title: NMES with rTMS for moderate to severe dysfunction after stroke.
abstract: BACKGROUND
  Motor dysfunction after stroke might be improved by neuromuscular electrical stimulation (NMES) combined with 1 Hz repetitive transcranial magnetic stimulation (rTMS) in patients with moderate and severe motor dysfunction.
  
  
  OBJECTIVE
  This preliminary study tested the effect of this treatment combination.
  
  
  METHODS
  Fifteen patients (60.5 ± 10.3 years old) participated in the study. All patients had been affected by cerebral artery infarction or hemorrhage and had moderate or severe motor dysfunction in their affected hand. The patients received NMES at paretic wrist extensor muscles combined with rTMS over the unaffected M1 hemisphere twice a day, six days/week over two weeks. All participants underwent the following battery of tests to evaluate the motor function of the affected hand: Upper limb Fugl-Meyer Assessment (UFMA), Wolf Motor Function Test (WMFT), and Box and Block Test (BBT).
  
  
  RESULTS
  UFMA, WMFT, and BBT scores improved significantly after the study.
  
  
  CONCLUSIONS
  These results suggest that NMES combined with rTMS could be useful for recovery of moderate and severe motor function after stroke.
authors.affiliation: Department of Rehabilitation, Kawamura Hospital, Gifu, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Koyama
authors.affiliation: Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Tanabe
authors.affiliation: Department of Rehabilitation, Kawamura Hospital, Gifu, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Warashina
authors.affiliation: Department of Rehabilitation, Kawamura Hospital, Gifu, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sakurai
authors.affiliation: Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan.
authors.forename: Yoshikiyo
authors.initials: Y
authors.lastname: Kanada
authors.affiliation: Department of Neurosurgical, Kawamura Hospital, Gifu, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Nagata
authors.affiliation: Department of Neurosurgical, Kawamura Hospital, Gifu, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Kanno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000150:complications; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D018482:Muscle, Skeletal / Q000503:physiopathology; D009460:Neurologic Examination; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D014953:Wrist / Q000503:physiopathology
keywords: Neuromuscular electrical stimulation; repetitive transcranial magnetic stimulation; severe stroke patients