REH14
Transcranial Magnetic Stimulation Associated with Physical Therapy on Balance of People with Multiple Sclerosis: A PILOT Study
Multiple Sclerosis (MS) is a demyelinating autoimmune disease that causes CNS damage and disabling symptoms. Transcranial Magnetic Stimulation (TMS) has benefits in the rehabilitation process when combined with therapeutic interventions.
Objectives:
To evaluate the influence of TMS combined with physiotherapy on the balance of people with MS.
Methods:
10 people with MS participated, 7 women and 3 men, aged 40 to 57 years and Kurtze Expanded Disability Status Scale (EDSS) between 1 and 5.5. The protocol consisted of 10 TMS sessions and 6 physiotherapy sessions with a protocol for lower limb strength training and static and dynamic balance. Participants were randomized and divided into 2 groups: Group I) with real stimulus, so that 5 received the TMS stimulus (primary motor cortex (Cz): 50 pulses per time, 30 trains, 20seconds of interval, totaling 1500 pulses at 90% of resting motor threshold and left dorsolateral prefrontal cortex (F3):10Hz, 50 pulses per train, 40 trains, 20 seconds interval, totaling 2000 pulses at 110% of resting threshold), and Group II) sham, so that received the application without TMS stimulation. All underwent physiotherapy. The Berg Balance Scale was applied before the combined interventions and after 30 days.
Results:
It was found that 90% of participants showed improvement in balance. Only one participant showed a worsening in this index.
The inferior result of this individual may be justified by his general condition in the week of the reassessment. He presented a bigger index of fatigue and stress in that period.
Conclusions:
This preliminary study suggests that TMS associated with physiotherapy has great potential in the rehabilitation of balance in people with MS. The promising results encourage the acquisition of additional evidence.