No abstract

No abstract

Objective-To test the potential adjuvant effect of repetitive transcranial magnetic stimulation (rTMS) on motor learning in a group of stroke survivors undergoing constraint-induced therapy (CIT) for upper-limb hemiparesis.Design-This was a prospective randomized, double-blind, sham-controlled, parallel group study. Nineteen individuals, one or more years poststroke, were randomized to either a rTMS + CIT (n = 9) or a sham rTMS + CIT (n = 10) group and participated in the 2-wk intervention.Results-Regardless of group assignment, participants demonstrated significant gains on the primary outcome measures: the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL)-Amount of Use, and on secondary outcome measures including the Box and Block Test (BBT) and the MAL-How Well. Participants receiving rTMS failed to show differential improvement on either primary outcome measure.Conclusions-Although this study provided further evidence that even relatively brief sessions of CIT can have a substantial effect, it provided no support for adjuvant use of rTMS. KeywordsStroke; Neuronal Plasticity; Transcranial Magnetic Stimulation; Rehabilitation; Hemiparesis Since its introduction as a noninvasive method to stimulate the human brain, 1 repetitive transcranial magnetic stimulation (rTMS) has provided a potential means to modulate cortical excitability and function. Depending on essential parameters of the stimulation frequency and number of trains of stimuli, rTMS can produce lasting up-or down-regulation of the corticospinal system. At higher frequencies (≥5 Hz) rTMS has been shown to increase excitability in the motor nervous system. 2-4 The extent to which these effects persist over time