Objective: To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with exercise training on balance function, coordination function, walking function, and activities of daily living in patients with cerebellar ataxia.

Methods: Four patients with cerebellar ataxia were enrolled, and they received a 15-day intervention of rTMS (high-frequency 5Hz stimulation targeting the cerebellar vermis, once daily for 20 minutes per session) combined with exercise training (twice daily for 30 minutes per session). Rehabilitation assessments were conducted before and after the intervention, including muscle strength (manual muscle testing, MMT), balance function (Berg balance scale, BBS), coordination function (finger-to-nose test, alternating movement test, heel-knee-shin test), walking function (Holden functional ambulation classification, FAC), and activities of daily living (modified Barthel index, MBI).

Results: After the intervention of rTMS combined with exercise training, all four patients showed improvements in MMT grade, BBS scores and MBI scores, three patients showed improvements in FAC grades. Results of finger-to-nose test, alternating movement test, and heel-knee-shin test demonstrated significant improvements in coordination function for all patients.

Conclusion: rTMS combined with exercise training can enhance balance function, coordination function, walking function, and activities of daily living in patients with cerebellar ataxia.