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Posted by on Jan 23, 2021 in Stroke | 0 comments

In a nutshell

This study investigated the effect of intermittent theta-burst stimulation (iTBS) in the cerebellum area in combination with physiotherapy (PT) in patients after stroke.

The study found that iTBS, combined with PT, can promote the recovery of movement and balance after stroke. 

Some background

A stroke causes damage in the brain area affected by a temporary blockage or a burst blood vessel. This starves brain cells of blood and oxygen and leads to severe symptoms like hemiparesis. Hemiparesis describes a muscle-weakness in one side of the body. It leads to limited movement. This, in turn, often causes the patients’ balance to be affected. Affected balance can lead to trips and falls with severe injuries. Because of this, it is one of the main goals to restore movement and balance during stroke rehabilitation. 

The part of the brain co-responsible for movement and balance is the cerebellum located in the back of the brain. It works like the rest of the brain by transmitting electric impulses. After a stroke, this transmission is affected. iTBS stimulates this area in intervals with magnetic impulses to rebuild the function of the cerebellum. Additionally, PT is a standard part of stroke rehabilitation to work on regaining balance and movement functions. 

Previous data suggest that iTBS may improve rehabilitation outcomes in stroke patients. However, the effectiveness of iTBS plus PT is unknown.  

Methods & findings

This study included 30 patients with more than 2 weeks after a stroke. All patients had signs of hemiparesis. All patients received PT five times per week for two weeks. One group (15 patients) received iTBS in the area of the cerebellum daily immediately before PT. For the second group, the researchers executed the same sequences of movement as if they were to apply iTBS without actually turning on the device (control group). Each PT session was 50 minutes long and consisted of exercises for trunk control and balance exercises specifically for stroke patients. Patients were evaluated before the study and after 1 and 2 weeks.

Overall, all scores regarding movement and balance improved significantly in both groups. However, the iTBS-group showed a greater improved in scores of balance compared to the control group.

The bottom line

The authors recommend using iTBS and PT to build an effective, low-cost, and efficient treatment program for patients after stroke. 

The fine print

The number of patients in this study was small. A follow-up time of two weeks is short. Long-term effects need to be determined. 

What’s next?

Ask your doctor about iTBS and PT and their compatibility with your treatment.

Published By :

Neurorehabilitation and neural repair

Date :

Nov 09, 2020

Original Title :

Cerebellar Theta-Burst Stimulation Combined With Physiotherapy in Subacute and Chronic Stroke Patients: A Pilot Randomized Controlled Trial.

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