1. Introduction
hand dexterity, stroke, paralysis, motor dysfunction, long-term disability, dysfunction of the upper extremities, hemiplegia, cerebrovascular injury, post-stroke dysfunction, strokes
STROKE, CORTEX, STROKES
Functional paralysis of the upper extremities occurs in >70% of all patients after having a stroke, and >60% showed decreased hand dexterity. A total of 30 patients with a subacute stroke were randomly allocated to either high-frequency repetitive transcranial magnetic stimulation combined with motor learning (A stroke is the sudden onset of neurological symptoms caused by cerebrovascular injury, and most adult patients with a stroke experience hemiplegia. After a stroke, 10–12% of all patients die, and more than 50% of survivors have long-term disability and daily life problems [These strokes cause motor dysfunction on the paralyzed side, indicating abnormalities in balance, asymmetrical postures, and symptoms of dysfunction of the upper extremities and hands [The motor learning (ML) principle is used as a treatment for post-stroke dysfunction [Moreover, repetitive transcranial magnetic stimulation (rTMS) has recently been widely used to restore upper-limb motor function in patients with a stroke. rTMS is a non-invasive treatment used to control the excitation of the cortex. Transcranial magnetic stimulation depolarizes nerve cells under a coil by applying strong electrical stimulation to the electromagnetic coil, resulting in changes in cerebral cortex excitation according to intensity, frequency, and the total number of stimuli [Furthermore, a previous study showed that high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) is more effective than low-frequency rTMS [Therefore, this study aimed to test the hypothesis that the combination of HF-rTMS and motor learning would result in greater improvements in upper-limb function compared to sham stimulation and motor learning alone in patients with a subacute stroke. This study aimed to present the effect of a program combining HF-rTMS with motor learning on motor function, grip force of the upper limbs, and activities of daily living in this patient population.