Theta burst stimulation in the rehabilitation of the upper limb: a semirandomized, placebo-controlled trial in chronic stroke patients.
BACKGROUND: Noninvasive cortical stimulation could represent an add-on treatment to enhance motor recovery after stroke. However, its clinical value, including anticipated size and duration of the treatment effects, remains largely unknown. OBJECTIVE: The authors designed a small semi-randomized cl...
| Päätekijät: | , , , , , , , , , , , , , , , , , , |
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| Aineistotyyppi: | Journal article |
| Kieli: | English |
| Julkaistu: |
2012
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| _version_ | 1826268221254139904 |
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| author | Talelli, P Wallace, A Dileone, M Hoad, D Cheeran, B Oliver, R VandenBos, M Hammerbeck, U Barratt, K Gillini, C Musumeci, G Boudrias, M Cloud, G Ball, J Marsden, J Ward, N Di Lazzaro, V Greenwood, R Rothwell, J |
| author_facet | Talelli, P Wallace, A Dileone, M Hoad, D Cheeran, B Oliver, R VandenBos, M Hammerbeck, U Barratt, K Gillini, C Musumeci, G Boudrias, M Cloud, G Ball, J Marsden, J Ward, N Di Lazzaro, V Greenwood, R Rothwell, J |
| author_sort | Talelli, P |
| collection | OXFORD |
| description | BACKGROUND: Noninvasive cortical stimulation could represent an add-on treatment to enhance motor recovery after stroke. However, its clinical value, including anticipated size and duration of the treatment effects, remains largely unknown. OBJECTIVE: The authors designed a small semi-randomized clinical trial to explore whether long-lasting clinically important gains can be achieved by adding theta burst stimulation (TBS), a form of repetitive transcranial magnetic stimulation (TMS), to a rehabilitation program for the hand. METHODS: A total of 41 chronic stroke patients received excitatory TBS to the ipsilesional hemisphere or inhibitory TBS to the contralesional hemisphere in 2 centers; each active group was compared with a group receiving sham TBS. TBS was followed by physical therapy for 10 working days. Patients and therapists were blinded to the type of TBS. Primary outcome measures (9-hole Peg Test [9HPT], Jebsen Taylor Test [JTT], and grip and pinch-grip dynamometry) were assessed 4, 30, and 90 days post treatment. The clinically important difference was defined as 10% of the maximum score. RESULTS: There were no differences between the active treatment and sham groups in any of the outcome measures. All patients achieved small sustainable improvements--9HPT, 5% of maximum (confidence interval [CI] = 3%-7%); JTT, 5.7% (CI = 3%-8%); and grip strength, 6% (CI = 2%-10%)--all below the defined clinically important level. CONCLUSIONS: Cortical stimulation did not augment the gains from a late rehabilitation program. The effect size anticipated by the authors was overestimated. These results can improve the design of future work on therapeutic uses of TMS. |
| first_indexed | 2024-03-06T21:06:20Z |
| format | Journal article |
| id | oxford-uuid:3c99008b-3d15-43e4-b3bc-8921e632b1a2 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:06:20Z |
| publishDate | 2012 |
| record_format | dspace |
| spelling | oxford-uuid:3c99008b-3d15-43e4-b3bc-8921e632b1a22022-03-26T14:14:30ZTheta burst stimulation in the rehabilitation of the upper limb: a semirandomized, placebo-controlled trial in chronic stroke patients.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3c99008b-3d15-43e4-b3bc-8921e632b1a2EnglishSymplectic Elements at Oxford2012Talelli, PWallace, ADileone, MHoad, DCheeran, BOliver, RVandenBos, MHammerbeck, UBarratt, KGillini, CMusumeci, GBoudrias, MCloud, GBall, JMarsden, JWard, NDi Lazzaro, VGreenwood, RRothwell, J BACKGROUND: Noninvasive cortical stimulation could represent an add-on treatment to enhance motor recovery after stroke. However, its clinical value, including anticipated size and duration of the treatment effects, remains largely unknown. OBJECTIVE: The authors designed a small semi-randomized clinical trial to explore whether long-lasting clinically important gains can be achieved by adding theta burst stimulation (TBS), a form of repetitive transcranial magnetic stimulation (TMS), to a rehabilitation program for the hand. METHODS: A total of 41 chronic stroke patients received excitatory TBS to the ipsilesional hemisphere or inhibitory TBS to the contralesional hemisphere in 2 centers; each active group was compared with a group receiving sham TBS. TBS was followed by physical therapy for 10 working days. Patients and therapists were blinded to the type of TBS. Primary outcome measures (9-hole Peg Test [9HPT], Jebsen Taylor Test [JTT], and grip and pinch-grip dynamometry) were assessed 4, 30, and 90 days post treatment. The clinically important difference was defined as 10% of the maximum score. RESULTS: There were no differences between the active treatment and sham groups in any of the outcome measures. All patients achieved small sustainable improvements--9HPT, 5% of maximum (confidence interval [CI] = 3%-7%); JTT, 5.7% (CI = 3%-8%); and grip strength, 6% (CI = 2%-10%)--all below the defined clinically important level. CONCLUSIONS: Cortical stimulation did not augment the gains from a late rehabilitation program. The effect size anticipated by the authors was overestimated. These results can improve the design of future work on therapeutic uses of TMS. |
| spellingShingle | Talelli, P Wallace, A Dileone, M Hoad, D Cheeran, B Oliver, R VandenBos, M Hammerbeck, U Barratt, K Gillini, C Musumeci, G Boudrias, M Cloud, G Ball, J Marsden, J Ward, N Di Lazzaro, V Greenwood, R Rothwell, J Theta burst stimulation in the rehabilitation of the upper limb: a semirandomized, placebo-controlled trial in chronic stroke patients. |
| title | Theta burst stimulation in the rehabilitation of the upper limb: a semirandomized, placebo-controlled trial in chronic stroke patients. |
| title_full | Theta burst stimulation in the rehabilitation of the upper limb: a semirandomized, placebo-controlled trial in chronic stroke patients. |
| title_fullStr | Theta burst stimulation in the rehabilitation of the upper limb: a semirandomized, placebo-controlled trial in chronic stroke patients. |
| title_full_unstemmed | Theta burst stimulation in the rehabilitation of the upper limb: a semirandomized, placebo-controlled trial in chronic stroke patients. |
| title_short | Theta burst stimulation in the rehabilitation of the upper limb: a semirandomized, placebo-controlled trial in chronic stroke patients. |
| title_sort | theta burst stimulation in the rehabilitation of the upper limb a semirandomized placebo controlled trial in chronic stroke patients |
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