Combining transcranial magnetic stimulation with action observation therapy better improves the neurological functioning of stroke survivors / 中华物理医学与康复杂志

ABSTRACT

Objective:To observe any effect of combining repetitive transcranial magnetic stimulation (rTMS) under the guidance of event related potentials (ERPs) with action observation therapy (AOT) on the cognitive and motor functioning of stroke survivors in the recovery period.Methods:Ninety stroke survivors were randomly divided into a control group, an rTMS group and an rTMS+ AOT group, each of 30. All three groups were given conventional rehabilitation treatment (including the training of waist, upper and lower limb function, balance, walking, memory, attention, orientation, spatial perception and executive ability). The rTMS group also received one session of ERP-based rTMS daily five times a week. The rTMS+ AOT group was given the same rTMS combined with AOT twice a day, five times a week. Before and after 4 weeks of treatment, the Mini-mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MOCA), the Fugl-Meyer assessment scale (FMA), the Berg Balance Scale (BBS) and the modified Barthel index (MBI) were used to evaluate each subject′s cognitive and motor ability and their skill in the activities of daily living.Results:After the treatment, the average MMSE, MOCA, FMA, BBS and MBI scores of all groups had improved significantly, but the average MMSE, MOCA, upper limb FMA and MBI scores of the rTMS group were then significantly higher than the control group′s averages. And the average scores of the rTMS+ AOT group were significantly better than those of the other two groups.Conclusion:Combining rTMS guided by ERPs with AOT can effectively improve the cognitive functioning, motor control and balance of stroke survivors, and improve their ability in the activities of daily living.