Intermittent theta burst stimulation of the cerebellum can improve the walking of stroke survivors with lower limb dysfunction
10.3760/cma.j.issn.0254-1424.2024.03.007
- VernacularTitle:小脑间歇性θ脉冲刺激对脑卒中后下肢功能障碍患者步行功能的影响
- Author:
Qing KONG
1
;
Zhuangli GUO
;
Chengfei GAO
;
Xiqin LIU
;
Chuanjian YI
Author Information
1. 青岛大学附属医院康复医学科，青岛 266003
- Keywords:
Theta burst stimulation;
Cerebellum;
Lower limb dysfunction;
Stroke
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2024;46(3):226-231
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe any effect of intermittent theta burst stimulation (iTBS) of a cerebellar hemisphere on the walking of stroke survivors with lower limb dysfunction, and to explore its possible mechanism.Methods:Thirty stroke survivors with walking dysfunction were randomly divided into an experimental group and a control group, each of 15. Before their daily routine rehabilitation, the control group received fake iTBS while the experimental group was given 600 pulses of iTBS over 200s. The experiment continued 5 days a week for 3 weeks. The Berg Balance Scale (BBS), the Fugl-Meyer lower extremity assessment (FMA-LE), the Modified Barthel Index (MBI) and Functional Ambulation Categories (FAC) were used before and after the treatment to evaluate the subjects′ balance, lower extremity motor function, walking and ability in the activities of daily living. Gait analysis was also performed. The amplitude of motor evoked potentials (MEPs) and the cortical silent period (CSP) were also noted to assess corticospinal excitability.Results:After the treatment, the average BBS, FMA-LE and MBI scores, FAC grading, stride length, stride speed, stride frequency, and the percentage of swing period in the walking cycle, as well as MEP amplitude and latency had improved significantly in the experimental group. All were then significantly better, on average, than in the control group. The control group also demonstrated significant improvement in all of the outcomes except the percentage of swing period in the walking cycle.Conclusion:iTBS of the cerebellum can improve the walking of stroke survivors with lower limb dysfunction. The mechanism may be related to the cerebellar regulation of spinal cord excitation of the cerebral cortex.
