Effect of Repeated Peripheral Magnetic Stimulations at Different Sites of Upper Limbs on Wrist Motor Function in Subacute Stroke Patients: a Randomized Controlled Trial

Abstract

Background Wrist motor dysfunction is a common sequela at post-stroke, and the wrist has an important role in improving hand practicality. Therefore, improving the range of motion of the wrist can effectively promote the activities of daily life in post-stroke patients. Although repetitive peripheral magnetic stimulations (rPMS) have been shown to have a significant effect on improving the range of motion of the wrist, the therapeutic effect of different stimulation sites still needs to be further explored. Objective To investigate the effect of rPMS on wrist extensor muscle and radial nerve for the motor function of wrist of subacute stroke patients. Methods A total of 60 subacute stroke patients with wrist motor dysfunction admitted to Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine from October 2022 to October 2023 were selected as the study subjects. The included patients were randomly divided into control group (20 cases), muscle stimulation group (20 cases) and nerve stimulation group (20 cases) by simple randomized grouping method using a random number table. Patients in all the three groups received routine rehabilitation training, and those in the muscle stimulation group and nerve stimulation group were additionally managed by rPMS on the wrist extensor muscle and the radial nerve, respectively. Before and after the interventions for 10 times of rPMS, integrated electromyography (iEMG), root mean square (RMS) and median frequency (MF) on the surface of the wrist extensor muscle, the Fugl-Meyer Assessment for upper extremity (FMA-UE), the Action Research Arm Test (ARAT) and the modified Barthel Index (MBI) were measured to assess the upper limb function of the affected side. Results During the intervention period, there were 2 cases of data loss due to voluntary withdrawal or forced termination of the trial, and finally 20 cases were included in the control group, 19 cases in the muscle stimulation group, and 19 cases in the nerve stimulation group. There were no significant differences in iEMG, RMS and MF of wrist extensor muscle among three groups before treatment (P>0.05). After treatment, iEMG, RMS and MF of wrist extensor muscle in muscle stimulation group and nerve stimulation group were significantly higher than those of control group (P<0.05). The iEMG, RMS and MF of wrist extensor muscle in nerve stimulation group were significantly higher than those of muscle stimulation group (P<0.05). The iEMG, RMS and MF of the wrist extensor muscle after treatment were higher than those before treatment in the three groups (P<0.05). There were no significant differences in FMA-UE, ARAT and MBI scores among the three groups before treatment (P>0.05). After treatment, FMA-UE, ARAT and MBI scores in muscle stimulation group and nerve stimulation group were significantly higher than those of control group (P<0.05). The scores of FMA-UE, ARAT and MBI in nerve stimulation group were significantly higher than those in muscle stimulation group (P<0.05). The scores of FMA-UE, ARAT and MBI in three groups were significantly higher after treatment than before treatment (P<0.05) . Conclusion rPMS on the wrist extensor muscle and the radial nerve can improve the wrist motor dysfunction after stroke, and the effect on the radial nerve is more significant than that on the wrist extensor muscle.

Keywords

• stroke|repetitive peripheral magnetic stimulation|wrist extensor muscle|radial nerve|wrist motor dysfunction|randomized controlled trial