Paper Title
The effects of High-Frequency Repetitive Transcranial Magnetic Stimulation Combined with Task-oriented Mirror Therapy training on Hand Rehabilitation of Acute Stroke Patients

Abstract
Impairments of hand function make it difficult to perform daily life activities and to return to work. The aim of this study was to investigate the effect of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) combined with task-oriented mirror therapy (TOMT) on hand rehabilitation in acute stroke patients. Twenty subacute stroke patients in the initial stages(<3 months) participated in the study. Subjects were allocated to 2 groups; the experimental group received HF-rTMS + TOMT and the control group received HF-rTMS. TOMT training was conducted in 10 sessions over 2 weeks for 30 min. TOMT program was composed of 5 motions including building block, hand picking sand, insert coin in the saving box, sand scoop with a spoon, and wipe a with a towel and 30min training was conducted under the supervision of physical therapist. rTMS was applied at a 20 Hz frequency over the hand motor area in the cortex of the affected hemisphere for 15 min. Outcomes, including motor-evoked potential (MEP), pinch grip, hand grip, and box and block test, were measured before and after training. Significant improvements in the MEP and hand function variables were observed in both group(p < 0.05). In particular, hand function variables were significantly different between two groups (p < 0.05). HF-rTMS combined with TOMT had a positive effect on hand function and can be used for the rehabilitation of precise hand movements in acute stroke patients. Keywords: Repetitive Transcranial Magnetic Stimulation, Task-Oriented Mirror Therapy, Stroke, Hand Function