None listed
Conditions
Brief summary
Background and purpose: Decreased gait performance is one of the functional limitations after stroke. It’s important to establish effective rehabilitation strategies to restore walking function. Repetitive transcranial magnetic stimulation (rTMS) can modulate the excitability of the motor cortex. Some studies showed that combining rTMS with motor training resulted in better improvements in hand function than motor training alone. However, such effects on lower extremity have not been established. The purpose of this study was to investigate effects of combining rTMS with treadmill training on gait performance in chronic stroke patients. Methods: This is a double-blinded randomized control trial. Fourteen participants with chronic stroke were randomly assigned to experimental (n=8) or control group (n=6). Participants in both groups received treadmill training for 30 minitues, 3 times a week for 3 weeks. Before treadmill training, the participants in the experimental group received real rTMS with 5Hz, 10s, 18 trains with total 900 pulses at 90% resting motor threshold for 15 minutes to the ipsilesional primary motor cortex of tibialis anterior (TA) muscle, and the control group received sham rTMS. The outcome measures were collected at pre-training, post-training, and 4 weeks follow-up, including gait velocity, spatial and temporal gait asymmetry index, and electromyography (EMG) of TA and rectus femoris (RF) during walking, lower extremity motor score of Fugl-Meyer Assessment , amplitude of motor evoked potential (MEP)for both hemispheres and brain MEP asymmetry. Friedman test was used to exam within-group improvement at different time points, Mann-Whitney U test was used to exam the differences between groups, and the significant level was set at a=0.05.
Interventions
Fourteen participants with chronic stroke were randomly assigned to experimental (n=8) or control group (n=6). Participants in both groups received treadmill training for 30 minitues, 3 times a week for 3 weeks. The treadmill training started with a 5 minutes warm up session walking at half of participant’s preferred speed. After warm up, the treadmill speed would be increased gradually until the maximum tolerable and safe speed of the participant has been reached. While training, a suspension s
Fourteen participants with chronic stroke were randomly assigned to experimental (n=8) or control group (n=6). Participants in both groups received treadmill training for 30 minitues, 3 times a week for 3 weeks. The treadmill training started with a 5 minutes warm up session walking at half of participant’s preferred speed. After warm up, the treadmill speed would be increased gradually until the maximum tolerable and safe speed of the participant has been reached. While training, a suspension system was used to ensure the safety of the participants, and a physiotherapist would be standing aside to ensure that the participants walked with good posture and appropriate weight transfer using verbal cues. Prior to each treadmill training session, the participants in the experimental group received real repetitive transcranial magnetic stimulation (rTMS) with 5Hz, 10s, 18 trains with total 900 pulses at 90% resting motor threshold for 15 minutes to the ipsilesional primary motor cortex of tibialis anterior (TA) muscle, and the control group received sham rTMS.
Sponsors
Ray-yau, Wang
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
(1) hemiparesis from a single stroke, (2) after stroke period more than 6 month. (3)able to walk independently for 10 meters with or without an assistive device. (4) Stable medical condition to allow participation in the testing protocol
Exclusion criteria
(1) subjects have contraindications of TMS, such as: intracranial metal implants, history of epilepsy or severe heart disease; (2) other non-stroke-related neurological diseases, Such as: cerebellum or vestibular system disease; (3) cognitive dysfunction; (4) muscular system diseases of lower limbs and interfere the walking function.
Outcome results
None listed