title: Randomized, multicenter, comparative study of NEURO versus CIMT in poststroke patients with upper limb hemiparesis: the NEURO-VERIFY Study.
abstract: BACKGROUND
  Many poststroke patients suffer functional motor limitation of the affected upper limb, which is associated with diminished health-related quality of life.
  
  
  OBJECTIVE
  The aim of this study is to conduct a randomized, multicenter, comparative study of low-frequency repetitive transcranial magnetic stimulation combined with intensive occupational therapy, NEURO (NovEl intervention Using Repetitive TMS and intensive Occupational therapy) versus constraint-induced movement therapy in poststroke patients with upper limb hemiparesis.
  
  
  METHODS
  In this randomized controlled study of NEURO and constraint-induced movement therapy, 66 poststroke patients with upper limb hemiparesis were randomly assigned at 2:1 ratio to low-frequency repetitive transcranial magnetic stimulation plus occupational therapy (NEURO group) or constraint-induced movement therapy (constraint-induced movement therapy group) for 15 days. Fugl-Meyer Assessment and Wolf Motor Function Test and Functional Ability Score of Wolf Motor Function Test were used for assessment.
  
  
  RESULTS
  No differences in patients' characteristics were found between the two groups at baseline. The Fugl-Meyer Assessment score was significantly higher in both groups after the 15-day treatment compared with the baseline. Changes in Fugl-Meyer Assessment scores and Functional Ability Score of Wolf Motor Function Test were significantly higher in the NEURO group than in the constraint-induced movement therapy group, whereas the decrease in the Wolf Motor Function Test log performance time was comparable between the two groups (changes in Fugl-Meyer Assessment score, NEURO: 5·39 ± 4·28, constraint-induced movement therapy: 3·09 ± 4·50 points; mean ± standard error of the mean; P < 0·05) (changes in Functional Ability Score of Wolf Motor Function Test, NEURO: 3·98 ± 2·99, constraint-induced movement therapy: 2·09 ± 2·96 points; P < 0·05).
  
  
  CONCLUSIONS
  The results of the 15-day rehabilitative protocol showed the superiority of NEURO relative to constraint-induced movement therapy; NEURO improved the motion of the whole upper limb and resulted in functional improvement in activities of daily living.
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan; Department of Rehabilitation Medicine, Tokyo General Hospital, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Abo
authors.forename: Wataru
authors.initials: W
authors.lastname: Kakuda
authors.forename: Ryo
authors.initials: R
authors.lastname: Momosaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Harashima
authors.forename: Miki
authors.initials: M
authors.lastname: Kojima
authors.forename: Shigeto
authors.initials: S
authors.lastname: Watanabe
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Sato
authors.forename: Aki
authors.initials: A
authors.lastname: Yokoi
authors.forename: Takuma
authors.initials: T
authors.lastname: Umemori
authors.forename: Jinichi
authors.initials: J
authors.lastname: Sasanuma
mesh_terms: D000203:Activities of Daily Living; D003131:Combined Modality Therapy / Q000379:methods; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009788:Occupational Therapy / Q000379:methods*; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020521:Stroke / Q000150:complications*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology
keywords: constraint-induced movement therapy; occupational therapy; randomized controlled trial; repetitive transcranial magnetic stimulation; stroke; upper limb hemiparesis