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[Clinical effectiveness of «thresholdless» low-frequency transcranial magnetic stimulation in patients with ischemic
L Sh Gumarova1,2, R A Bodrova1, D R Khasanova3
1Kazan State Medical Academy - branch of Russian Medical Academy of Continuing Professional Education of the Ministry of Health of Russia, Kazan, Russia.
Problem Relevance:
As you know, complete successful recovery in stroke patients occurs only in 8% of cases, 20% need constant care. The use of innovative rehabilitation technologies, namely «thresholdless» low-frequency transcranial magnetic stimulation, will speed up the process of restoring impaired functions, increase independence in everyday life and, accordingly, the quality of life.
Aim Of Study:
To evaluate the effectiveness of use of low-frequency «thresholdless» transcranial magnetic stimulation in the treatment of patients in acute period of ischemic stroke.
Materials And Methods:
The study included 93 patients aged from 49 to 68 years on second-third days of ischemic stroke. The 1st (main) group (n=48) received low-frequency «thresholdless» transcranial magnetic stimulation from the «Diamag» apparatus (AlMag-03) daily for 20 minutes, course - 8-10 procedures, with the background of drug treatment, and in addition to classes with an exercise therapy instructor and an occupational therapist. In the 2nd (control) group (n=45), standard therapy was carried out in accordance with the Procedure for rendering medical care to patients with stroke, only with the exception of physiotherapy. Assessment methods: clinical and neurological examination, indicators of duplex scanning of brachiocephalic vessels, Rivermead mobility index, modified Rankin scale, FIM scale (Functional Independence Measure), Hospital anxiety and depression scale (HADS).
Results And Discussion:
In patients of the 1st (main) group, an increase in the linear velocity of blood flow in the internal carotid artery on the side of lesion was revealed by 18.1% when compared with the 2nd (control) group (p=0.042); mobility increased by 42.1%, functional independence in everyday life - by 38.1%, muscle strength - by 50%, compared with the 2nd (control) group (p=0.0005). According to the HADS scale, in 29 (60.8%) patients of the main group, psychoemotional disorders were not detected, neither a single case of significantly expressed symptoms of depression (p<0.0001).
Conclusion:
The inclusion of low-frequency transcranial electromagnetic stimulation in complex rehabilitation leads to the regression of movement disorders, reduces the level of anxiety and depression, improves daily activity and, as a consequence, the quality of life.
