EFIKASI KOMBINASI mCIMT + rTMS TERHADAP FUNGSI MOTORIK EKSTREMITAS ATAS DAN PERUBAHAN DTABR PADA PASIEN STROKE ISKEMIK

This randomized controlled pretest–posttest study included 32 patients with subacute ischemic stroke allocated to either a combination therapy group (rTMS+mCIMT, n=16) or an mCIMT-only group (n=16). Motor recovery was assessed using the Fugl-Meyer Assessment Upper Extremity (FMA-UE), while neurophysiological changes were evaluated using quantitative electroencephalography (qEEG) based on the Delta-Theta-Alpha-Beta Ratio (DTABR). Results: Significant improvements in upper extremity motor function and neurophysiological parameters were observed in both groups after intervention (all p<0.001). However, the combination therapy group showed superior outcomes compared with the mCIMT-only group, including a greater increase in FMA-UE score (ΔFMA-UE: 18.50 [13.00–24.00] vs 12.00 [7.00–16.00], p=0.001) and a greater reduction in DTABR (ΔDTABR: −0.33 [−1.28 to −0.03] vs −0.15 [−0.49 to −0.04], p=0.008). Conclusions: Combined rTMS and mCIMT demonstrated greater effectiveness than mCIMT alone in improving upper extremity motor function and neurophysiological outcomes in patients with subacute ischemic stroke. This multimodal intervention may represent a promising rehabilitation strategy to optimize post-stroke recovery.