Improvement in Paralyzed Upper Limb Function following Two Courses of Low-frequency Repetitive Transcranial Magnetic Stimalation (rTMS) Combined with Intensive Occupational Therapy
10.2490/jjrmc.51.555
- VernacularTitle:「低頻度反復性経頭蓋磁気刺激と集中的作業療法の併用療法」の複数回施行の効果について
- Author:
Hiroaki TAMASHIRO
;
Shingo YAMANE
;
Seiichi ANDO
;
Takatsugu OKAMOTO
;
Wataru KAKUDA
;
Masahiro ABO
- Publication Type:Journal Article
- Keywords:
repetitive transcranial magnetic stimulation;
intensive occupational therapy;
NEURO-15;
upper limb hemiplegia after stroke;
two courses
- From:The Japanese Journal of Rehabilitation Medicine
2014;51(8-9):555-564
- CountryJapan
- Language:Japanese
-
Abstract:
Background : Both low-frequency repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) have been recently reported to be clinically beneficial for post-stroke patients with upper limb hemiparesis. We have already reported that the function of the paralyzed upper limb in the post-stroke hemiplegic patients was improved after a 15-day hospitalization protocol, named NEURO-15. In this present study, we investigated whether two courses (2X) of NEURO-15 were superior to a single one in therapeutic efficacy. Methods: During NEURO-15, each patient was scheduled to receive 21 treatment sessions of 20-min low-frequency rTMS followed by 120-min intensive OT daily. Low-frequency pulses of 1 Hz were applied to the motor cortex of the nonlesional hemisphere. Fugl-Meyer Assessment (FMA), log performance time of the Wolf Motor Function Test (WMFT) and modified Ashworth Scale (MAS) were evaluated on the days of admission and discharge. The first NEURO-15 was given to 16 apoplectic hemiplegic patients whose Brunnstrom Recovery Stage in their fingers ranged from IV to V. After an average of 13.6 months, the second NEURO-15 was administered to all 16 patients. Results : The 2X protocol was completed by all patients without any adverse effects. After the first course of NEURO-15, all patients showed improvement in their paralyzed upper limb function ; improvements which remained until the second NEURO-15 course. The second NEURO-15 course yielded even further improvement in the paralyzed upper limb function. Conclusions : Our proposed combination treatment is a safe, feasible, and clinically useful neurorehabilitative intervention for post-stroke patients with upper limb hemiparesis when administered as both a single application or as a 2X protocol. The effectiveness of the 2X protocol or even more frequent application of NEURO-15 courses needs to be further explored.
