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Randomized Controlled Trial
. 2007 Sep;86(9):707-15.
doi: 10.1097/PHM.0b013e31813e0de0.

Repetitive transcranial magnetic stimulation as an adjunct to constraint-induced therapy: an exploratory randomized controlled trial

Matthew P Malcolm  1 , William J Triggs, Kathye E Light, Leslie J Gonzalez Rothi, Sam Wu, Kimberly Reid, Stephen E Nadeau
Affiliations
Randomized Controlled Trial

Repetitive transcranial magnetic stimulation as an adjunct to constraint-induced therapy: an exploratory randomized controlled trial

Matthew P Malcolm et al. Am J Phys Med Rehabil. 2007 Sep.

Abstract

Objective: To test the potential adjuvant effect of repetitive transcranial magnetic stimulation (rTMS) on motor learning in a group of stroke survivors undergoing constraint-induced therapy (CIT) for upper-limb hemiparesis.

Design: This was a prospective randomized, double-blind, sham-controlled, parallel group study. Nineteen individuals, one or more years poststroke, were randomized to either a rTMS + CIT (n = 9) or a sham rTMS + CIT (n = 10) group and participated in the 2-wk intervention.

Results: Regardless of group assignment, participants demonstrated significant gains on the primary outcome measures: the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL)--Amount of Use, and on secondary outcome measures including the Box and Block Test (BBT) and the MAL--How Well. Participants receiving rTMS failed to show differential improvement on either primary outcome measure.

Conclusions: Although this study provided further evidence that even relatively brief sessions of CIT can have a substantial effect, it provided no support for adjuvant use of rTMS.

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Figures

FIGURE 1
FIGURE 1
Schematic of rTMS set-up. The magnetic stimulating coil was positioned over the motor cortex of the damaged hemisphere and 2000 stimuli were administered as 50 trains of 40 stimuli, stimulus rate of 20 Hz, stimulus train duration of 2 secs, with an intertrain interval of 28 secs. Passive bipolar electromyographic surface electrodes were applied over the FDI for the purpose of monitoring muscle activation during and between stimulations.
FIGURE 2
FIGURE 2
Baseline and change scores, by group, for the Wolf Motor Function Test (WMFT), Motor Activity Log (MAL)–Amount, and Motor Activity Log–How Well. The ordinate for WMFT is in seconds, and the ordinates for MAL–Amount and MAL–How Well are average scale scores.
See this image and copyright information in PMC

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