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Application of combined 6-Hz primed low-frequency rTMS and intensive occupational therapy for upper limb hemiparesis after stroke

KAKUDA W; ABO M; KOBAYASHI K; MOMOSAKI R; YOKOI S; FUKUDA H; UMEMORI T
NEUROREHABILITATION , 2011, vol. 29, n° 4, p. 365-371
Doc n°: 160203
Localisation : Centre de Réadaptation de Lay St Christophe

D.O.I. : http://dx.doi.org/DOI:10.3233/NRE-2011-0714
Descripteurs : KB1 - TECHNIQUES D'ERGOTHERAPIE, DD16 - TRAITEMENTS - MEMBRE SUPERIEUR, AF21 - ACCIDENTS VASCULAIRES CEREBRAUX

The purpose of this study was to clarify the safety, feasibility
and efficacy of 6-Hz primed low-frequency repetitive transcranial magnetic
stimulation (rTMS) applied with intensive occupational therapy (OT) for upper
limb hemiparesis after stroke. SUBJECTS AND METHODS: Eleven patients with history
of stroke and upper limb hemiparesis (age at intervention: 61.0 +/- 13.7 years,
time after stroke onset: 70.2 +/- 39.8 months) were studied. Each patient
received 22 sessions of 6-Hz primed low-frequency rTMS (10-min 6-Hz priming
stimulation followed by 20-min low-frequency rTMS of 1-Hz) applied to the
non-lesional hemisphere plus intensive OT comprising 60-min one-to-one training
and 60-min self-training during 15-day hospitalization. The motor function of the
affected upper limb was evaluated by Fugl-Meyer Assessment (FMA) and Wolf Motor
Function Test (WMFT) on the days of admission and discharge. RESULTS: All
patients completed the 15-day protocol without any adverse effects. The treatment
increased the FMA score (from 42.2 +/- 6.9 to 45.6 +/- 7.2 points, p< 0.005) and
shortened the log performance time of WMFT (from 3.26 +/- 1.21 to 2.81 +/- 1.26
sec, p< 0.05). CONCLUSIONS: The 15-day protocol of 6-Hz primed low-frequency rTMS
combined with intensive OT seems safe and a potentially useful therapeutic
modality for upper limb hemiparesis after stroke.

Langue : ANGLAIS

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