Article

OBJECTIVE: To compare the effects of rTMS combined with sensory cueing, rTMS
alone, and conventional rehabilitation on unilateral neglect, hemiplegic arm
functions and performance of activities of daily living.
DESIGN: A single-blinded
randomized controlled trial. SETTING: A convalescent hospital. SUBJECTS: Sixty
inpatients with left unilateral neglect after stroke. INTERVENTIONS: Patients
were randomly assigned to three groups: rTMS combined with sensory cueing, rTMS,
and conventional rehabilitation alone. rTMS at 1 Hz was applied over P5 of the
contralesional hemisphere while vibration cueing was emitted using a wristwatch
device on the hemiplegic arm, five days per week for two weeks. The first two
groups received the same dosage of conventional rehabilitation on top of their
experimental interventions. Blinded assessments were administered at baseline, 2
weeks postintervention, and 6 weeks follow-up. MAIN MEASURES: Neglect and arm
motor performance. RESULTS: Both rTMS combined with sensory cueing (99.6+/-33.0)
and rTMS alone (88.2+/-28.7) significantly reduced unilateral neglect than
conventional rehabilitation (72.7+/-33.1) when measured using the conventional
subtests of the Behavioural Inattention Test, but the combination was better than
rTMS alone. Hemiplegic arm functions and activities of daily living improved in
all patients across the three groups but no significant differences were found
between the groups. CONCLUSION: The combination of inhibitory P5-rTMS with
sensory cueing was better than either rTMS or conventional rehabilitation alone
in producing a stronger and long-lasting improvement in unilateral neglect, but
the improvement was not associated with improved arm function or independence in
activities of daily living.

Langue : ANGLAIS