Effect of Combined Low-frequency Repetitive Transcranial Magnetic Stimulation and Virtual Reality Training on Upper Limb Function in Subacute Stroke：a Double-blind Randomized Controlled Trail

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences Vol. 35; no. 2; pp. 248 - 254
• Main Author: 郑婵娟 廖维靖 夏文广
• Format: Journal Article
• Language: English
• Published: Heidelberg Huazhong University of Science and Technology 01.04.2015; Department of Physical Medicine and Rehabilitation, Hubei Xinhua Hospital, Wuhan 430015, China%Department of Physical Medicine and Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan 430071, China%Department of Physical Medicine and Rehabilitation, Hubei Xinhua Hospital, Wuhan 430015, China; Department of Physical Medicine and Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
• Subjects: Aged; Arm - physiopathology; Double-Blind Method; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Prospective Studies; Stroke - physiopathology; Stroke - therapy; Transcranial Magnetic Stimulation; Virtual Reality Exposure Therapy; 上肢; 中风; 亚急性; 低频; 经颅磁刺激; 虚拟现实; 训练; 随机对照试验; low-frequency repetitive transcranial magnetic stimulation; stroke; virtual reality training
• ISSN: 1672-0733; 1993-1352
• DOI: 10.1007/s11596-015-1419-0

The effect of combined low-frequency repetitive transcranial magnetic stimulation（LF r TMS） and virtual reality（VR） training in patients after stroke was assessed. In a double-blind randomized controlled trial, 112 patients with hemiplegia after stroke were randomly divided into two groups： experimental and control. In experimental group, the patients received LF r TMS and VR training treatment, and those in control group received sham r TMS and VR training treatment. Participants in both groups received therapy of 6 days per week for 4 weeks. The primary endpoint including the upper limb motor function test of Fugl-meyer assessment（U-FMA） and wolf motor function test（WMFT）, and the secondary endpoint including modified Barthel index（MBI） and 36-item Short Form Health Survey Questionnaire（SF-36） were assessed before and 4 weeks after treatment. Totally, 108 subjects completed the study（55 in experimental group and 53 in control group respectively）. After 4-week treatment, the U-FMA scores [mean difference of 13.2, 95% confidence interval（CI） 3.6 to 22.7, P〈0.01], WMFT scores（mean difference of 2.9, 95% CI 2.7 to 12.3, P〈0.01）, and MBI scores（mean difference 16.1, 95% CI 3.8 to 9.4, P〈0.05） were significantly increased in the experimental group as compared with the control group. The results suggested the combined use of LF r TMS with VR training could effectively improve the upper limb function, the living activity, and the quality of life in patients with hemiplegia following subacute stroke, which may provide a better rehabilitation treatment for subacute stroke.