Effect of repetitive transcranial magnetic stimulation combined with robot-assisted training on wrist muscle activation post-stroke
Research output: Contribution to journal › Article
Colleges, School and Institutes
- Sunny Hill Health Centre for Children, Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada. Electronic address: firstname.lastname@example.org.
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; Department of Physical Therapy, Western University, London, ON, Canada.
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
- Menrva Research Group, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Burnaby, BC, Canada.
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
OBJECTIVE: To compare the effects of active assisted wrist extension training, using a robotic exoskeleton (RW), with simultaneous 5 Hz (rTMS + RW) or Sham rTMS (Sham rTMS + RW) over the ipsilesional extensor carpi radialis motor cortical representation, on voluntary wrist muscle activation following stroke.
METHODS: The two training conditions were completed at least one week apart in 13 participants >1-year post-stroke. Voluntary wrist extensor muscle activation (motor unit (MU) recruitment thresholds and firing rate modulation in a ramp-hold handgrip task), ipsilesional corticospinal excitability (motor evoked potential [MEP] amplitude) and transcallosal inhibition were measured Pre- and Post-training.
RESULTS: For MUs active both Pre and Post training, greater reductions in recruitment thresholds were found Post rTMS + RW training (p = 0.0001) compared to Sham rTMS + RW (p = 0.16). MU firing rate modulation increased following both training conditions (p = 0.001). Ipsilesional MEPs were elicited Pre and Post in only 5/13 participants. No significant changes were seen in ipsilesional corticospinal excitability and transcallosal inhibition measures (p > 0.05).
CONCLUSIONS: Following a single rTMS + RW session in people >1-year post-stroke, changes were found in voluntary muscle activation of wrist extensor muscles. Alterations in ipsilesional corticospinal or interhemispheric excitability were not detected.
SIGNIFICANCE: The effects of rTMS + RW on muscle activation warrant further investigation as post-stroke rehabilitation strategy.
|Number of pages||9|
|Early online date||20 May 2019|
|Publication status||Published - 1 Aug 2019|