Does a combined intervention program of repetitive transcranial magnetic stimulation and intensive occupational therapy affect cognitive function in patients with post-stroke upper limb hemiparesis?

Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.

The Effectiveness of the Functional Magnetic Stimulation Therapy in Treating Sciatica Syndrome

Introduction: Degenerative or traumatic causes are most common in generating sciatica syndrome, which is normally treated with well-known physical therapy methods. A relatively new way of treating sciatica problems is so-called functional magnetic stimulation (FMS), whose principle is based on electromagnetic field inducing electrical field inside the body. Electrical field triggers action potential of nerve cells and that way stimulates peripheral motor nerve system. Aim: Aim of this study is to measure and estimate the effectiveness of implementing therapy with functional magnetic stimulation in regular physical treatment of sciatica syndrome. Materials and Methods: 28 male patients aged between 30 and 55 with back problem were recruited on an outpatient basis. FMS therapy was performed with TESLA Stym? device (Iskra Medical d.o.o., Slovenia) treating lumbosacral region equally on both sides of the spine. Physical examination was performed to evaluate tree parameters: the mobility of the lumbar spine in flexion and extension, together with the straight leg raise test (Lasegue sign). We estimated patients’ progress, comparing angle values of mobility from the first examination day with other examination days. Results: In FMS treated group of patients, lumbosacral flexion, extension and Lasegue test angle were significantly higher compared to day 0 on the first physical examination day (day 3) (p < 0.05). In control group such increase of a measured angle was not noticed until a second physical examination day (day 5) or a third physical examination day (day 8) (p < 0.05). Discussion: Results in this study showed that applying FMS therapy along with other standard physical therapy methods rapidly increased effectiveness of the treatment of sciatica syndrome (lat. ischialgia). It suggests that functional magnetic therapy could be suggested as a regular physical therapy method in treating this kind of pain syndromes.

Analytical solutions of transient pulsed eddy current problem due to elliptical electromagnetic concentrative coils

The electromagnetic concentrative coils are indispensable in the functional magnetic stimulation and have potential applications in nondestructive testing. In this paper, we propose a figure-8-shaped coil being composed of two arbitrary oblique elliptical coils, which can change the electromagnetic concentrative region and the magnitude of eddy current density by changing the elliptical shape and/or spread angle between two elliptical coils. Pulsed current is usually the excitation source in the functional magnetic stimulation, so in this paper we derive the analytical solutions of transient pulsed eddy current field in the time domain due to the elliptical concentrative coil placed in an arbitrary position over a half-infinite plane conductor by making use of the scale-transformation, the Laplace transform and the Fourier transform are used in our derivation. Calculation results of field distributions produced by the figure-8-shaped elliptical coil show some behaviours as follows： 1） the eddy currents are focused on the conductor under the geometric symmetric centre of figure-8-shaped coil; 2） the greater the scale factor of ellipse is, the higher the eddy current density is and the wider the concentrative area of eddy current along y axis is; 3） the maximum magnitude of eddy current density increases with the increase of spread angle. When spread angle is 180°, there are two additional reverse concentrative areas on both sides of x axis.