Hand function disorder after stroke G81.9
Conditions
Interventions
Group 1: Stroke patients with mild to moderate hemiparesis receive a 1HzTMS (Transcranial magnetic stimulation) over the contralateral primary motor cortex for 15 minutes
Group 2: Stroke patients with
Sponsors
Vamed Klinik Kipfenberg
Eligibility
Sex/Gender
All
Age
18 Years to 85 Years
Inclusion criteria
Inclusion criteria: - Age of 18 - 85 years - first stroke - Mild to moderate disruption of hand movement
Exclusion criteria
Exclusion criteria: 1. Demential impairment defined by the Minimental Status Examination = 24 (Folstein et al., 1975), 2. Depression defined by the Beck's Depression Inventory <18 (Beck et al., 1996)), 3. Aphasia, apraxia, neglect, or visual impairment 4. Coexisting psychiatric or neurological disorders 5. Consuming diseases or impaired bodily or mental fitness 6. Non-executable persons and persons in official or judicial custody. 7. Contraindications for transcranial magnetic stimulation (electromagnetic body implants, such as any metal implanted in the head (except the mouth), cochlear implants, implanted brain stimulators, ocular implants, aneurysm clips or stents, cardiac pacemakers, cardioverter defibrillators, implanted medication pumps or intracardiac lines, significant heart disease, cerebrovascular disease, hearing loss, history of epilepsy, dementia, head trauma, increased intracranial pressure, or central nervous system (CNS) tumors).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The motor function of both hands is examined with three hand function tests ( "Nine-Hole Peg Test", "Box and Block Test", "Jebsen Taylor Hand Function Test"). The measurements are made before and after the one-time intervention. | — |
Secondary
| Measure | Time frame |
|---|---|
| The cortical hand representation will be probed by transcranial magnetic stimulation with a stimulation intensity of 110% of the resting motor threshold The stimulation coil is shifted over the skull overlying the primary motor cortex in steps of one centimeter. In each position 5 pulses are applied. The position is defined as "active" when an identifiable MEP (=50 µV) can be triggered in a relaxed contralateral hand muscle with at least 2 (of 5) passages. From this data, the size, the extent and the position of the cortical hand representation are calculated. The motor resting treshold is re-determined for each patient at each test time. It is defined as the lowest stimulator output intensity that can trigger an identifiable motor response potential (MEP) of =50 µV (at a stimulation of the optimal stimulus location) in a relaxed contralateral hand muscle, at least 50% of the passages. For testing the cortical excitability, a commercially available magnetic stimulator with a butterfly coil is used (Magstim Company, Dyfed, UK). The electromyographic activity is measured by two electrodes (belly tendon montage). The coil is positioned over the motor representation of the first interosseous dorsal muscle with an orientation of 45 ° to the sagittal. Two tests of cortical excitability are performed: a test of the motor rest and a test of the cortical hand representation. The measurements are made before and after the one-time intervention. | — |
Countries
Germany
Contacts
Public ContactKathrin Bösl
VAMED Klinik Kipfenberg
Outcome results
None listed