400 Section - The Impact of TMS on the Prognosis of Activities of Daily Living in Stroke Patients Under Multidisciplinary Rehabilitation Interventions

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

CW

Chenxi Wang, n/a

Medical Student
Southeast University
Nanjing, China, Jiangsu, China (People's Republic)
GL

Guanqi Li, n/a

Medical Student
Southeast University
Nanjing， China, Jiangsu, China (People's Republic)

Co-Author/Coautor(s)

CT

Chuwei Tian, MD

Doctor
School of Medicine, Southeast University, NO. 87 Ding Jia Qiao, Nanjing, PR China.
Nanjing, Jiangsu, China (People's Republic)

Corresponding Author/Autor a quien dirigir la corr(s)

JW

Jinyu Wang, PhD

Professor
Department of Rehabilitation, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China.
Nanjing, Jiangsu, China (People's Republic)

Objectives :

Post-stroke dependence in activities of daily living leads(ADL) to long-term disability and poor quality of life. Multimodal rehabilitation is standard for functional recovery. Transcranial magnetic stimulation(TMS) may enhance cortical excitability, but its independent contribution within real-world comprehensive programs remains unclear. This study aimed to quantify the independent effect of transcranial magnetic stimulation on activities of daily living recovery and identify influential baseline and treatment factors.

Design:

A retrospective cohort study included 942 stroke patients with admission Barthel Index(BI) below 60 who received multimodal rehabilitation at Zhongda Hospital from January 2021 to May 2025. Patients were divided into TMS and non-TMS groups. Propensity score matching using 15 covariates created balanced subgroups. The primary outcome was improvement in BI, analyzed using multivariable logistic regression.

Results:

Before matching, significant differences existed in seven baseline factors (all P < 0.05). After 1:1 propensity score matching, 99 patients per group were balanced across all baseline characteristics (all P > 0.05) and key rehabilitation interventions. Multivariable logistic regression showed that male sex (OR: 0.133, 95% CI: 0.032–0.552, P = 0.005), higher hand Brunnstrom stage (OR: 2.856, 95% CI: 1.551–5.795, P = 0.01), speech therapy (OR: 0.050, 95% CI: 0.005–0.479, P = 0.009), pelvic floor magnetic stimulation (OR: 0.081, 95% CI: 0.008–0.802, P = 0.032), normal inflammatory markers (OR: 0.194, 95% CI: 0.038–0.988, P = 0.048), and higher admission BI (OR: 1.088, 95% CI: 1.015–1.167, P = 0.017) were independent predictors of ADL recovery. TMS showed no significant effect.

Conclusion:

Within comprehensive stroke rehabilitation, TMS did not independently improve ADL outcomes. Key prognostic factors include sex, hand motor function, speech therapy, pelvic floor stimulation, inflammatory status, and baseline function. These findings support individualized, multidimensional rehabilitation strategies over isolated interventions.