Rehabilitation Interventions Combined with Noninvasive Brain Stimulation on Upper Limb Motor Function in Stroke Patients

Abstract

(1) Background: This systematic review aimed to focus on the effects of rehabilitation interventions combined with noninvasive brain stimulation on upper limb motor function in stroke patients. (2) Methods: PubMed, MEDLINE, and CINAHL were used for the literature research. Articles were searched using the following terms: “Stroke OR CVA OR cerebrovascular accident” AND “upper limb OR upper extremity” AND “NIBS OR Non-Invasive Brain Stimulation” OR “rTMS” OR “repetitive transcranial magnetic stimulation” OR “tDCS” OR “transcranial direct current stimulation” AND “RCT” OR randomized control trial.” In total, 12 studies were included in the final analysis. (3) Results: Analysis using the Physiotherapy Evidence Database scale for qualitative evaluation of the literature rated eight articles as “excellent” and four as “good.” Combined rehabilitation interventions included robotic therapy, motor imagery using brain–computer interaction, sensory control, occupational therapy, physiotherapy, task-oriented approach, task-oriented mirror therapy, neuromuscular electrical stimulation, and behavior observation therapy. (4) Conclusions: Although it is difficult to estimate the recovery of upper limb motor function in stroke patients treated with noninvasive brain stimulation alone, a combination of a task-oriented approach, occupational therapy, action observation, wrist robot-assisted rehabilitation, and physical therapy can be effective.

Improving Upper Limb and Gait Rehabilitation Outcomes in Post-Stroke Patients: A Scoping Review on the Additional Effects of Non-Invasive Brain Stimulation When Combined with Robot-Aided Rehabilitation

“…One could argue that NIBS could also have positive effects when coupled with conventional therapy. Actually, several works assessed NIBS coupled with conventional physiotherapy as compared to stand-alone for either upper or lower limbs, showing the coupled intervention as an effective strategy to improve motor function recovery in post-stroke patients [ 2 , 87 ]. No studies directly compared RAR, NIBS, and conventional physiotherapy.…”

Transcranial Magnetic Stimulation, Connectome and Its Clinical Applications

“…Since late 1990s, applications of TMS on neurological rehabilitation and treatment of different neurological diseases have been the focus of researches. TMS on motor rehabilitation and dysphasia is gaining more and more support from evidences in literature [7][8][9][10]. With advancement in technology, introduction of navigated TMS provides more precise application of TMS in mapping and treatment.…”

The stratified effects of repetitive transcranial magnetic stimulation in upper limb motor impairment recovery after stroke: a meta-analysis

“…Noninvasive brain stimulation can modify cortical excitability and improve behavioral performance by regulating brain electrical activity. Several studies have also suggested the effectiveness of combining noninvasive brain stimulation with other therapies to enhance upper limb motor impairment (3)(4)(5). According to estimates, the application of repetitive transcranial magnetic stimulation (rTMS) could potentially lead to a 10-20% improvement in upper limb motor function after five sessions (6).…”