Abstract: BACKGROUND: At present, there are a large number of studies on contralateral low-frequency repetitive transcranial magnetic stimulation treatment or affected side high-frequency repetitive transcranial magnetic stimulation treatment, both of which can improve the upper limb motor function of stroke patients, whereas the effect on lower limb motor function is less reported.
OBJECTIVE: To investigate the effect of low-frequency repetitive transcranial magnetic stimulation on hemiplegic gait by collecting gait parameters through three-dimensional gait analysis.
METHODS: Thirty-six patients with hemiplegic stroke recovery were randomly divided into experimental group and pseudo stimulation group (n=18 per group), receiving both conventional drug and rehabilitation treatments. The experimental group on the basis of routine therapy received low-frequency repetitive transcranial magnetic stimulation using Magneuro100 transcranial magnetic stimulator. The 8-shaped coil was tangent to the brain surface of the first motor cortex corresponding to the healthy side of the patient’s skull. The stimulation frequency was set to 1 Hz, the stimulation intensity was 90% of the motor threshold, 20 pulses per sequence, 30 sequences once. The sequence interval was 2 seconds, and each treatment lasted for 20 minutes. The pseudo stimulation group was given false repetitive transcranial magnetic stimulation. Treatment in each group was performed once a day, 6 days per week, for 3 consecutive weeks. Gait Watch three-dimensional gait analyzer was used to collect the gait parameters of patients in the two groups to evaluate the efficacy. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Guangdong Pharmaceutical University.
RESULTS AND CONCLUSION: There was no significant difference in gait parameters between the two groups prior to the treatment (P > 0.05), whereas walking velocity, stride length, stride frequency, gait cycle, affected side to healthy side limb support phase ratio, and affected side to healthy side swing phase ratio in the experimental group were superior to those in the pseudo stimulation group after treatment (P < 0.05). No significant differences were found between the two groups in terms of stride width, double limb support phase, affected side limb support phase (%), affected side limb swing phase (%), contralateral support phase (%), and contralateral swing phase (%) (P > 0.05). To conclude, low-frequency repetitive transcranial magnetic stimulation improves walking velocity, stride frequency, stride length and gait symmetry parameters, but has no effect on balance related parameters such as double limb support phase and stride width. Low-frequency repetitive transcranial magnetic stimulation can improve the gait of patients with hemiplegia to some extent.

Key words: low-frequency repetitive transcranial magnetic stimulation, hemiplegic gait, three-dimensional gait analysis