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Cortical and spinal excitability changes after repetitive transcranial magnetic stimulation combined to physiotherapy in stroke spastic patients
- Publication Year :
- 2019
- Publisher :
- Springer-Verlag Italia s.r.l., 2019.
-
Abstract
- Objective: Repetitive Transcranial Magnetic Stimulation (rTMS) has been used to treat post-stroke upper limb spasticity (ULS) in addition to physiotherapy (PT). To determine whether rTMS associated with PT modulates cortical and spinal cord excitability as well as decreases ULS of post-stroke patients. Methods: Twenty chronic patients were randomly assigned to either the intervention group-1 Hz rTMS on the unaffected hemisphere and PT, or control group-sham stimulation and PT, for ten sessions. Before and after sessions, ULS was measured using the modified Ashworth scale and cortical excitability using the output intensity of the magnetic stimulator (MSO). The spinal excitability was measured by the Hmax/Mmax ratio of the median nerve at baseline, at the end of treatment, and at the 4-week follow-up. Results: The experimental group showed at the end of treatment an enhancement of cortical excitability, i.e., lower values of MSO, compared to control group (p = 0.044) and to baseline (p = 0.028). The experimental group showed a decreased spinal cord excitability at the 4-week follow-up compared to control group (p = 0.021). ULS decreased by the sixth session in the experimental group (p < 0.05). Conclusion: One-hertz rTMS associated with PT increased the unaffected hemisphere excitability, decreased spinal excitability, and reduced post-stroke ULS.
- Subjects :
- Male
medicine.medical_specialty
Neurology
Upper extremity
medicine.medical_treatment
Modified Ashworth scale
Stimulation
Dermatology
03 medical and health sciences
0302 clinical medicine
Double-Blind Method
Physical Therapy Modalitie
Spastic
medicine
Humans
030212 general & internal medicine
Stroke
Physical Therapy Modalities
H-reflex
Aged
business.industry
Stroke Rehabilitation
General Medicine
Middle Aged
Spinal cord
medicine.disease
Combined Modality Therapy
Transcranial Magnetic Stimulation
Transcranial magnetic stimulation
Psychiatry and Mental health
medicine.anatomical_structure
Treatment Outcome
Spinal Cord
Muscle Spasticity
Cortical Excitability
Physical therapy
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Human
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....41c2da05c396a26de9d2a7938c7f4371