400 Section - The Effect of Brachial Plexus Nerve Mobilization Combined with Transcranial Magnetic Stimulation on Upper Limb Function in Patients with Chronic Stroke

 Based on the concept of “peripheral-central closed-loop rehabilitation”, this study aimed to explore the effect of brachial plexus nerve mobilization combined with transcranial magnetic stimulation on upper limb function in community-dwelling patients with chronic stroke, and verify the feasibility of the combined protocol as an appropriate community-based rehabilitation technology.

Design:

Thirty-two patients with chronic stroke who met the inclusion criteria were recruited and randomly divided into the combined intervention group (n=16) or the conventional rehabilitation group (n=16). The conventional rehabilitation group was given additional self-initiated activities of both upper limbs and device-assisted rehabilitation exercises before treatment; whereas the combined intervention group received brachial plexus nerve mobilization combined with transcranial magnetic stimulation. Evaluations were conducted on patients of both groups before treatment, at 4 weeks after treatment, and at 8 weeks after treatment to assess their quality of life. The evaluation indicators included the Fugl-Meyer Motor Assessment Scale (FMA) for upper limb motor function, Range of Motion (ROM) of the shoulder joint, grip strength, Resting Motor Threshold (RMT), and Modified Barthel Index (MBI).

Results:

The ANOVA analysis of the FMA scores showed that a continuous improvement in the combined intervention group. Moreover, the FMA score of the combined intervention group was significantly higher than that of the conventional rehabilitation group after 8 weeks of treatment, (P < 0.05). However, before treatment and 4 weeks after treatment, there was no significant difference in FMA scores between the two groups (P > 0.05). No significant differences were found between two groups among other measurements.

Conclusions:

The study proved that based on the closed-loop rehabilitation concept, the intervention of brachial plexus nerve mobilization combined with transcranial magnetic stimulation can effectively improve the upper limb function of community-dwelling patients with chronic stroke. This combined intervention technology might have the ability to be promoted and applied as an appropriate community rehabilitation technology.