Priming constraint-induced movement therapy with intermittent theta burst stimulation to enhance upper extremity recovery in patients with stroke: protocol for a randomized controlled study
- 8 February 2024
- journal article
- research article
- Published by Springer Nature in Acta Neurologica Belgica
- Vol. 124 (3) , 887-893
Abstract
Background The treatments based on motor control and motor learning principles have gained popularity in the last 20 years, as well as non-invasive brain stimulations that enhance neuroplastic changes after stroke. However, the effect of intermittent theta burst stimulation (iTBS) in addition to evidence-based, intensive neurorehabilitation approaches such as modified constraint-induced movement therapy (mCIMT) is yet to be investigated. Aim We aim to establish a protocol for a randomized controlled study investigating the efficiency of mCIMT primed with iTBS after stroke. Methods In this randomized controlled, single-blind study, patients with stroke (N = 17) will be divided into 3 groups: (a) mCIMT + real iTBS, (b) mCIMT + sham iTBS, and (c) mCIMT alone. 600-pulse iTBS will be delivered to the primary motor cortex on the ipsilesional hemisphere, and then, patients will receive mCIMT for 1 h/session, 3 sessions/week for 5 weeks. Upper extremity recovery will be assessed with Fugl-Meyer Test-Upper Extremity and Wolf Motor Function Test. Electrophysiological assessments, such as Motor-Evoked Potentials, Resting Motor Threshold, Short-Intracortical Inhibition, and Intracortical Facilitation, will also be included. Conclusions In this study, a protocol of an ongoing intervention study investigating the effectiveness of iTBS on ipsilesional M1 prior to the mCIMT in patients with stroke is proposed. This will be the first study to research priming mCIMT with iTBS and it may have the potential to reveal the true effect of the iTBS when it is added to the high-quality neurorehabilitation approaches. Trial registration Trial registration number: NCT05308667Keywords
This publication has 44 references indexed in Scilit:
- An Updated Definition of Stroke for the 21st CenturyStroke, 2013
- The Cochrane Collaboration's tool for assessing risk of bias in randomised trialsBMJ, 2011
- Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and researchClinical Neurophysiology, 2009
- Responsiveness and Validity of Three Outcome Measures of Motor Function After Stroke RehabilitationStroke, 2009
- Motor cortex rTMS restores defective intracortical inhibition in chronic neuropathic painNeurology, 2006
- The Motor Activity Log-28Neurology, 2006
- A Sham-Controlled Trial of a 5-Day Course of Repetitive Transcranial Magnetic Stimulation of the Unaffected Hemisphere in Stroke PatientsStroke, 2006
- Theta Burst Stimulation of the Human Motor CortexNeuron, 2005
- The reliability of the Wolf Motor Function Test for assessing upper extremity function after strokeArchives of Physical Medicine and Rehabilitation, 2001
- Preferential activation of different I waves by transcranial magnetic stimulation with a figure-of-eight-shaped coilExperimental Brain Research, 1997