Authors: (including presenting author): :
Hong KY (1), So SYI(2), Liu KLA(2), Chan WKW(3), Lau LC(3), So YW(1), Tseung CHT(1), Cheng KYA(1), Wu MCL(1), Yuen KH(1)
Affiliation: :
(1) Department of Medicine & Rehabilitation, Tung Wah Eastern Hospital (2) Department of Physiotherapy, Tung Wah Eastern Hospital (3) Department of Occupational Therapy, Tung Wah Eastern Hospital
Keyword 2: :
Transcranial Magnetic Stimulation
Keyword 3: :
stroke rehabilitation
Keyword 4: :
upper limb motor recovery
Objectives: :
To investigate the clinical effectiveness of rTMS on upper limb functional recovery of subacute post-stroke patients
Methodology: :
Methodology: Stroke patients with upper limb motor deficit were recruited from February 2024 to April 2025. Eligibility was assessed by physicians using contraindication checklist. The “hotspot” on the contra-lesion primary motor cortex (M1) was identified via the motor evoked potential (MEP) from the First Dorsal Interosseous (FDI). 6 inpatient & 4 ambulatory-phase sessions of inhibitory rTMS (1Hz) with suprathreshold intensity to contralesional hotspot were scheduled prior to physical training. Active Range Of Movement (AROM), Modified Ashworth Scale (MAS), handgrip strength, pinch grip strength, and Fugl-Meyer Upper Extremity Scale (FM-UE) were evaluated before and after rTMS. The results were analyzed by Paired t-test and Wilcoxon signed-rank test.
Result & Outcome: :
To proof that rTMS restores Upper Limb Movement & ignites Hope of Stroke Rehab Patients Results: 18 patients were recruited. Mean age was 61.3; 61% were male. 56% paretic side was left; 16.7% received rTPA treatment. Mean time elapsed since stroke was 26.7 days. No major incident except minor ones including insomnia (1.1%). Significant improvement was observed in AROM, pinch strength and FM-UE (p< 0.05). Safety rTMS is a safe and well-tolerated treatment. Side effects include mild headaches only. Contraindication checklist is used to eliminate potential adverse effects. Rehabilitation physicians are on standby for emergencies. CQI Implementation Concept: Previous rTMS service was too doctor-centred with low throughput. Since 2024, it’s revolutionized by a Team Approach engaging trained colleagues. EDU APN becomes site manager to coordinate immediate physical sessions to maximize clinical benefits. Moreover, rTMS is started early during IP stay. Therefore, more patients can benefit from rTMS. Outcome: rTMS restores UL Movement and ignites Hope of stroke patients.
