| The curative effect of intermittent theta burst stimulation combined with Bobath training in treating post-stroke upper limb spasticity |
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| DOI：10.3870/zgkf.2026.06.004 |
| EN KeyWords: intermittent theta burst stimulation Bobath training stroke upper limb spasticity |
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| EN Abstract: |
| Objective: To evaluate the efficacy of intermittent theta burst stimulation (iTBS) combined with Bobath training (BT) in patients with post-stroke upper limb spasticity (PS-ULS). Methods: A total of 153 patients with PS-ULS admitted to our hospital from January 2024 to June 2025 were enrolled and randomly assigned (using SPSS-generated random numbers) into three groups: the control group (n=51, receiving BT alone), the iTBS group (n=51, receiving iTBS alone), and the study group (n=51, receiving BT plus iTBS). We compared their clinical efficacy, spasticity severity, motor function, modified Barthel index (MBI), surface electromyography (sEMG) parameters, cerebral vascular hemodynamics (CVH), and incidence of adverse events. Results: The modified Ashworth Scale (MAS) score of the study group was significantly better than that of the control and iTBS groups (P<0.05). After treatment, the scores of the Fugl-Meyer Assessment for Upper Limb (FMA-UE), MBI, the sEMG amplitude during maximal voluntary contraction (MVC) of the biceps brachii, and the mean blood flow velocity (Vm) were significantly increased compared to baseline in all three groups (all P<0.05), with the study group showing greater improvements than both the control and iTBS groups (all P<0.05). Conversely, the elbow joint flexion-extension recurrent excitation ratio (RER), resting sEMG amplitude of the biceps brachii, pulsatility index (PI), and resistance index (RI) were significantly decreased from baseline in all three groups (all P<0.05), with the study group demonstrating lower values than the control and iTBS groups (all P<0.05). No significant differences were observed in the overall incidence of adverse events among the three groups. Conclusion: The iTBS combined with BT effectively alleviates spasticity, enhances motor function, MBI, sEMG parameters, and cere-bral vascular hemodynamics in patients with PS-ULS, yielding significant clinical efficacy without increasing the risk of adverse events. |
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