To explore the effects of low frequency repetitive transcranial magnetic stimulation (LF-rTMS) combined with large-surface superficial sensory stimulation on hemiplegia and upper limb functional deficits in subacute ischemic stroke.

A total of 96 patients with subacute ischemic stroke hemiplegia accompanied by upper limb dysfunction, admitted to the Department of Neurology and Rehabilitation Medicine of Xuzhou Municipal Hospital affiliated to Xuzhou Medical University from February 2023 to December 2024, were selected as the study subjects. They were randomly divided into a control group and a study group, with 48 cases in each group. The control group received standard drug therapy and rehabilitation training for 3 weeks, including comprehensive training for hemiplegic limbs and low-frequency pulsed electrical stimulation. The study group received additional interventions based on the above, including contralateral 1 Hz repetitive transcranial magnetic stimulation (once daily) and ipsilateral upper limb large-area superficial sensory stimulation (twice daily), for a continuous treatment period of 3 weeks. Before and after treatment, the Fugl-Meyer assessment upper extremity scale (FMA-UE) score was used to evaluate the overall upper limb motor function and hand fine motor function of two groups, and the modified Ashworth scale (MAS) was used to assess muscle tone of the affected upper limb. The incidence of complications after treatment were compared between the two groups.

Before treatment, there were no statistically significant differences in the FMA-UE scores (for both overall upper limb motor function and hand fine motor function) and MAS scores between the two groups (P>0.05). After 3 weeks of treatment, both the study and control groups showed significant increases in FMA-UE scores and significant decreases in MAS scores compared to pre-treatment levels (all P<0.05). The post-treatment FMA-UE scores (for both overall upper limb motor function and hand fine motor function) in the study group were significantly higher than those in the control group, while the MAS scores were significantly lower (all P<0.05). The incidence of shoulder complications (including hand swelling, shoulder subluxation, shoulder pain, shoulder-hand syndrome, rotator cuff injury, accidental skin injury, and shoulder dislocation) in the study group was 18.75% (9/48), significantly lower than the 39.58% (19/48) observed in the control group (P<0.05).

Combination of LF-rTMS and large-area shallow sensory stimulation can improve upper limb muscle tone, enhance upper limb movement and fine motor function in patients with hemiplegia and upper limb dysfunction in subacute ischemic stroke, with fewer complications.