Background
Intermittent
theta-burst stimulation (iTBS) has been suggested to improve poststroke
rehabilitation. The cerebellum is considered crucial for motor control.
However, the effects of cerebellar iTBS with routine physical therapy
on balance and motor recovery in subacute and chronic stroke patients
have not been explored.
Objective
To
measure the short-term effects of cerebellar iTBS with physiotherapy on
the balance and functional outcomes in subacute and chronic stroke
patients with hemiparesis.
Methods
Thirty
hemiparetic patients were recruited for this randomized,
double-blinded, sham-controlled trial, and randomized into either the
treatment or sham group. Both groups participated in physiotherapy 5
times per week for 2 weeks, and cerebellar iTBS or sham iTBS was
performed daily, immediately before physiotherapy. The primary outcome
was the Berg balance scale (BBS) score. Secondary outcomes included the
trunk impairment scale (TIS) score, Fugl-Meyer assessment scale score
for lower extremities (FMA-LE), Barthel index (BI), and corticospinal
excitability, as measured by transcranial magnetic stimulation. The
outcomes were measured before and 1 week and 2 weeks after the
intervention.
Results
Compared
with those at baseline, significant increases were identified in all
clinical scores (BBS, TIS, FMA-LE, and BI) in both groups after the
2-week intervention. The BBS and TIS scores improved more in the iTBS
group than in the sham group.
Conclusions
Cerebellar
iTBS with physiotherapy promotes balance and motor recovery in
poststroke patients. Therefore, this method can be used in low-cost,
fast, and efficient protocols for stroke rehabilitation (Chinese
Clinical Trial Registry: ChiCTR1900026450).
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