医学
随机对照试验
运动功能
冲程(发动机)
康复
运动障碍
试点试验
物理医学与康复
神经影像学
物理疗法
并发症
外科
精神科
机械工程
工程类
作者
Zhiqing Tang,Jianting Huang,Ying Zhou,Jianxun Ren,Xinyu Duan,Xiaoxuan Fu,Ruiqi Pan,Rongrong Wang,Ping Zhang,Mengying Ding,Jian Sun,Xiaonian Zhang,Qianqian Chi,Yue Zhang,Xin Zhang,Weiyong Yu,Xu Liu,Hao Zhang,Hesheng Liu
出处
期刊:Stroke
[Lippincott Williams & Wilkins]
日期:2024-07-17
卷期号:55 (9): 2212-2220
被引量:21
标识
DOI:10.1161/strokeaha.124.046597
摘要
BACKGROUND: Upper extremity (UE) motor function impairment is a major poststroke complication whose recovery remains one of the most challenging tasks in neurological rehabilitation. This study examined the efficacy and safety of the personalized neuroimaging–guided high-dose theta-burst stimulation (TBS) for poststroke UE motor function recovery. METHODS: Patients after stroke with UE motor impairment from a China rehabilitation center were randomly assigned to receive high-dose intermittent TBS (iTBS) to ipsilesional UE sensorimotor network, continuous TBS (cTBS) to contralesional UE sensorimotor network, or sham stimulation, along with conventional therapy for 3 weeks. The primary outcome was the score changes on the Fugl-Meyer assessment-UE from baseline to 1 and 3 weeks. The secondary outcomes included the response rate on Fugl-Meyer assessment-UE scores posttreatment (≥9-point improvement) and score changes in multidimensional scales measuring UE, lower extremity, and activities and participation. RESULTS: From June 2021 to June 2022, 45 participants were randomized and 43 were analyzed. The iTBS and continuous TBS groups showed significantly greater improvement in Fugl-Meyer assessment-UE (mean improvement, iTBS: 10.73 points; continuous TBS: 10.79 points) than the sham group (2.43 points) and exhibited significantly greater response rates on Fugl-Meyer assessment-UE (iTBS, 60.0%; continuous TBS, 64.3%) than the sham group (0.0%). The active groups consistently exhibited superior improvement on the other 2 UE assessments at week 3. However, only the iTBS group showed greater efficacy on 1 lower extremity assessment than the sham group at week 3. Both active groups showed significant improvements in activities and participation assessments. CONCLUSIONS: The study provides evidence for the efficacy and safety of high-dose TBS in facilitating poststroke UE rehabilitation. REGISTRATION: URL: www.chictr.org.cn ; Unique identifier: ChiCTR2100047340.
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