Spastic diplegic Cerebral Palsy (CP) is marked by stiff muscle tone that hinders mobility and lengthens achievement of developmental milestones. Though it is a lifetime disorder, many interventional therapies are employed to improve motor abilities to help patient perform ADL tasks. Repetitive Transcranial magnetic stimulation (rTMS) is one such non-invasive interventional tool gaining importance for treating motor disorders. Reports suggest that neuromodulatory effect of rTMS provides functional gain in motor performances in CP patients; but its  lasting effect depends on appropriate use of frequency and the pulse trains which was the aim of this study. The study was performed in two phases – in phase-I, a group of 9 patients in each  category, 5 and 10Hz rTMS frequency was administered for 15 minutes daily follwed by RT of 30 minutes for 20 days. It was found that functional motor gain improved by 1.74% and 2.88% in 5Hz and 10Hz group in comparison to 0.82% in RT group. In phase-II, three groups of 7 patients were administered pulse train of 1500, 2000 and 2500 keeping constant frequency at 10Hz. The time duration of rTMS and RT was maintained as in phase-I. Functional motor gain observed was 2.85%, 4.03% and 6.35% against 1500, 2000, and 2500 pulse trains respectively. Additionally, improvement in cognitive paremeters such as attention, alertness, memory, etc., was performed employing EEG studies that showed percentage change of above 50% and 30% in alpha and beta rhythms respectively post rTMS therapy.

VARIATIONS IN FREQUENCY AND PULSE TRAINS OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION DIRECTLY INFLUENCES MOTOR ACTIVITY IN SPASTIC DIPLEGIC CEREBRAL PALSY CHILDREN