Efficacy of manual lymphatic drainage combined with repetitive transcranial magnetic stimulation in post-stroke complex regional pain syndrome: a pilot study

PURPOSE: The aim of this study was to investigate the efficacy of manual lymphatic drainage (MLD) combined with repetitive transcranial magnetic stimulation (rTMS) on the recovery of upper limb in patients with post-stroke complex regional pain syndrome (CRPS). METHODS: This pilot study was conducted with 54 patients with post-stroke CRPS. Patients were randomized into three groups: the MLD combined with rTMS group (MLD + rTMS group), the rTMS group and the sham-rTMS group. The results of numeric rating scale (NRS), volumetric measurement, Fugl-Meyer assessment of upper extremity (FMA-UE), CRPS severity score (CSS), generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) before and after the intervention were analyzed. RESULTS: < 0.05). CONCLUSION: MLD combined with rTMS has an add-on efficacy on the basis of rTMS therapy in post-stroke patients, especially in pain. MLD could also have an effect on anxiety and depression.