Journal of Basic and Clinical Health Sciences 2000 , Vol 1 , Issue 1
The Effects of Navigated Repetitive Transcranial Magnetic Simulation and Brunnstrom Movement Therapy on Upper Extremity Proprioceptive Sense and Spasticity in Stroke Patients: A Double-Blind Randomized Trial
Mehmet Özkeskin1,Vesile Öztürk2,Raif Çakmur2,Bilge Kara3,Fadime Küçük4
1Department of Physical Therapy and Rehabilitation, Dokuz Eylül University Institute of Health Sciences, İzmir, Turkey
2Department of Neurology, Dokuz Eylül University School of Medicine, İzmir, Turkey
3Department of Neurological Physiotherapy and Rehabilitation, Dokuz Eylül University School of Physical Therapy and Rehabilitation, İzmir, Turkey
4Department of Physical Therapy and Rehabilitation, Hacettepe University Institute of Health Sciences, Ankara, Turkey
DOI : 10.5152/jbachs.2017.110 Purpose: The purpose of this study is to investigate the effects of various treatments (repetitive transcranial magnetic stimulation and Brunnstrom movement therapy) on upper extremity proprioceptive sense and spasticity.

Methods: Twenty-one stroke patients were included in the study. The treatment group (Group 1; n=10) was administered navigated real repetitive transcranial magnetic stimulation (rTMS), and the control group (Group 2; n=11) was administered sham rTMS by the first researcher. The patients in both groups had upper extremity exercises according to Brunnstrom movement therapy (BMT). The patients were assessed using the Brunnstrom recovery stages (BRS), proprioceptive sense assessment, and the modified Ashworth scale (MAS).

Results: Between the treatment group and control group patients, there were no significant statistical differences obtained from pre-treatment and postreatment tenth day, first month, and third month by BRS wrist, hand, and upper extremity stages. The intragroup comparison of the treatment group patients revealed a statistically significant difference between the pre-treatment and post-treatment third month BRS-hand and BRS-upper extremity stages.The pretreatment and postreatment tenth day and first month evaluations of the wrist proprioceptive sense of the groups presented a significant difference. There was no statistically significant difference between the groups in terms of MAS scores before and after treatment evaluations.

Conclusion: The rTMS and BMT approaches that were implemented in the study affected the proprioceptive sense of the wrist after the treatment and in the early period but did not change spasticity. Keywords : Repetitive transcranial magnetic stimulation, stroke, Brunnstrom recovery stages, proprioceptive sense, spasticity