Effects of cortical intermittent theta burst stimulation combined with precise root stimulation on motor function after spinal cord injury: a case series study.

Activation and reconstruction of the spinal cord circuitry is important for improving motor function following spinal cord injury. We conducted a case series study to investigate motor function improvement in 14 patients with chronic spinal cord injury treated with 4 weeks of unilateral (right only) cortical intermittent theta burst stimulation combined with bilateral magnetic stimulation of L3-L4 nerve roots, five times a week. Bilateral resting motor evoked potential amplitude was increased, central motor conduction time on the side receiving cortical stimulation was significantly decreased, and lower extremity motor score, Berg balance score, spinal cord independence measure-III score, and 10 m-walking speed were all increased after treatment. Right resting motor evoked potential amplitude was positively correlated with lower extremity motor score after 4 weeks of treatment. These findings suggest that cortical intermittent theta burst stimulation combined with precise root stimulation can improve nerve conduction of the corticospinal tract and lower limb motor function recovery in patients with chronic spinal cord injury.

[Improvement of Dystonia after Spinal Cord Injury by Applying Repetitive Transcranial Magnetic Stimulation on the Premotor Cortex: Case Report].

This article reports a patient with spinal cord injury who was treated with conventional rehabilitation therapy plus repeated transcranial magnetic stimulation (rTMS) during the postoperative rehabilitation, and to observe the effects of rTMS on dystonia. A 66-year-old male patient fell from the bed 8 months ago. At that time, he felt pain in his neck, dysfunction in limbs movement, and loss of sensation in trunk and limbs. Magnetic resonance imaging (MRI) revealed spinal cord injury. Under general anesthesia, anterior cervical decompression and bone graft fusion (ACDF) and cervical spine internal fixation of C 3-C 6 were performed. Postoperative hyperbaric oxygen chamber and conventional rehabilitation treatment were performed. Eight months after surgery, he was admitted to the hospital due to motor function, balance dysfunction, neurogenic bladder/rectal dysfunction. After admission, the patient was treated with rTMS plus rehabilitation treatment, once per day, 5 times/week, for 4 weeks. rTMS worked by wearing a positioning cap for transcranial magnetic stimulation (80% resting motor threshold, 1 Hz, 30 min), and then conduct walking, balance proprioception, muscle strength training, and coordination training. After 4 weeks, MEP, sEMG and H reflex were improved. Therefore, rTMS on the premotor cortex to improve the dystonia after spinal cord injury is effective in this case, which can be further studied.

Effects of Tai Chi and Multimodal Exercise Training on Movement and Balance Function in Mild to Moderate Idiopathic Parkinson Disease.

OBJECTIVE: The primary aim of this study was to investigate the effects of two different patterns of rehabilitation training on movement and balance function in patients with idiopathic Parkinson disease. DESIGN: Forty patients with Parkinson disease were randomized into the tai chi group (n = 20) or the multimodal exercise training group (n = 20). Outcome measures were assessed at baseline and after 12 wks of exercise. Balance was assessed using the Berg Balance Scale, and movement was assessed by the Unified Parkinson's Disease Rating Scale-Motor Examination, stride length, gait velocity, and Timed Up and Go Test. RESULTS: The multimodal exercise training group improved significantly in movement from baseline, and a reduction in balance impairment was observed for the multimodal exercise training group. The questionnaire results after training showed that the multimodal exercise training is easy to learn and adhere to. No major adverse events were noted in both groups. CONCLUSIONS: This multimodal exercise training could improve motion function and benefit balance function in patients with Parkinson disease. The multimodal exercise training is easy to learn and practice.