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Abstract
Background: Repetitive transcranial magnetic stimulation(rTMS) can enhance brain plasticity after stroke thus maximizing recovery . At low frequencies rTMS has an inhibitory effect, whereas at high frequencies it has an excitatory effect.Combining both frequencies in bilateral stimulation is a new rTMS protocol under investiagtion. Purpose: To evaluate the efficacy of bilateral rTMS protocol applied to the primary motor cortex in improvement of upper limb motor disablity in stroke. Subjects and Methods: Fifty five patients with subacute stroke were divided into four groups according to r TMS protocol delivered: bilateral, inhibitory, stimualtory and control groups. All groups received concomitant task oriented physiotherapy. Before to after treatment assessment was carried twice, immedialtly after sessions and then one month later. Motor power and performance were evaluated by Fugl Meyer and Wolf motor function tests, for spasticity Ashworth scale was used and finaly for cortical excitabilty Motor evoked potentials were compared, correlations with clinical picture were done as well