The goal of this clinical trial is to evaluate whether combining repetitive transcranial magnetic stimulation (rTMS) with machine-assisted bimanual therapy (BT) can improve upper limb function in stroke patients. The participants will be individuals aged 40-80 years who have experienced a first-time ischemic or hemorrhagic stroke. The main questions it aims to answer are:
* Does the combined therapy enhance motor recovery compared to traditional rehabilitation methods? * Are changes in brain activity associated with improvements in upper limb function?
Participants will be randomly assigned to different groups and will:
* Receive rTMS stimulation on specific areas of the brain to modulate neural activity, * Perform machine-assisted bimanual exercises to promote motor skills, and * Undergo assessments before, immediately after, and during follow-up periods to measure functional improvements.
Age 40-80 years;
First-onset stroke patients;
Patients diagnosed with cerebral infarction or hemorrhage through CT or MRI;
Signed informed consent form by the patient and their family;
A history of epilepsy or family history of epilepsy;
Presence of suicidal tendencies;
Currently using medications that lower the seizure threshold;
Pregnant or planning to become pregnant;
Chang Gung Memorial Hospital
Lead sponsor