Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, April 27, 2026

Comparative efficacy of motor imagery augmented with central non-invasive brain stimulation versus peripheral electrical stimulation for upper extremity rehabilitation post-stroke: a systematic review and network meta-analysis

 So, our fuckingly incompetent stroke medical 'professionals' STILL HAVEN'T WRITTEN ANY PROTOCOLS TO GET SURVIVORS RECOVERED! WOW! This was totally useless research then! Hope you blithering idiots like not recovering when you become the 1 in 4 per WHO that has a stroke!

And you've known of motor imagery for HOW LONG AND DONE NOTHING?


Comparative efficacy of motor imagery augmented with central non-invasive brain stimulation versus peripheral electrical stimulation for upper extremity rehabilitation post-stroke: a systematic review and network meta-analysis

    We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

    Abstract

    Background

    Upper limb dysfunction is a common and debilitating consequence of stroke, severely affecting patients’ activities of daily living and quality of life. Motor imagery (MI) has emerged as a promising rehabilitation technique, and its combination with various forms of non-invasive stimulation, both central (e.g., repetitive transcranial magnetic stimulation, rTMS; transcranial direct current stimulation, tDCS) and peripheral (e.g., functional electrical stimulation, FES), has been increasingly investigated. While previous meta-analyses have confirmed the general benefit of combined interventions, the relative efficacy of different MI-based combination strategies remains unclear. This systematic review and network meta-analysis aimed to directly and indirectly compare the effectiveness of MI augmented with different non-invasive central or peripheral stimulation modalities for upper extremity recovery post-stroke.

    Methods

    We registered the study on PROSPERO (CRD420251131264) and followed the PRISMA guidelines. Randomized controlled trials (RCTs) were searched in PubMed, Cochrane Library, EMBASE, Scopus, CNKI, and Wanfang databases from inception until August 4, 2025. The included RCTs involved adult stroke patients with upper limb dysfunction receiving MI combined with any non-invasive stimulation. The primary outcome was the change in upper limb motor function measured by the Fugl-Meyer Assessment (FMA or FMA-UE). A frequentist network meta-analysis was performed using random-effects models. Risk of bias was assessed using the Cochrane RoB 2 tool. Subgroup, sensitivity, and meta-regression analyses were conducted to explore heterogeneity.

    Results

    Seventeen RCTs involving 846 participants were included in the systematic review, with 13 studies forming the network for meta-analysis, comparing 9 intervention strategies. Network meta-analysis for the FMA outcome showed that MI combined with low-frequency rTMS (MI-LF-rTMS) showed a statistically significant difference compared to conventional rehabilitation alone (Standardized Mean Difference, SMD = 1.755, 95% CI 0.631 to 2.879, p = 0.002). No other intervention, including MI-tDCS, MI-FES, or any single therapy, showed a statistically significant difference compared to conventional rehabilitation. MI-LF-rTMS also showed a statistically significant difference in upper limb functional activity (Action Research Arm Test). Subgroup analyses indicated that the statistically significant difference for MI-LF-rTMS was also observed across intervention durations ≤ 4 weeks, disease stages ≤ 3 months post-stroke, and in protocols not using brain-computer interface technology. Meta-regression identified that the use of a brain-computer interface, publication year, and patient mean age were significant sources of heterogeneity.

    Conclusion

    Among the intervention strategies evaluated in this network meta-analysis, motor imagery combined with low-frequency repetitive transcranial magnetic stimulation (MI-LF-rTMS) showed a statistically significant difference compared to conventional rehabilitation. This regimen integrates central neuromodulation with cognitive training and may be a clinically feasible option, particularly for patients in the early phase after stroke. Future research should focus on parameter optimization, mechanistic exploration, and validation in larger, more diverse populations.

    Posted by at
    Labels: , , , , , , , ,

    No comments:

    Post a Comment

    Subscribe to: Post Comments (Atom)