Repetitive Transcranial Magnetic Stimulation Combined With Motor Rehabilitation Improves Motor and Functional Outcomes After Ischemic Stroke

Inclusion Criteria: * Aged 18 to 80 years. * Diagnosed with a first-ever ischemic stroke, confirmed by neuroimaging. * Presence of unilateral hemiparesis attributable to the first-ever ischemic stroke. * Time since stroke onset: * Acute stage: \< 1 month after stroke onset * Subacute stage: 1 to 6 months after stroke onset * Chronic stage: \> 6 months after stroke onset * Moderate neurological impairment, defined as a baseline NIHSS score between 5 and 14. * Cognitive ability sufficient to understand and follow instructions, indicated by a baseline MMSE score ≥ 20. * Medically stable and able to participate in a structured motor rehabilitation program. * Provided written informed consent prior to study enrollment. * NIHSS and MMSE scores are assessed at baseline only to characterize neurological severity and cognitive status at study entry Exclusion Criteria: * Motor impairment caused by conditions other than ischemic stroke, such as musculoskeletal disorders, traumatic brain injury, Parkinson's disease, encephalitis, or other neurological conditions. * Contraindications to repetitive transcranial magnetic stimulation, including but not limited to intracranial metallic implants, implanted electronic medical devices (e.g., pacemaker), cochlear implants, known bleeding disorders, pregnancy, history of epilepsy or seizure disorders, severe cardiac disease, severe psychiatric or neurological disorders interfering with participation, or active skin conditions at the stim…