Effect Of Synchrous High-frequency Repetitive Peripheral Magnetic Stimulation Of Upper And Lower Limb On Motor Performance In Hemiplegia After Intracerebral Haemorrhage

Aims of the studyThe aim of the randomized,double-blind,sham-controlled trial was to explore the efficacy and safety of HF-rPMS synchronosly applied to the axilla(stimulating the brachial plexus)and the popliteal fossa(stimulating the tibial nerve and common peroneal nerve)in patients with intracerebral hemorrhage on rehabilitation of motor functions,providing a new therapeutic method and new therapeutic sites.Methods30 eligible patients with intracerebral haemorrhage in the acute or early subacute period were consecutively recruited between April 2019 and March 2021,and randomly assigned to the HF-rPMS group or the sham rPMS group.For patients in the rPMS group,the coils were applied over the both of the brachial plexus and sciatic nerve to the affected limb.But in the sham group,patients received the ineffective rPMS and only heard the sound which occurred as in the rPMS group.Clinical outcomes included the change of Fugl-Meyer Assessment(FMA)scale and Medical Research Council(MRC)scale before and after rPMS.SPSS 22.0 software was performed for statistical analysis.Data were expressed as median[IQR].Student’s t-test and the Mann-Whitney test was used for comparing normally distributed parameters and parameters that exhibited skewed distribution pattern,respectively.Categorical data was compared by the Fisher’s precision probability test.The P-value less than 0.05 was considered as statistically significant.ResultsOf 30 eligible patients who were included,only 26 patients completed the study.There was a significant increase of UE-FMA score(P=0.001)and LE-FMA score(P=0.002)in the HF-rPMS group and an increase of UE-FMA score(P=0.005)and LE-FMA score(P=0.005)in the sham rPMS group.In the rPMS group,the change in the proximal MRC of upper extremity(p=0.000),the distal MRC of upper extremity(p=0.004),the proximal MRC of lower extremity(p=0.001)and the distal MRC of lower extremity(p=0.002)was significantly higher after stimulation.Likely,the change in the proximal MRC of upper extremity(p=0.007),the distal MRC of upper extremity(p=0.020),the proximal MRC of lower extremity(p=0.009)and the distal MRC of lower extremity(p=0.005)were significantly higher after stimulation in the sham group.The differences on the improvement of the upper extremity FMA(P=0.012),the lower extremity FMA(P=0.001),the proximal MRC of upper extremity(p=0.043),the proximal MRC of lower extremity(p=0.004)and the distal MRC scores of lower extremity(p=0.008)among the the rPMS group and the sham rPMS group were statistically significant.ConclusionsSynchrous HF-rPMS intervention at the axilla and the popliteal fossa can improve motor function,proximal muscle strength of upper and lower limb of patients in the acute or early subacute intracerebral hemorrhage,without any obvious adverse effects.