Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Physical Therapy for Neuromuscular and Neurosurgery

Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder associated with motor and cognitive impairments. With progression of disease; antiparkinsonian medications become less effective. Developments of therapeutic strategies to improve motor and cognitive impairments are needed The aim of this study was to assess the influence of combined repetitive transcranial magnetic stimulation (rTMS) with treadmill training on cognitive and motor performance and to determine the correlation between cognitive and motor functions in PD patients. Methods: Forty five PD patients from both sexes were assigned into three equal groups. Group I (GI; control group) treated by a designed program of therapeutic exercises. Group II (GII) treated by aerobic exercise on treadmill in addition to the same program of (GI). Group III (GIII) received (5Hz) rTMS followed by the same program of (GII). The treatment program was conducted three sessions per week, for four weeks. Balance, bradykinesia and gait were assessed by Biodex balance system, keyboard tapping and two- dimensional motion analysis; respectively. Cognitive functions were assessed by Parkinson's disease cognitive rating scale (PD-CRS) and auditory event related potential (P300). All variables were assessed pre and post treatment in all groups. The results: pretreatment, there was a non-significant difference in the mean values of all variables in the three groups. Post treatment, a significant improvement in spatiotemporal gait parameters and bradykinesia was observed in the three groups with more improvement in (GIII) (P<0.05). Improvement in balance and cognitive functions was observed in GII and GIII

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