The results indicated that both LF- and LF-HF rTMS were effective in promoting upper limb motor recovery in patients with acute stroke. Combining HF- and LF-rTMS protocol in the present study is tolerable and more beneficial for motor improvement than the unilateral use of LF-rTMS alone.

Purpose. To observe the effect of a brain-computer interface-operated lower limb rehabilitation robot (BCI-LLRR) on functional recovery from stroke and to explore mechanisms. Methods. Subacute-phase stroke patients were randomly divided into two groups. In addition to the routine intervention, patients in the treatment group trained on the BCI-LLRR and underwent the lower limb pedal training in the control group, both for the same time (30 min/day). All patients underwent assessment by instruments such as the National Institutes of Health Stroke Scale (NIHSS) and the Fugl–Meyer upper and lower limb motor function and balance tests, at 2 and 4 weeks of treatment and at 3 months after the end of treatment. Patients were also tested before treatment and after 4 weeks by leg motor evoked potential (MEP) and diffusion tensor imaging/tractography (DTI/DTT) of the head. Results. After 4 weeks, the Fugl–Meyer leg function and NIHSS scores were significantly improved in the treatment group vs. controls ( P < 0.01 ). At 3 months, further significant improvement was observed. The MEP amplitude and latency of the treatment group were significantly improved vs. controls. The effect of treatment on fractional anisotropy values was not significant. Conclusions. The BCI-LLRR promoted leg functional recovery after stroke and improved activities of daily living, possibly by improving cerebral-cortex excitability and white matter connectivity.