RNR Medicine offers the best for stroke motor rehabilitation in Mumbai for the patients to get better after a stroke. Our team of experts really cares about making sure you get the right treatment to help with moving and feeling better. If you or someone you know is getting back on their feet after a stroke, think about RNR Medicine. Give us a shout, and let’s work together to make things better for you or your loved one.

Stroke is an acute syndrome of clinical signs of focal (or global) disturbance of cerebral function. Reduced arm and leg function leads to significant disability that affects daily living and increases the burden on these patients and their families. In many areas of the world, dedicated research is ongoing that can help patients to reduce their suffering from disability. Transcranial magnetic stimulation is such a novel innovative method that has shown promising results in recent studies. It is a painless, noninvasive method that modulates cortical excitability.

• Stroke causes lifelong disabling paralysis, weakness or numbness. These all patients are potential candidates for TMS.
  • Patients with arm paralysis may have difficulty in writing, holding and gripping objects
  • Leg weakness leads to impaired walking. Some patients might experience imbalance while walking or standing.
  • A few patients have difficulty in swallowing/ chewing/ drinking.

• These all are the potential candidates for TMS.
• Even patients with pregnancy, hypertension, diabetes, thyroid disorders, kidney diseases, heart diseases etc. can take part in this treatment.
• Medical devices which are commonly used now-a-days like stents, pacemakers, coils, orthopedic implants etc. are usually MRI compatible so they usually do not interfere with the TMS.

TMS has been researched around the world since about the 1980s. Lots of literature has been published so far in peer-reviewed journals on TMS with positive outcomes and negligible adverse effects. Hereby, we are mentioning a few significant studies on TMS on patients with arm or leg weakness after stroke.

In a study conducted in Italy wherein chronic stroke patients with lower limb motor impairments were subject to 3-week of high-frequency deep TMS, the patients experienced long term improvement in lower limb functions lasting at least 1 month after the end of treatment.

Additionally, another study was conducted to explore the efficacy of 11 TMS sessions in 20 patients with upper limb motor difficulties. The patients who received TMS experienced 70% improvement in upper limb movement than the patients in the sham group i.e. those who did not receive the treatment.

Method

• TMS is a non-invasive way of Neuromodulation.
• It involves low energy magnetic stimulation of the particular site of the brain through the skull
• This is delivered through a specially designed coil, incorporated in a helmet.
• When the patient comes in, the nurse will take a detailed history and update the doctor. The doctor will thereafter discuss the most suitable protocol with the patient, which will include the duration of each sitting, the frequency of sittings/week and the total no. of sittings.
• Once all confirmed, this will be fed in the computer
• Following this, necessary evaluation is done to determine the MT (Motor threshold) by imparting stimulation through the helmet.
• Based on the predesigned protocols, TMS will be administered to the patient.
• For the stroke, the patient will require about 16sessions over the period of 4 weeks. Each session will be approximately 15-20 minutes long.
• The procedure does not require any sedation or anesthesia. Patient is not required to keep fasting before the procedure.

The Jaslok Hospital & Research Centre is one of the oldest tertiary care, multi-specialty Trust hospitals in the country. Jaslok Hospital has research activities ongoing in various fields in collaboration with other institutions in India & abroad. The hospital has a dedicated “Restorative and Regenerative Medicine” department including consultants in various fields with more than 20 years of experience.

The department has procured the state-of-art technology and equipment from internationally reputed and trusted “Brainsway” company. It contains the advanced technology of  H1-7 coils instead of conventional coils, that can deliver noninvasive deep TMS in precise manner to get maximum result. It has FDA and CE clearance for treatment of various neurological and psychiatric conditions. The conventional TMS can only deliver specific target sites, limiting their use and capabilities. Deep TMS can reach following target sites; insula, cingulate gyrus, etc.