學院 |
醫學院 |
系所 |
職能治療學系 |
題名 |
Intermittent theta burst
stimulation enhances upper limb motor function in patients with chronic
stroke: A pilot randomized controlled trial. |
作者 |
Chen, Y-J., Huang, Y-Z., Chen, C-Y., Chen, C-L.*, Chen, H-C., Wu, C-Y., |
期刊名稱 |
BMC Neurology
(SCIE-Indexed) |
發表日期 |
2019 |
著作性質 |
原著 |
語文 |
英文 |
關鍵字 |
Transcranial
magnetic stimulation (TMS), Theta burst stimulation (TBS), Stroke, Motor
function, Rehabilitation |
摘要 |
Abstract Background:
Intermittent theta burst stimulation (iTBS) is a form of repetitive transcranial
stimulation that has been used to enhance upper limb (UL) motor recovery.
However, only limited studies have examined its efficacy in patients with
chronic stroke and therefore it remains controversial. Methods:
This was a randomized controlled trial that enrolled patients from a rehabilitation
department. Twenty two patients with first-ever chronic and unilateral
cerebral stroke, aged 30–70 years, were randomly assigned to the iTBS or
control group. All patients received 1 session per day for 10 days of either
iTBS or sham stimulation over the ipsilesional primary motor cortex in
addition to conventional neurorehabilitation. Outcome measures were assessed before
and immediately after the intervention period: Modified Ashworth Scale (MAS),
Fugl-Meyer Assessment Upper Extremity (FMA-UE), Action Research Arm Test
(ARAT), Box and Block test (BBT), and Motor Activity Log (MAL).
Analysis of covariance was adopted to compare the treatment effects between
groups. Results:
The iTBS group had greater improvement in the MAS and FMA than the control
group (η2 = 0.151–0.233; p <
0.05), as well as in the ARAT and BBT (η2
= 0.161–0.460; p < 0.05) with large effect size. Both groups showed an improvement
in the BBT, and there were no significant between-group differences in MAL
changes. Conclusions:
The iTBS induced greater gains in spasticity decrease and UL function improvement,
especially in fine motor function, than sham TBS. This is a promising finding
because patients with chronic stroke have a relatively low potential for fine
motor function recovery. Overall, iTBS may be a beneficial adjunct therapy to
neurorehabilitation for enhancing UL function. Further larger-scale study is
warranted to confirm the findings and its long-term effect. Trial
registration: This trial was registered under ClinicalTrials.gov ID No. NCT01947413 on September 20,
2013. |