Objective
To investigate the effect of low frequency cerebellar repetitive transcranial magnetic stimulation (rTMS) on balance impairment in patients with cerebral infarction.
Methods
Thirty-two patients were randomly divided into two groups: rTMS group (n=16) and control (n=16). In the rTMS group, treatment was performed five times per week for 2 weeks (10 sessions), and in the control group, a sham coil was used with the sound and sensation of scalp similar to the rTMS coil. Patients in both groups underwent a conventional rehabilitation program. Berg Balance Scale (BBS) was used as the primary outcome measurement. Timed Up and Go test (TUG), 10-m walk test (10mWT), and Activity-specific Balance Confidence scale (ABC) were used as the secondary outcome measurement. All scales were measured at baseline (T0), after 10 sessions of rTMS (T1), and at 4 weeks after treatment completion (T2) by therapists with over 5 years of clinical experience.
Results
There were significant improvements between T0 and T1, and between T0 and T2, for all assessed items in the rTMS group. Whereas there were significant improvements between T0 and T1, and between T0 and T2, for the BBS and 10mWT in the control group. TUG (-4.87±5.05 vs. -0.50±2.97 seconds) and ABC score (8.10±8.33 vs. 0.16±0.97) were observed significant differences in comparison of the changes from T0 to T1 between the two group. BBS score (4.40±3.66 vs. 1.88±3.14), TUG (-4.87±4.56 vs. -0.62±2.96 seconds) and ABC score (8.22±7.70 vs. -0.09±0.86) differed significantly from T0 to T2 between the two groups.
Conclusion
Our findings suggest that low-frequency cerebellar rTMS is helpful for improving balance in patients with cerebral infarction, and maybe a beneficial treatment for these patients.

Citations

• Can cerebellar noninvasive brain stimulation improve lower limb function in stroke? Evidence from meta-analyses based on ICF
  Xiaolong Yang, Lei Cao, Linlin Ye, Tiantian Zhang, Yi Shan, Lin Hua, Jin Xu, Weiqun Song, Jie Lu
  Disability and Rehabilitation.2026; : 1.     CrossRef
• Differential Effect of M1 and Cerebellar Repetitive Transcranial Magnetic Stimulation on Balance Performance in Stroke
  Vyoma Parikh, Ann Medley, Jodi Thomas, Hui‐Ting Goh
  European Journal of Neuroscience.2026;[Epub]     CrossRef
• Effect of repetitive transcranial magnetic stimulation on balance function in patients with stroke: A systematic review
  Ningling Chen, Shuo Xu, Yilong Zou, Shaofan Chen, Xiujia Luo, Zhengcong Zhang, Tingting Chen, Huijie Zou, Xiaofen Xu, Haoqing Jiang
  Journal of Back and Musculoskeletal Rehabilitation.2026;[Epub]     CrossRef
• Exploring cerebellar transcranial magnetic stimulation in post-stroke limb dysfunction rehabilitation: a narrative review
  Zhan Wang, Likai Wang, Fei Gao, Yongli Dai, Chunqiao Liu, Jingyi Wu, Mengchun Wang, Qinjie Yan, Yaning Chen, Chengbin Wang, Litong Wang
  Frontiers in Neuroscience.2025;[Epub]     CrossRef
• Effects of cerebellar repetitive transcranial magnetic stimulation on stroke rehabilitation: A systematic review and meta-analysis
  Xin Wang, Guilan Huang, Daoran Wang, Lu Sun, Haobo Leng, Kai Zheng, Xinlei Xu, Guofu Zhang, Caili Ren
  Brain Research Bulletin.2025; 225: 111341.     CrossRef
• Effects of Cerebellar Transcranial Magnetic Stimulation on the Motor Function of Patients With Stroke: A Systematic Review and Meta‐Analysis
  Yongxin Zhu, Juncong Yang, Kun Wang, Xianwen Li, Jiahui Ling, Xie Wu, Lianhui Fu, Qi Qi
  Brain and Behavior.2025;[Epub]     CrossRef
• Effects of cerebellar non-invasive brain stimulation on balance and gait performance in individuals with stroke: a systematic review and meta-analysis
  Jiaxin JIANG, Yawen CHEN, Florence S. FAN, Qiang GAO, Brenton HORDACRE, Margaret K. MAK, Meizhen HUANG
  European Journal of Physical and Rehabilitation Medicine.2025;[Epub]     CrossRef
• Effects of repetitive transcranial magnetic stimulation over the supplementary motor area on balance and postural control in stroke patients: a randomized controlled trial
  Hanhong Jiang, Wangqingyuan Wang, Saiqing Ye, Huiyan Song, Qiang Gao
  Topics in Stroke Rehabilitation.2025; : 1.     CrossRef
• Efficacy of Cerebellar Transcranial Magnetic Stimulation for Post-stroke Balance and Limb Motor Function Impairments: Meta-analyses of Random Controlled Trials and Resting-State fMRI Studies
  Yuheng Zeng, Zujuan Ye, Wanxin Zheng, Jue Wang
  The Cerebellum.2024; 23(4): 1678.     CrossRef
• Cerebellar transcranial magnetic stimulation for improving balance capacity and activity of daily living in stroke patients: a systematic review and meta-analysis
  Jingfeng Wang, Zhisheng Wu, Shanshan Hong, Honghong Ye, Yi Zhang, Qiuxiang Lin, Zehuang Chen, Liling Zheng, Jiawei Qin
  BMC Neurology.2024;[Epub]     CrossRef
• Effects of Cerebellar Non-Invasive Stimulation on Neurorehabilitation in Stroke Patients: An Updated Systematic Review
  Qi Liu, Yang Liu, Yumei Zhang
  Biomedicines.2024; 12(6): 1348.     CrossRef
• Bilateral Cerebellar Repetitive Transcranial Magnetic Stimulation for Chronic Ataxia After Hemorrhagic Stroke: a Case Report
  Evan Hy Einstein, Juliana Corlier, Cole Matthews, Doan Ngo, Michael K. Leuchter, Cole Citrenbaum, Nikita Vince-Cruz, Bhavna Ramesh, Aaron Slan, Scott A. Wilke, Nathaniel Ginder, Thomas Strouse, Andrew F. Leuchter
  The Cerebellum.2023; 23(3): 1254.     CrossRef

Objective
To investigate changes in blood glucose level after steroid injection in patients with type 2 diabetes mellitus (DM) and factors affecting those changes.
Methods
We retrospectively studied 51 patients with type 2 DM who underwent steroid injection for shoulder and back pain. Mean fasting blood sugar (FBS) levels for 7 days before steroid injection was used as the baseline blood glucose level, which was compared with FBS levels for 14 days after steroid injection. We compared the differences in blood glucose changes between HbA1c >7% and HbA1c ≤7% groups and those between insulin and non-insulin treated groups. Demographic data, injection site, and steroid dose were analyzed.
Results
Compared to baseline, blood glucose significantly (p=0.012) elevated 1 day after steroid injection but not 2 days after injection. In the HbA1c >7% and insulin groups, blood glucose was significantly increased 1 day after injection compared to that in the HbA1c ≤7% (p=0.011) and non-insulin (p=0.024) groups, respectively. Higher HbA1c level before injection was significantly (p=0.003) associated with the degree of blood glucose increase 1 day after injection. No significant differences were noted in the degree of blood glucose increase according to injection site or steroid dose.
Conclusion
Higher HbA1c level was associated with greater elevation in blood glucose 1 day after steroid injection. Careful monitoring of blood glucose is required on the first day after steroid injection in patients with poorly controlled DM.

Citations

• Comparative effect of triamcinolone/lidocaine ultrasonophoresis and injection on pain, disability, quality of life in patients with acute rotator cuff related shoulder pain: a double blinded randomized controlled trial
  Salman Nazary-Moghadam, Mohammad Reza Tehrani, Amir Reza Kachoei, Shiva Golmohammadzadeh, Ali Moradi, Mohammad Ali Zare, Afsaneh Zeinalzadeh
  Physiotherapy Theory and Practice.2025; 41(1): 35.     CrossRef
• Impact of diabetes mellitus on spinal injection two-week outcomes in patients with predominant lower extremity pain
  Youngjune Kim, Choong Guen Chee, Yusuhn Kang, Eugene Lee, Joon Woo Lee
  Skeletal Radiology.2025; 54(12): 2803.     CrossRef
• Impact of Intra-Articular Corticosteroid Injection on Glycemic Control: A Population-Based Cohort Study
  Terin T. Sytsma, Laura S. Greenlund, Karen M. Fischer, Rozalina G. McCoy
  Clinical Diabetes.2024; 42(1): 96.     CrossRef
• Is It Time for a New Algorithm for the Pharmacotherapy of Steroid-Induced Diabetes?
  Aleksandra Ostrowska-Czyżewska, Wojciech Zgliczyński, Lucyna Bednarek-Papierska, Beata Mrozikiewicz-Rakowska
  Journal of Clinical Medicine.2024; 13(19): 5801.     CrossRef
• Elective hand surgery and concomitant corticosteroid injection: Confirming increased infection risk using A national dataset
  Benjamin J. Kirby, Jashvant Poeran, Nicole Zubizarreta, Daniel A. London
  Surgery in Practice and Science.2024; 19: 100259.     CrossRef
• Association between elevated glycosylated hemoglobin and cognitive impairment in older Korean adults: 2009–2010 Ansan cohort of the Korean genome and epidemiology study
  Jung Sook Kim, Byung Chul Chun, Kyoungho Lee
  Frontiers in Public Health.2024;[Epub]     CrossRef
• Responsible Use of Oral Corticosteroids in People with Comorbid Diabetes: An Expert Consensus
  Banshi Saboo, Shashank Joshi, Amit Gupta, Anuj Maheshwari, Bharat Saboo, Brij Mohan Makkar, Ganapathi Bantwal, Jothydev Kesavadev, L Sreenivasamurthy, Mangesh Tiwaskar, Manoj Chawla, Minakshisundaram Shunmugavelu, Nagendra Kumar Singh, Pratap Jethwani, Sa
  Journal of the Association of Physicians of India.2024; 72(7): 79.     CrossRef
• The Effect of Subglottic Steroid injection on Blood Glucose in a Cohort of Patients With Subglottic Stenosis
  Yael Bensoussan, Eduardo Martinez, Benjamin Van Der Woerd, Michael Johns, Caroline Nguyen, Stephanie Watts, Karla O'Dell
  The Laryngoscope.2023; 133(7): 1590.     CrossRef
• Shoulder Impingement Syndrome
  Evan H. Horowitz, William R. Aibinder
  Physical Medicine and Rehabilitation Clinics of North America.2023; 34(2): 311.     CrossRef
• Ketorolac as a Local Analgesic in Orthopaedic Conditions: A Systematic Review of Safety and Efficacy
  Joshua Eskew, Tyler Kelly, Gabriella Ode
  Current Orthopaedic Practice.2023; 34(4): 142.     CrossRef
• Perioperative hyperglycemic response to single-dose dexamethasone in patients undergoing surgery under spinal anesthesia
  Kamal Nayan Joshi, Aditya Kumar Chauhan, Urmila Palaria
  Ain-Shams Journal of Anesthesiology.2023;[Epub]     CrossRef
• Frozen shoulder
  Marta Karbowiak, Thomas Holme, Maisum Mirza, Nashat Siddiqui
  BMJ.2022; 377: e068547.     CrossRef
• The effect of steroid injection into the shoulder on glycemia in patients with type 2 diabetes
  Ori Safran, Gabriel Fraind-Maya, Leonid Kandel, Gil Leibowitz, Shaul Beyth
  JSES International.2022; 6(5): 843.     CrossRef
• Narrative review of peripheral nerve blocks for the management of headache
  Jennifer I. Stern, Chia‐Chun Chiang, Narayan R. Kissoon, Carrie E. Robertson
  Headache: The Journal of Head and Face Pain.2022; 62(9): 1077.     CrossRef
• Morton's neuroma: review of anatomy, pathomechanism, and imaging
  M.S. Mak, R. Chowdhury, R. Johnson
  Clinical Radiology.2021; 76(3): 235.e15.     CrossRef
• Effectiveness of Shock Wave Therapy versus Intra-Articular Corticosteroid Injection in Diabetic Frozen Shoulder Patients’ Management: Randomized Controlled Trial
  Ahmed Ebrahim Elerian, David Rodriguez-Sanz, Abdelaziz Abdelaziz Elsherif, Hend Adel Dorgham, Dina Mohamed Ali Al-Hamaky, Mahmoud S. El Fakharany, Mahmoud Ewidea
  Applied Sciences.2021; 11(8): 3721.     CrossRef
• Effect of diabetes and corticosteroid injection on glenohumeral joint capsule in a rat stiffness model
  Kwang Il Kim, Yong Soo Lee, Ja Yeon Kim, Seok Won Chung
  Journal of Shoulder and Elbow Surgery.2021; 30(12): 2814.     CrossRef