Improvement in Paralyzed Upper Limb Function following Two Courses of Low-frequency Repetitive Transcranial Magnetic Stimalation (rTMS) Combined with Intensive Occupational Therapy

• TAMASHIRO Hiroaki

  Nishi-Hiroshima Rehabilitation Hospital

• YAMANE Shingo

  Hiroshima University Institute of Biomedical & Health Sciences

• ANDO Seiichi

  Nishi-Hiroshima Rehabilitation Hospital

• OKAMOTO Takatsugu

  Nishi-Hiroshima Rehabilitation Hospital

• KAKUDA Wataru

  Department of Rehabilitation Medicine, The Jikei University School of Medicine

• ABO Masahiro

  Department of Rehabilitation Medicine, The Jikei University School of Medicine

Bibliographic Information

Other Title

• 「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
• 「 テイヒンド ハンプクセイケイ ズガイ ジキ シゲキ ト シュウチュウテキ サギョウ リョウホウ ノ ヘイヨウ リョウホウ 」 ノ フクスウカイ シコウ ノ コウカ ニ ツイテ

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.

Journal

• The Japanese Journal of Rehabilitation Medicine

  The Japanese Journal of Rehabilitation Medicine 51 (8-9), 555-564, 2014

  The Japanese Association of Rehabilitation Medicine

Keywords

• repetitive transcranial magnetic stimulation
• intensive occupational therapy
• NEURO-15
• upper limb hemiplegia after stroke
• two courses

Details

• CRID: 1390001205273997056
• NII Article ID: 130004687783
• NII Book ID: AN00250275
• DOI: 10.2490/jjrmc.51.555
• ISSN: 18818560
• ISSN: 18813526
• NDL BIB ID: 025775876
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I025775876
• Web Site: https://www.jstage.jst.go.jp/article/jjrmc/51/8-9/51_555/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2014357172
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed