The Effects of Combined Low Frequency Repetitive Transcranial Magnetic Stimulation and Motor Imagery on Upper Extremity Motor Recovery Following Stroke

Abstract

Objective: To investigate the effects of low frequency transcranial magnetic stimulation (LF-rTMS) combined with motor imagery (MI) on upper limb motor function during stroke rehabilitation. Background: Hemiplegic upper extremity activity obstacle is a common movement disorder after stroke. Compared with a single intervention, sequential protocol or combination of several techniques has been proven to be better for alleviating motor function disorder. Non-invasive neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS) and motor imagery (MI) have been verified to augment the efficacy of rehabilitation. Methods: Participants were randomly assigned to 2 intervention cohorts: (1) experimental group (rTMS+MI group) was applied at 1 Hz rTMS over the primary motor cortex of the contralesional hemisphere combined with audio-based MI; (2) control group (rTMS group) received the same therapeutic parameters of rTMS combined with audiotape-led relaxation. LF-rTMS protocol was conducted in 10 sessions over 2 weeks for 30 min. Functional measurements include Wolf Motor Function Test (WMFT), the Fugl-Meyer Assessment Upper Extremity (UE-FMA) subscore, the Box and Block Test (BBT), and the Modified Barthel index (MBI) were conducted at baseline, the second week (week 2) and the fourth week (week 4). Results: All assessments of upper limb function improved in both groups at weeks 2 and 4. In particular, significant differences were observed between two groups at end-intervention and after intervention ( p < 0.05). In these findings, we saw greater changes of WMFT ( p < 0.01), UE-FMA ( p < 0.01), BBT ( p < 0.01), and MBI ( p < 0.001) scores in the experimental group. Conclusions: LF-rTMS combined with MI had a positive effect on motor function of upper limb and can be used for the rehabilitation of upper extremity motor recovery in stroke patients.

Prediction of Motor Recovery in the Upper Extremity for Repetitive Transcranial Magnetic Stimulation and Occupational Therapy Goal Setting in Patients With Chronic Stroke: A Retrospective Analysis of Prospectively Collected Data

“…Neurorehabilitation has been proposed and used for the treatment of motor paralysis in stroke, and its effect has been verified (10)(11)(12)(13)(14). One of the treatment methods, the NovEl intervention Using Repetitive transcranial magnetic stimulation and Occupational therapy (NEURO), facilitates peripheral muscle movement by controlling the excitability of the motor cortices by repetitive transcranial magnetic stimulation (rTMS).…”

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“…Therefore, we examined if the combination of 1 Hz TMS is able to affect the upper extremity in patients with postischemic stroke [33]. It is suggested that intensive motor training combined with TMS is able to improve the WMFT log performance time from 3.23 (1.70-4.07) to 2.51 (1.36-3.86) and the total score of UEFMA from 48 to 51 (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57) in patients with mild to moderate stroke [13]. The motor function showed significant differences between TMS with the rehabilitation program and TMS on the 7th day of upper extremity postischemic stroke (Table 3).…”

Repetitive Transcranial Magnetic Stimulation (rTMS) Improves the Gait Disorders of Rats Under Simulated Microgravity Conditions Associated With the Regulation of Motor Cortex

“…The first finding is that rTMS can potentially reverse SM-induced weight loss in rats and improve muscle atrophy, however the changes in body weight may have been caused by modeling effects on feeding and excretion in rats ( Pan et al, 2019 ). As for sport-related hindlimb muscles, why did SM cause the Sol to atrophy, but not the MG?…”