Randomized, Multicenter, Comparative Study of NEURO versus CIMT in Poststroke Patients with Upper Limb Hemiparesis: The NEURO-VERIFY Study

Abo, Masahiro; Kakuda, Wataru; Momosaki, Ryo; Harashima, Hiroaki; Kojima, Miki; Watanabe, Shigeto; Sato, Toshihiro; Yokoi, Aki; Umemori, Takuma; Sasanuma, Jinichi

doi:10.1111/ijs.12100

Cited by 68 publications

(54 citation statements)

References 16 publications

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“…In a series of studies, we demonstrated the therapeutic effects of rTMS and OT for post-stroke upper limb hemiparesis [20][21][22]. Currently, more than 1000 stroke patients have received the combination of rTMS and OT across Japan, and the clinical results of the treatment are favorable.…”

Section: Discussionmentioning

confidence: 99%

“…Informed consent was obtained from the three patients. The inclusion criteria were almost similar to those applied in our previous studies on rTMS and OT, namely [20][21][22]: (1) Brunnstrom stage for hand-fingers of 3-5 (ability, at least, subjectively to flex all fingers of the affected upper limb in full range of motion). (2) Age at intervention of 18-80 years.…”

Section: Methodsmentioning

confidence: 99%

“…We have reported the use of repetitive transcranial magnetic stimulation (rTMS) combined with intensive occupational therapy (OT) for treatment of post-stroke patients with upper limb hemiparesis [20][21][22]. The combination treatment proved to be safe and beneficial for such patient population.…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic administration of atomoxetine combined with rTMS and occupational therapy for upper limb hemiparesis after stroke: a case series study of three patients

et al. 2015

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Atomoxetine, a selective noradrenaline reuptake inhibitor, has been reported to enhance brain plasticity, but has not yet been used in stroke patients. We reported the feasibility and clinical benefits on motor functional recovery of the combination of repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) in stroke patients. This pilot study was designed to evaluate the additive effects of oral atomoxetine to rTMS/OT in post-stroke hemiparetic patients. The study included three post-stroke patients with upper limb hemiparesis. Treatment with 40 mg/day atomoxetine commenced 2 weeks before admission. After confirming tolerance, the dose was increased to 120 mg/day. Low-frequency rTMS/OT was provided daily for 15 days during continued atomoxetine therapy. Motor function of the affected upper limb was evaluated with the Fugl-Meyer Assessment and Wolf Motor Function test. All patients completed the protocol and showed motor improvement up to 4 weeks after the treatment. No atomoxetine-related side effects were noted. Our protocol of triple therapy of atomoxetine, low-frequency rTMS, and OT is safe and feasible intervention for upper limb hemiparesis after stroke.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Therapeutic administration of atomoxetine combined with rTMS and occupational therapy for upper limb hemiparesis after stroke: a case series study of three patients

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“…After increasing the plasticity of the cerebrum with low-frequency rTMS, an occupational therapist uses a one-on-one approach of intensive frequency to improve the use of the upper limbs in daily living through intensive occupational therapy. High effectiveness of NEURO-15 in patients in the chronic phase of stroke has been reported in a randomized comparative study that used constraint-induced movement therapy as the control group [11]. Kakuda et al [12] reported on the safety and improved upper-limb function in a comparative study of over 1,700 stroke patients in the chronic phase of stroke.…”

Section: The Impact Of Neuro-15 On Performance Skills and Related Facmentioning

confidence: 98%

The Impact of NEURO-15 on Performance Skills and Related Factors in Activities of Daily Living in Patients in the Chronic Phase of Stroke

et al. 2018

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NEURO-15 is a 15-day program that combines low-frequency repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy for patients with chronic hemiparesis following stroke. Though the evaluation of upper-limb function has been used in the past to verify the effects of NEURO-15, the reacquisition of performance skills required for daily living has not been sufficiently evaluated. Therefore, we conducted this study with an objective of clarifying the effectiveness of NEURO-15 from the viewpoint of regaining performance skills in daily living. We conducted the Assessment of Motor and Process Skills (AMPS) and evaluated upper-limb function before and after NEURO-15 to evaluate performance skills in activities of daily living (ADL) in 20 patients with chronic hemiparesis after stroke. Our results found that not only upper-limb function performance, but also ADL performance skills changed significantly. Significant difference was found in the Wolf Motor Function Test (WMFT) log performance time, the Simple Test for Evaluating Hand Function (STEF), and paralysis of the dominant hand between those who improved and not improved on the AMPS. In particular, the results of this study on dominant hands would be a key findings for applying NEURO-15. This study showed the effectiveness of NEURO-15 in patients with chronic hemiparesis after stroke from the viewpoint of regaining performance skills.

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“…Low-frequency rTMS of approximately 1 Hz on the contralesional motor area could suppress excitation of this area and encourage activity in the ipsilesional motor area (Takeuchi & Izumi, 2012). Several studies have shown that OT training after low-frequency rTMS for two weeks improves upper limb paralysis in chronic stroke patients (Abo et al, 2014;Kakuda et al, 2016Kakuda et al, , 2012.…”

Section: Introductionmentioning

confidence: 99%

Effects of peripheral nerve stimulation on paralysed upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy: A pilot study

Maeda

Mutai

Toya³

et al. 2020

Hong Kong Journal of Occupational Therapy

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Objective Upper limb paralysis, which is a sequela of stroke, limits patients’ activities of daily living and lowers quality of life. The objective of this study was to examine the effects of peripheral nerve stimulation on hemiparetic upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy. Methods The subjects were chronic stroke patients who participated in a two-week inpatient programme including repetitive transcranial magnetic stimulation and occupational therapy. There were two groups of patients: the peripheral nerve stimulation group (11 patients who underwent peripheral nerve stimulation) and the control group (11 patients who previously participated in the same inpatient programme but without peripheral nerve stimulation, selected via propensity score matching). The peripheral nerve stimulation group had 1 h of peripheral nerve stimulation on the median and ulnar nerves during occupational therapy. The outcome measures were the Wolf Motor Function Test, Fugl-Meyer Assessment, and Motor Activity Log. Results Wolf Motor Function Test, Fugl-Meyer Assessment, and Motor Activity Log showed significant improvement after the intervention in the peripheral nerve stimulation group. Particularly, the Fugl-Meyer Assessment hand score significantly improved in the peripheral nerve stimulation group compared to that in the control group (median change: 2 versus 0; p = 0.021, r = 0.49). Conclusion The combined use of peripheral nerve stimulation with occupational therapy after repetitive transcranial magnetic stimulation may result in a better functional recovery of in hemiparetic upper limb. Peripheral nerve stimulation with stimulation above the sensory threshold and below the motor threshold is easy to combine with occupational therapy upper limb function training and is therefore clinically useful.

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Randomized, Multicenter, Comparative Study of NEURO versus CIMT in Poststroke Patients with Upper Limb Hemiparesis: The NEURO-VERIFY Study

Abstract: The results of the 15-day rehabilitative protocol showed the superiority of NEURO relative to constraint-induced movement therapy; NEURO improved the motion of the whole upper limb and resulted in functional improvement in activities of daily living.

Cited by 68 publications

References 16 publications

Therapeutic administration of atomoxetine combined with rTMS and occupational therapy for upper limb hemiparesis after stroke: a case series study of three patients

Therapeutic administration of atomoxetine combined with rTMS and occupational therapy for upper limb hemiparesis after stroke: a case series study of three patients

The Impact of NEURO-15 on Performance Skills and Related Factors in Activities of Daily Living in Patients in the Chronic Phase of Stroke

Effects of peripheral nerve stimulation on paralysed upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy: A pilot study

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