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To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) for managing upper limb muscular spasticity after stroke, and to examine its therapeutic effects on spasticity and motor function in the upper limb. A total of 110 post-stroke patients with upper limb spasticity were randomly assigned to the experimental or the control group. The experimental group received rTMS in conjunction with conventional rehabilitation therapy. The affected side of the head received daily treatment for 20 min each at Erb's point and the stimulation point, totaling 15 sessions over six days per week. The stimulation frequencies were 10 Hz (high frequency, M1 region) and 1 Hz (low frequency, Erb's point), with an intensity at 120% of the threshold. The control group received sham stimulation alongside conventional rehabilitation therapy. Assessments including the Modified Ashworth Scale (MAS) and Fugl-Meyer Assessment for Upper Extremity (FM-UE), were also conducted before treatment initiation and after 15 rounds of rTMS. Post hoc subgroup analyses were conducted using independent-sample t-tests for FM-UE scores and Mann-Whitney U tests for MAS scores to assess heterogeneity in treatment responses by stroke type (cerebral infarction vs. intracerebral hemorrhage). Among these 110 patients, 25 patients were excluded from the study for various reasons. Hence, 53 patients were included in the control group and 32 patients were included in the experimental group. Following 15 rounds of rTMS, the experimental group exhibited a reductions in MAS score (P = 0.004). FM-UE scores increased significantly in both groups (both P < 0.05), with significant improvement observed in the experimental group (P < 0.05). Subgroup analyses revealed no significant differences in FM-UE or MAS outcomes between stroke types, likely due to the limited sample size of intracerebral hemorrhage participants (experimental group: n = 8; control group: n = 16). rTMS effectively alleviates upper limb spasticity and enhances motor function after stroke by modulating cortical and spinal nerve excitability.
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http://dx.doi.org/10.1038/s41598-025-02443-8 | DOI Listing |
CNS Neurosci Ther
September 2025
School of Information and Communication Engineering, North University of China, Taiyuan, China.
Aims: Decoding the motor intention by electroencephalography to control external devices is an effective method of helping spinal cord injury (SCI) patients to regain motor function. Still, SCI patients have much lower accuracy in the decoding of motor intentions compared to healthy individuals, which severely hampers the clinical application. However, the underlying neural mechanisms are still unknown.
View Article and Find Full Text PDFInd Health
September 2025
Dokuz Eylul University, Faculty of Medicine, Department of Occupational Medicine, Turkey.
Jockeys endure considerable physical and psychological demands, rendering them vulnerable to occupational injuries such as fractures, concussions, and soft tissue damage. This descriptive case series presents the medical and occupational histories of three professional jockeys with long-term disabilities following work-related accidents. Each individual commenced their jockey career in early adolescence.
View Article and Find Full Text PDFWorld Neurosurg
September 2025
Swedish Neuroscience Institute, Seattle, WA; Seattle Science Foundation, Seattle, WA.
Introduction: Lateral Lumbar Interbody Fusion (LLIF) is based on a less-invasive access corridor through the retroperitoneum and psoas muscle, though concerns persist over postoperative weakness and neuropathy on the surgical side. This study investigates if the trans-psoas LLIF approach is associated with long-term changes in psoas morphology, hip flexor (HF) weakness, and lower extremity dysesthesia.
Methods: The authors retrospectively reviewed all LLIF cases at a single institution from January 2016 to June 2024.
Rev Esp Anestesiol Reanim (Engl Ed)
September 2025
Instituto Nacional de Rehabilitación, Ciudad de México, Mexico.
Brachial plexus block at the interscalene level is a regional anesthetic technique widely used to provide analgesia in shoulder and upper extremity surgery; However, it is associated with a high incidence of phrenic nerve block with diaphragmatic paralysis which has clinical implications in patients with underlying respiratory disease, showing respiratory difficulty symptoms. As consequence, it has been contraindicated in certain population groups. Once diaphragmatic paralysis and respiratory symptoms are established, management is supportive and expectant.
View Article and Find Full Text PDFJ Hand Surg Am
September 2025
Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, NY.
Purpose: This study aimed to evaluate how major US health care policy changes have influenced long-term Medicare reimbursement trends for upper-extremity flap and microvascular procedures from 2002 to 2023.
Methods: Reimbursement data for 28 common flap and microvascular procedures were extracted from the Medicare Physician Fee Schedule database using Current Procedural Terminology codes. Adjustments for inflation were made using the Consumer Price Index.