Transcranial Magnetic Stimulation Therapy in Spastic Cerebral Palsy Children Improves Motor Activity

Abstract

Transcranial magnetic stimulation (TMS) is a new interventional tool used in the study of neuronal activity and treatment of psychiatric disorders. Repetitive TMS (rTMS) is a non-invasive technique of stimulating the brain employing magnetic pulses. Recent research has demonstrated the efficacy of rTMS in facilitating motor functions. Using these evidences, we studied the effectiveness of rTMS in improving motor activity in spastic cerebral palsy (CP) children. CP is a neuro-developmental disorder of movement and posture that is caused by injury to the developing brain that restrict activities of daily living. In the quest to treat CP, several interventions are used among which physical therapy is the mainstay therapy. In this study, we selected 45 spastic CP children and divided them randomly into three groups-the reference group (RG) that was provided only physical therapy (PT) for 30 minutes daily for 20 days; the interventional group (IG) that was administered rTMS frequency of 5Hz (IG-A) and 10Hz (IG-B) for 15 minutes (1500 pulses) daily followed by PT as in RG. Gross motor function measure (GMFM) was used as assessment tool to evaluate the motor performance. Prior to start of therapy, pre-assessment of GMFM was performed on all participants and post assessment after completion of 20 sessions. The result was statistically significant in all three groups (p<0.001) and the mean change demonstrated 0.64%, 1.75% and 2.59% improvement in motor activity among participants in RG, IG-A and IG-B respectively. The study demonstrated positive effect of rTMS in improving motor activity when combined with PT.