The Effect of rTMS with Rehabilitation on Hand Function and Corticomotor Excitability in Sub-Acute Stroke
Abstract:
Background
Stroke is the leading cause of long-term disability. Hand motor impairment resulting from chronic stroke may have extensive physical, psychological, financial, and social implications despite available rehabilitative treatments. The best time to start treatment for stroke, is in sub-acute period.
Objectives
Repetitive transcranial magnetic stimulation (rTMS) is a method of stimulating and augmenting the neurophysiology of the motor cortex in order to promote the neuroplastic changes that are associated with motor recovery. The purpose of this study was to compare the effects of repetitive transcranial magnetic stimulation protocols plus routine rehabilitation on hand motor functions and hand corticomotor excitability in stroke patients with hemiplegia with pure routine rehabilitation programs.
Materials And Methods
This study was a randomized clinical trial which was performed on 24 patients with hemiplegia who were randomly divided in to three groups. One group (n=7), received high frequency repetitive transcranial magnetic stimulation(Hf rTMS) on lesioned M1 with routine rehabilitation program, and the other group (n=7), received rehabilitation program with low frequency repetitive transcranial magnetic stimulation stimulation(Lf rTMS) on nonlesined M1, and a control group(n=10), who were given only routine rehabilitation programs. The treatment was performed for 10 sessions , three times peri-test, Post and follow-up about neurophysiological contralesional hemisphere evaluations using record of MEP wave indices by single pulse TMS, and assessing functional wolf test and hand grip power of disabled hand by dynamometer.
Results
The results demonstrated that the rest MEP threshold reduction in experimental group which received high frequency magnetic stimulation was statistically significant (p
Conclusions
According to the results, However it seems that Hf rTMS combined with routin physiotherapy can significantly improve hand functions and brain neurophysiology via specifically increase of contralesional corticomotor excitability in sever stroke patients that is representative of the role of neuroplasticity in nonlesioned hemisphere but the hypothesis of movement improvement related cognitive balance cant be eliminated by exploring powerful approved effect of Hf rTMS on mood regulation.
Language:
English
Published:
Iranian Rehabilitation Journal, Volume:13 Issue: 26, Dec 2015
Pages:
46 to 52
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