- Repetitive transcranial magnetic stimulation (rTMS) has been recognized as a promising intervention for treatment of stroke patients. The purpose of this double-blind placebo-controlled crossover study was to assess the efficacy of 20 Hz rTMS delivered with H-coil on lower limb (LL) motor function in patients with chronic (>6 months) subcortical stroke. Nine patients received both real and sham rTMS in a random sequence. rTMS treatments were composed of 11 sessions (administered over 3-weeks) and were separated by a 4-week wash-out period. LL functions were assessed by the Fugl-Meyer LL scale (FM-LL), the 10-meters walking test (10MWT) and the six minutes walking test (6MWT), before and 1 day after the end of each treatment period, as well as at a 4-week follow-up. Real rTMS treatments were associated with a significant improvement in FM-LL scores. This effect persisted at follow-up and was significantly greater than that observed with sham stimulation. A significant increase in walking speed was also found after real rTMS but this effect did not reach statistical significance in comparison with the sham stimulation. These data demonstrated that 3-weeks of high-frequency deep rTMS could induce long-term improvements in LL functions in the chronic post-stroke period.