Combination Effect of Proprioceptive Training and Transcranial Magnetic Stimulation on Selected Gait Kinematic Parameters in Stroke Patients

Combination Effect of Proprioceptive Training and Transcranial Magnetic Stimulation on Selected Gait Kinematic Parameters in Stroke Patients

this study was done to investigate the Combination effect of proprioceptive training and transcranial magnetic stimulation on selected gait kinematic parameters in stroke patients.

After a stroke, mobility is influenced by the central nervous system and peripheral neuromuscular and sensory systems. Effective standing and walking require managing body support against gravity and generating propulsion. Gait deficits in stroke survivors often arise from neural, sensory, muscular issues, and coordination problems, leading to movement disorders like spasticity and ataxia that hinder motor control and gait performance. Typically, stroke patients display reduced gait velocity and abnormal kinematics, marked by asymmetries and decreased weight bearing on the affected limb. Research indicates that combining high-frequency Transcranial magnetic stimulation with task-oriented mirror therapy enhances motor function more effectively than Transcranial magnetic stimulation alone, yielding improvements in hand function and cortical excitability. Similar findings for subacute stroke patients highlight the benefits of integrating action observation with Transcranial magnetic stimulation for better upper limb function.

Inclusion Criteria:

Thirty patients with stroke from both sexes.

2) Age will range from 50 to 60 years old.

3) Duration of stroke ≥ 6 months.

4) Spasticity of the lower limb ranges from 1+ to 2 according to modified ashworth scale

5) The patients able to walk with or without assistive device.

6) Body mass index is less than 30 kg/m2.

7) Patients with sufficient cognitive abilities that enables them to understand and follow instructions (Mini-Mental State Examination scale >24).

Exclusion Criteria:

1. Previous history of any other neurological disorder
2. Recurrent stroke.
3. Vestibular deficits.
4. Cognitive impairment (a score less than 24 according to mini mental state examination).

5- Cardiac pacemaker

6- Metallic Implants.

7- Aphasia, deafness or blindness

7. Deformities or contractures of the lower limbs