Effects and safety of combined rTMS and action observation for recovery of function in the upper extremities in stroke patients: A randomized controlled trial.
Restor Neurol Neurosci
; 37(3): 219-230, 2019.
Article
en En
| MEDLINE
| ID: mdl-31177248
ABSTRACT
BACKGROUND:
Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability and facilitates motor learning to improve motor recovery after stroke. Action observation (AO) therapy effectively facilitates physical training for motor memory formation.OBJECTIVE:
To compare the effectiveness of rTMS alone with that of combined rTMS and AO for the functional recovery of upper extremity function in subacute stroke patients and to verify the safety of the interventions.METHODS:
The present study was a prospective, randomized controlled trial involving subacute unilateral stroke patients. In total, 22 patients were randomly assigned to 2 groups the trial group (rTMS with AO) and the control group (rTMS alone). Both groups received 1âHz rTMS (intensity 120% of resting motor threshold; rMT) over the contralesional primary motor cortex for 20 minutes on 10 consecutive days. Trial group received rTMS while watching a video of 5 different complex hand movements. The functional parameters were the Brunnstrom stage, Fugl-Meyer assessment (FMA) score of the upper extremity, Manual Function Test (MFT) score, and grip power. The following motor evoked potential (MEP) parameters were recorded from the abductor pollicis brevis muscle rMT, latency, and amplitude. Both parameters were measured before and after the 2 week intervention.RESULTS:
After the 2 week trial, the total FMA and MFT scores were significantly improved in both groups, but the MFT subscores of hand motor function and grip power were significantly improved in the combination therapy group only. In contrast, the changes (Δ) of FMA, MFT, grip power test, and MEP outcomes were not significantly different between the 2 groups. No adverse events or complications were reported.CONCLUSIONS:
Distal upper extremity function, as measured by MFT and grip power, was improved after rTMS and AO in combination. The combination of rTMS with AO may be applied safely to improve upper extremity function after stroke.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Potenciales Evocados Motores
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Recuperación de la Función
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Accidente Cerebrovascular
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Extremidad Superior
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Estimulación Magnética Transcraneal
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Rehabilitación de Accidente Cerebrovascular
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Hemiplejía
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Corteza Motora
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Guideline
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Prognostic_studies
Idioma:
En
Revista:
Restor Neurol Neurosci
Asunto de la revista:
NEUROLOGIA
Año:
2019
Tipo del documento:
Article