Article

Although much research has been done on repetitive transcranial magnetic
stimulation (rTMS) in chronic stroke, only sparse research has been done in acute
stroke despite the particularly rich potential for neuroplasticity in this stage.
We attempted a preliminary clinical trial in one active, high-quality inpatient
rehabilitation facility (IRF) in the -United States. But after enrolling only 4
patients in the grant period, the study was stopped because of low enrollment.
The purpose of this paper is to offer a perspective describing the important
physiologic rationale for including rTMS in the early phase of stroke, the
reasons for our poor patient enrollment in our attempted study, and
recommendations to help future studies succeed. We conclude that, if scientists
and clinicians hope to enhance stroke outcomes, more attention must be directed
to leveraging conventional rehabilitation with neuromodulation in the acute phase
of stroke when the capacity for neuroplasticity is optimal. Difficulties with
patient enrollment must be addressed by reassessing traditional inclusion and
exclusion criteria. Factors that shorten patients' length of stay in the IRF must
also be reassessed at all policy-making levels to make ethical decisions that
promote higher functional outcomes while retaining cost consciousness.
CI - (c) 2017 American Physical Therapy Association.

Langue : ANGLAIS