Article

OBJECTIVE: To investigate whether multiple sessions of 1-Hz repetitive
transcranial magnetic stimulation (rTMS) facilitates the effect of repetitive
facilitation exercises on hemiplegic upper-limb function in chronic stroke
patients. DESIGN: Randomized double-blinded crossover study. PATIENTS: Eighteen
patients with hemiplegia of the upper limb. METHODS: Patients were assigned to 2
groups: a motor-before-sham rTMS group, which performed motor rTMS sessions for 2
weeks followed by sham rTMS sessions for 2 weeks; or a motor-following-sham rTMS
group, which performed sham rTMS sessions for 2 weeks followed by motor rTMS
sessions for 2 weeks. Patients received 1-Hz rTMS to the unaffected motor cortex
for 4 min and performed repetitive facilitation exercises for 40 min during motor
rTMS sessions. The Fugl-Meyer Assessment, Action Research Arm Test (ARAT) and
Simple Test for Evaluating Hand Function were used to evaluate upper-limb
function. The Modified Ashworth Scale and F-wave were measured to evaluate
spasticity. RESULTS: Motor function improved significantly during the motor, but
not sham, rTMS sessions. ARAT score gains were 1.5 (0-4.0) (median, interquartile
range) during the motor rTMS session, and 0 (-0.8-1.8) during the sham rTMS
session (p = 0.04). Spasticity did not significantly change during either
session. Conclusion: Multiple sessions of 1-Hz rTMS facilitated the effects of
repetitive facilitation exercises in improving motor function of the affected
upper limb, but did not change spasticity.

Langue : ANGLAIS