NMES with rTMS for moderate to severe dysfunction after stroke

Article type: Research Article

Authors: Koyama, Soichiro^a | Tanabe, Shigeo^{b; *} | Warashina, Hiroaki^a | Kaneko, Tomoaki^a | Sakurai, Hiroaki^b | Kanada, Yoshikiyo^b | Nagata, Junji^c | Kanno, Tetsuo^c

Affiliations: [a] Department of Rehabilitation, Kawamura Hospital, Gifu, Japan | [b] Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan | [c] Department of Neurosurgical, Kawamura Hospital, Gifu, Japan

Correspondence: [*] Address for correspondence: Shigeo Tanabe, 98-1 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan. Tel.: +81 562 93 9000; Fax: +81 562 95 6817; E-mail: [email protected]

Abstract: Background:Motor dysfunction after stroke might be improved by neuromuscular electrical stimulation (NMES) combined with 1 Hz repetitive transcranial magnetic stimulation (rTMS) in patients with moderate and severe motor dysfunction. Objective:This preliminary study tested the effect of this treatment combination. Methods:Fifteen patients (60.5 ± 10.3 years old) participated in the study. All patients had been affected by cerebral artery infarction or hemorrhage and had moderate or severe motor dysfunction in their affected hand. The patients received NMES at paretic wrist extensor muscles combined with rTMS over the unaffected M1 hemisphere twice a day, six days/week over two weeks. All participants underwent the following battery of tests to evaluate the motor function of the affected hand: Upper limb Fugl-Meyer Assessment (UFMA), Wolf Motor Function Test (WMFT), and Box and Block Test (BBT). Results:UFMA, WMFT, and BBT scores improved significantly after the study. Conclusions:These results suggest that NMES combined with rTMS could be useful for recovery of moderate and severe motor function after stroke.

Keywords: Neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation, severe stroke patients

DOI: 10.3233/NRE-141127

Journal: NeuroRehabilitation, vol. 35, no. 3, pp. 363-368, 2014