Effects of deep transcranial magnetic stimulation and repetitive transcranial magnetic stimulation on balance and gait in stroke patients

OBJECTIVES: To compare the effects of deep transcranial magnetic stimulation (dTMS) and repetitive transcranial magnetic stimulation (rTMS) on balance function and gait of stroke patients. METHODS: This randomized, single-blind trial enrolled 66 eligible stroke patients with hemiplegia. These participants were randomly assigned to either the deep transcranial magnetic stimulation (dTMS) group (n = 33) or the repetitive transcranial magnetic stimulation (rTMS) group (n = 33). All patients received conventional rehabilitation therapy. Moreover, the dTMS group received dTMS treatment, while the rTMS group received rTMS treatment. The stimulation was administered to the M1 region for a period of 4 weeks. Outcome evaluations were conducted both before and after the intervention. The balance function was assessed using the Berg Balance Scale (BBS) and the Pro-kin balance tester. For evaluating lower limb function and walking ability, the Timed Up and Go (TUG) test was employed. Additionally, a gait analyzer was utilized to perform gait analysis. RESULTS: Following 4 weeks of treatment, both groups showed significant improvements in BBS scores, gait velocity, stride rate, step length, and limits of stability (LOS) compared with the baseline values (all P < 0.001). Notably, the dTMS group exhibited significantly greater improvements in BBS scores (P < 0.01) and gait velocity (P < 0.05) than the rTMS group. However, there were no significant between-group differences in stride rate, step length, or LOS (all P > 0.05). Similarly, both groups demonstrated significant reductions in TUG test time, center of pressure (COP) path length, and COP displacement area compared with the baseline (all P < 0.01). Moreover, the dTMS group exhibited more pronounced decreases in TUG test time (P < 0.01), COP path length (P < 0.05), and COP displacement area (P < 0.05) than the rTMS group. CONCLUSION: Both dTMS and rTMS effectively improved balance and gait functions in stroke patients. Notably, dTMS demonstrated superior efficacy compared to rTMS in enhancing these parameters, providing evidence to support its clinical utility.