Article

Incomplete spinal cord injury (SCI) patients have the potential to
regain some ambulatory function, and optimal reorganization of remaining circuits
can contribute to this recovery. We hypothesized that repetitive transcranial
magnetic stimulation (rTMS) may promote active recovery of motor function during
gait rehabilitation. METHODS: A total of 17 incomplete SCI patients were
randomized to receive active rTMS or sham stimulation coupled with rehabilitation
therapy; 3 patients who began in the sham group crossed over to the active rTMS
group after a washout period of more than 3 weeks. Active rTMS consisted of 15
daily sessions over the leg motor area (at 20 Hz). We compared lower-extremity
motor score (LEMS), 10-m walking test for walking speed, timed up and go, Walking
Index for SCI Scale, Modified Ashworth Scale, and Spinal Cord Injury Spasticity
Evaluation Tool at baseline, after the last session, and 2 weeks later in the
active rTMS and sham stimulation groups. RESULTS:
A significant improvement was
observed after the last rTMS session in the active group for LEMS, walking speed,
and spasticity. Improvement in walking speed was maintained during the follow-up
period. Sham stimulation did not induce any improvement in LEMS, gait assessment,
and spasticity after the last session and neither during follow-up. CONCLUSION:
In incomplete SCI, 15 daily sessions of high-frequency rTMS can improve motor
score, walking speed, and spasticity in the lower limbs.
The study provides
evidence for the therapeutic potential of rTMS in the lower extremities in SCI
rehabilitation.

Langue : ANGLAIS