Six-day course of repetitive transcranial magnetic stimulation plus occupational therapy for post-stroke patients with upper limb hemiparesis: a case series study.
OBJECTIVE
To clarify the safety and feasibility of a 6-day protocol of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive occupational therapy (OT) for upper limb hemiparesis.


METHODS
In-hospital combination treatment was provided for 5 post-stroke patients with upper limb hemiparesis after more than 12 months of the onset of stroke. Over 6 consecutive days, each patient received 10 sessions of combination treatment with 1 Hz rTMS and intensive OT (one-on-one training and self-training). Motor function in the affected upper limb was evaluated by Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Ten-Second Test at admission, discharge, and 4 weeks after treatment.


RESULTS
All patients completed the 6-day treatment protocol and none showed any adverse effects throughout the treatment. At the end of treatment, improvements in the scores of FMA, WMFT, and Ten-Second Test were found in all patients. No deterioration of improved upper limb function was observed at 4 weeks after the treatment.


CONCLUSIONS
Our proposed protocol of combination treatment seems to be safe and feasible for post-stroke patients with upper limb hemiparesis, although the efficacy of the protocol needs to be confirmed in a large number of patients.
Kakuda
Wataru
W
Department of Rehabilitation Medicine, Jikei University School of Medicine, Minato-Ku, Tokyo, Japan.
Abo
Masahiro
M
Kaito
Nobuyoshi
N
Ishikawa
Atsushi
A
Taguchi
Kensuke
K
Yokoi
Aki
A
D000368:Aged; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D009788:Occupational Therapy; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation / Q000628:therapy*; D010865:Pilot Projects; D020127:Recovery of Function; D020521:Stroke / Q000150:complications / Q000628:therapy*; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome