Repetitive Transcranial Magnetic Stimulation with Body Weight-supported Treadmill Training Enhances Independent Walking of Individuals with Chronic Incomplete Spinal Cord Injury: A Pilot Randomized Clinical Trial.

IF 2.3 3区 医学 Q3 CLINICAL NEUROLOGY Brain Topography Pub Date : 2024-11-01 Epub Date: 2024-08-20 DOI:10.1007/s10548-024-01072-0
Fernanda Nogueira, Lívia Shirahige, Rodrigo Brito, Hamably Lima, João Victor, María Paz Sanchez, Jocemar Ilha, Katia Monte-Silva
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Abstract

The purpose of this study is to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with body weight-support treadmill training (BWSTT) for improving walking function of individuals with chronic incomplete spinal cord injury (iSCI). A 4-week, double-blinded, randomized, sham-controlled pilot study involved 12 sessions of real (10 Hz, 1800 pulses) or sham rTMS combined with BWSTT (15-20 min, moderate intensity). Walking independence was assessed using the Walking Index for Spinal Cord Injury II (WISCI-II). Lower extremity motor function (lower extremity motor score [LEMS]) and spasticity, sensory function, functional independence (Spinal Cord Injury Measure III [SCIM-III]), and quality of life were also assessed. Walking independence (WISCI-II) after the 6th session was higher in the BWSTT/rTMS real (n = 7) (median change (IQR): 3 (1.5 to 3.5)) than in the sham group (n = 8) (median change (IQR): 0 (0 to 0.25), but there was no difference between groups after 12th session (BWSTT/rTMS real median change (IQR): 4 (2 to 5); BWSSTT/rTMS sham median change (IQR): 0 (0 to 3.25). Compared to baseline, LEMS and SCIM-III mobility scores were increased after 12 sessions in the BWSTT/rTMS real but not in the sham group. Within- and between-group sensory function, functional independence, and quality of life remained similar. This preliminary result suggests that combining BWSTT with rTMS could lead to earlier gait improvement in patients with chronic iSCI.

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重复经颅磁刺激与体重支持跑步机训练可提高慢性不完全脊髓损伤患者的独立行走能力:一项试点随机临床试验。
本研究旨在评估重复经颅磁刺激(rTMS)结合体重支撑跑步机训练(BWSTT)对改善慢性不完全脊髓损伤(iSCI)患者行走功能的疗效。一项为期 4 周的双盲、随机、假对照试验研究包括 12 次真实(10 赫兹、1800 脉冲)或假经频磁刺激结合体重支撑跑步机训练(15-20 分钟,中等强度)。步行独立性采用脊髓损伤步行指数 II (WISCI-II) 进行评估。此外,还对下肢运动功能(下肢运动评分 [LEMS])、痉挛、感觉功能、功能独立性(脊髓损伤测量 III [SCIM-III])和生活质量进行了评估。第六次治疗后,BWSTT/经颅磁刺激真实组(n = 7)的行走独立性(WISCI-II)(中位数变化(IQR):3(1.5 至 3.5))高于假体组(n = 8)(中位数变化(IQR):0(0 至 0.25))。25),但在第 12 次治疗后,组间没有差异(BWSTT/rTMS 真实变化中位数(IQR):4(2 至 5);BWSSTT/rTMS 假变化中位数(IQR):0(0 至 3.25))。与基线相比,BWSTT/rTMS真实组在12次治疗后LEMS和SCIM-III活动度评分有所提高,而假组没有提高。组内和组间的感觉功能、功能独立性和生活质量保持相似。这一初步结果表明,将 BWSTT 与经颅磁刺激相结合可使慢性 iSCI 患者更早地改善步态。
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来源期刊
Brain Topography
Brain Topography 医学-临床神经学
CiteScore
4.70
自引率
7.40%
发文量
41
审稿时长
3 months
期刊介绍: Brain Topography publishes clinical and basic research on cognitive neuroscience and functional neurophysiology using the full range of imaging techniques including EEG, MEG, fMRI, TMS, diffusion imaging, spectroscopy, intracranial recordings, lesion studies, and related methods. Submissions combining multiple techniques are particularly encouraged, as well as reports of new and innovative methodologies.
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