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Randomized Controlled Trial
. 2024 Apr 8;21(1):49.
doi: 10.1186/s12984-024-01341-w.

Synergistic efficacy of repetitive peripheral magnetic stimulation on central intermittent theta burst stimulation for upper limb function in patients with stroke: a double-blinded, randomized controlled trial

Chi-Shou Chang  1   2 , Chia-Ling Chen  3   4   5 , Rou-Shayn Chen  2   6   7 , Hsieh-Ching Chen  8 , Chung-Yao Chen  2   9 , Chia-Ying Chung  10   11 , Katie Pei-Hsuan Wu  10   12 , Ching-Yi Wu  10   13 , Keh-Chung Lin  14   15
Affiliations
Randomized Controlled Trial

Synergistic efficacy of repetitive peripheral magnetic stimulation on central intermittent theta burst stimulation for upper limb function in patients with stroke: a double-blinded, randomized controlled trial

Chi-Shou Chang et al. J Neuroeng Rehabil. .

Abstract

Background: Non-invasive techniques such as central intermittent theta burst stimulation (iTBS) and repetitive peripheral magnetic stimulation (rPMS) have shown promise in improving motor function for patients with stroke. However, the combined efficacy of rPMS and central iTBS has not been extensively studied. This randomized controlled trial aimed to investigate the synergistic effects of rPMS and central iTBS in patients with stroke.

Method: In this study, 28 stroke patients were randomly allocated to receive either 1200 pulses of real or sham rPMS on the radial nerve of the affected limb, followed by 1200 pulses of central iTBS on the ipsilesional hemisphere. The patients received the intervention for 10 sessions over two weeks. The primary outcome measures were the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and the Action Research Arm Test (ARAT). Secondary outcomes for activities and participation included the Functional Independence Measure-Selfcare (FIM-Selfcare) and the Stroke Impact Scale (SIS). The outcome measures were assessed before and after the intervention.

Results: Both groups showed significant improvement in FMA-UE and FIM-Selfcare after the intervention (p < 0.05). Only the rPMS + iTBS group had significant improvement in ARAT-Grasp and SIS-Strength and activity of daily living (p < 0.05). However, the change scores in all outcome measures did not differ between two groups.

Conclusions: Overall, the study's findings suggest that rPMS may have a synergistic effect on central iTBS to improve grasp function and participation. In conclusion, these findings highlight the potential of rPMS as an adjuvant therapy for central iTBS in stroke rehabilitation. Further large-scale studies are needed to fully explore the synergistic effects of rPMS on central iTBS.

Trial registration: This trial was registered under ClinicalTrials.gov ID No.NCT04265365, retrospectively registered, on February 11, 2020.

Keywords: Motor function; Participation; Peripheral magnetic stimulation; Rehabilitation; Stroke; Theta burst stimulation; Upper limb.

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Conflict of interest statement

There are no competing interests among the authors, Chang Gung Medical Foundation and Ministry of Science and Technology.

Figures

Fig. 1
Fig. 1
Flow diagram of recruitment and randomized allocation
Fig. 2
Fig. 2
Experimental protocol
See this image and copyright information in PMC

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