper limb extensors improves arm function and muscle strength for grip and elbow flexion and extension.