| Objective: To investigate the clinical effect of low-frequency repeated transcranial magnetic stimulation（rTMS）combined with tizanidine hydrochloride in treating patients with the upper limb flexor spasm after stroke.
Method: A total of 60 patients with upper limb flexor spasm after stroke who were admitted to the Beijing Bo'ai Hospital for rehabilitation treatment from December 2020 to December 2023 were retrospectively analyzed and divided into the observation group and control group according to different treatment methods, featuring 30 patients per group. The observation group underwent a combined therapy of tizanidine hydrochloride and low-frequency rTMS, whereas the control group solely received tizanidine hydrochloride. Before the start of treatment and at the end of the fourth week, a comprehensive evaluation of the patient will be conducted using the following three assessment tools. The modified Ashworth Spasm Scale (MAS) was utilized for assessing the degree of spasticity in the flexor muscles of the upper extremity, the upper limb Fugl-Meyer assessment(UFMA) was employed to assess motor function and performance of the upper limb, and the modified Barthel Index (MBI) was served as a metric to quantify the patient's functionality in their activities of daily living (ADL). The occurrence of adverse reactions was recorded in both groups.
Result: Before the start of treatment, the MAS, UFMA, and MBI scores of the two groups of patients were similar, with no statistically significant difference (P>0.05). At the end of the fourth week of treatment, both groups of patients demonstrated notable progress in the previously mentioned three assessment metrics compared to their pre-treatment levels. The observation group showed significant improvements in UFMA and MBI scores, as well as a decrease in MAS scores, compared to the control group, and the variations observed were statistically meaningful (P<0.05). The occurrence of adverse reactions in the two groups was less and mild, mainly including drowsiness and dizziness. The incidence of adverse reactions was equivalent between the two groups, with no significant difference observed (6.67% in both groups).
Conclusion: The combination of low-frequency rTMS and tizanidine hydrochloride is more effective than tizanidine hydrochloride alone in the treatment of upper limb flexor spasm after stroke, which can relieve hemiplegic upper limb spasm, improve the upper limb motor function and improve the quality of life. At the same time, the safety of both is good. |