脳性麻痺の痙縮性片麻痺児における下肢運動機能回復のための低頻度反復性経頭蓋磁気刺激法

The quest for effective treatments for cerebral palsy (CP) remains a significant challenge, crucial for improving outcomes in affected individuals. This study aimed to evaluate the therapeutic effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on lower limb function in children with hemiplegic cerebral palsy (HCP) through a controlled clinical trial. Forty children with HCP were randomly assigned to either a sham stimulation group or an rTMS treatment group, with 20 participants in each. The rTMS group received low-frequency rTMS in conjunction with conventional rehabilitation, while the sham group received sham stimulation paired with the same rehabilitation. Conventional rehabilitation included physical therapy, occupational therapy, orthopedic shoes, acupuncture, and other training modalities. Treatments were administered 5 days a week for 12 weeks. We assessed gross and fine motor skills, spasticity, and gait parameters before and after treatment using the modified Ashworth scale (MAS), dorsiflexion angle, gross motor function measure 88 (GMFM-88), Gesell developmental scale, and plantar pressure gait analysis. After 12 weeks, both groups exhibited improvements in MAS scores of the affected hamstring muscle, dorsiflexion angles, GMFM-88 D and E zone scores, Gesell developmental scale scores (gross motor), and gait parameters (P < .05). Notably, the rTMS group demonstrated significantly greater improvements (P < .05). Low-frequency rTMS combined with conventional rehabilitation therapy leads to better outcomes in gross and fine motor functions while reducing spasticity and improving gait parameters in children with HCP compared to sham stimulation.