Effect of Combined Therapy of Robot and Low-Frequency Repetitive Transcranial Magnetic Stimulation on Hemispatial Neglect in Stroke Patients

Kim, Sang Beom; Lee, Kyeong Woo; Lee, Jong Hwa; Lee, Sook Jeong; Park, Jin Gee; Lee, Joung Bok

doi:10.5535/arm.2018.42.6.788

Cited by 14 publications

(19 citation statements)

References 32 publications

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“…On the other hand, only the cTBS group showed significant increase in fractional anisotropy (FA) and mean diffusivity (MD) in superior longitudinal fasciculus, superior occipitofrontal fascicle and inferior fronto-occipital fasciculus on the left side (stimulation side) and the capsula external and inferior fronto-occipital fasciculus on the right side (contra-stimulation side). In a study by Kim et al 25 using both robotic therapy and rTMS, significant improvements were observed in all groups, but there were no significant differences between the groups.…”

Section: Treatment Characteristics Outcomes and Resultsmentioning

confidence: 87%

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A Systematic Review of effect of Non-Invasive Brain Stimulation on Cognition Impairment after a Stroke and Traumatic Brain Injury

Hara

Shanmugalingam

McIntyre

et al. 2020

Preprint

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Background:In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for stroke and traumatic brain injury (TBI) populations.Methods: All English articles from the following sources were searched from inception up to December 31, 2018: PubMed, Scopus, CINAHL, Embase, PsycINFO and CENTRAL.Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals post stroke or TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included.Results: A total of 17 studies met eligibility criteria which included 546 patients receiving either repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS). Sample sizes ranged 5-25 subjects per group. Seven studies used rTMS and ten studies used tDCS. Target symptoms included global cognition (n=8), memory (n=1), attention (n=1), and unilateral spatial neglect (USN) (n=7). Nine studies combined rehabilitation or additional therapy with NIBS. Six of ten studies showed significant improvement in attention, memory, working memory, and executive function. In the USN study, five of the seven studies had a significant improvement in the intervention group. Conclusions:The effect of NIBS on executive functions including attention and memory post stroke or TBI yielded mixed results with variable stimulation parameters. A significant, consistent improvement was observed for USN post stroke or TBI. Future studies using advanced neurophysiological and neuroimaging tools to allow network-based approach to NIBS for cognitive symptoms post stroke or TBI are warranted.After a stroke and traumatic brain injury (TBI), cognitive impairment may lead to significant dysfunction for individuals. The main symptoms are memory disorder, attention disorder, executive dysfunction, and social behavior disorder. 1 In a national epidemiological cohort study of population and prevalence after brain injury in the chronic phase, Nakajima et al. 1 reported that the most common cognitive symptoms were memory impairment (90%), attention disorder (82%), and executive function impairment (75%). The scope and severity of cognitive symptoms depend on many factors, including injury mechanism, demographic and social factors. According to previous studies, impairment of attention disorder occurs among 42-92% of individuals in the acute phase and is evident in 24-51% at discharge from acute care. 2,3 Studies have reported that memory impairment persists in 23-55% of individuals up to 3 months post stroke and 11-31% at one year post stroke; this figure is similar in the TBI population (25%). 4,5 Unilateral Spatial neglect (USN) is an attention disorder that occurs after stroke and is characterized by the inability to orient or respond to or report the stimuli appearing contralateral to lesion side. 6 The incidence of USN has been reported as low as 8% and a...

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Section: Treatment Characteristics Outcomes and Resultsmentioning

confidence: 87%

“…In terms of the impairment assessed, eight articles reported on global cognition and seven on USN. Kim et al 25 compared rTMS alone, robot rehabilitation, and combination therapy. In terms of the stimulation pattern, five articles of rTMS study used inhibition stimulation pattern.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of effect of Non-Invasive Brain Stimulation on Cognition Impairment after a Stroke and Traumatic Brain Injury

Hara

Shanmugalingam

McIntyre

et al. 2020

Preprint

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“…A total of 630 studies were identified, and after reading the titles and abstracts, 23 studies were selected for eligibility analysis, 18 of which were excluded because they were prospective studies ( n = 2), case series ( n = 3), proof of concept ( n = 1), did not use any type of robot ( n = 4), did not include USN patients ( n = 5), used robot without limb activation ( n = 1), and were clinical trial protocols ( n = 2). In total, two RCTs, 53,54 two pilot RCTs, 55,56 and one quasi-RCT 57 were included in the qualitative analysis. A flowchart of the review steps is shown in Figures 1 and 2.…”

Section: Resultsmentioning

confidence: 99%

“…The mean age of the individuals in the experimental and control groups was 60.65 (±8.88) years and 63.41 (±9.13) years, respectively. Three studies included patients in the subacute phase, 53,54,56 one in the chronic phase, 55 and one in the acute phase 57 of stroke. In all studies, the individuals had ischemic and/or hemorrhagic strokes.…”

Section: Resultsmentioning

confidence: 99%

Effect of Robot-Assisted Training on Unilateral Spatial Neglect After Stroke: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Bazan

Fonseca

Miranda

et al. 2022

Neurorehabil Neural Repair

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Background Several studies have shown that robotic devices can effectively improve motor function in stroke patients through limb activation. However, the effects of robot-assisted therapy on perceptual deficits after stroke is unclear. Objective This review aimed to evaluate the effectiveness of robotic limb activation in patients with unilateral spatial neglect (USN) after stroke. Methods In this systematic review, a literature search was performed using MEDLINE, EMBASE, CENTRAL, CINAHL, and LILACS databases without language restrictions. Randomized controlled trials (RCTs) and quasi-RCTs of robot-assisted therapy for USN after stroke were selected. Two reviewers independently assessed the risk of bias and certainty of the evidence of the included studies. Results A total of 630 studies were identified, including five studies for qualitative synthesis and four meta-analyses. The results of RCTs comparing robotic limb activation with a control group suggested an improvement in the degree of USN measured by the line bisection test (standardized mean difference [SMD], −0.64; 95% confidence interval [CI], −1.13 to −0.15; P = .01). There were no differences between the groups in the motor-free visual perception test 3rd edition (SMD, 0.27; 95% CI, −0.25–0.79; P = .31), star cancellation test (SMD, 0.26; 95% CI, −0.42−0.94; P = .54), Albert’s test (SMD, −0.67; 95% CI, −2.01−0.66; P = .32), and Catherine Bergego Scale (SMD, −0.81; 95% CI, −2.07−0.45; P = .21). Conclusion The study demonstrated that limb activation through robotic therapy can improve midline perception. However, there was no impact on tasks assessing visual scanning, functionality, or activities of daily living.

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“…Nevertheless, given a recent previous study reporting that robot-assisted therapy could be simultaneously provided with repetitive transcranial magnetic stimulation and it was found to be clinically effective, a combination treatment for visual sensory stimulation needs to be investigated rather than an individual treatment to maximize its effects in clinical settings. [ 27 ]…”

Section: Discussionmentioning

confidence: 99%

The effects of robot-assisted left-hand training on hemispatial neglect in older patients with chronic stroke

Park

2021

Medicine

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Background: Even though a variety of rehabilitative technique have been implemented to ameliorate neglect symptoms of patients with stoke, the effects of limb activation using a robotic device are still unknown. The purpose of this study was to investigate the effects of the robot-assisted hand training on hemispatial neglect of older patients with chronic stroke. Methods: The participants were randomly allocated to the experimental group (EG) receiving robot-assisted left-hand training (n = 12) or the control group (CG) receiving conventional treatments for neglect symptoms (n = 12). All participants received 20 sessions for 4-week. To examine the effects on hemispatial neglect, the line bisection test (LBT), the Albert test, and the Catherine Bergego Scale (CBS) were utilized. The outcome measures were analyzed before and after the 20 training sessions. Results: After the intervention, improvements in the LBT, the Albert test, and the CBS were found in the EG whereas there were significant improvements in the LBT and the CBS but not the Albert test in the CG. In addition, the EG showed a significantly greater gain in all outcome measures compared to the CG ( p < .05). Conclusions: These results indicate that robot-assisted hand training was beneficial to improving the hemispatial neglect of elderly person with chronic stroke compared to the conventional treatments. Robot-assisted limb activation might be useful to ameliorate hemispatial neglect of the elderly with chronic stroke.

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Effect of Combined Therapy of Robot and Low-Frequency Repetitive Transcranial Magnetic Stimulation on Hemispatial Neglect in Stroke Patients

Cited by 14 publications

References 32 publications

A Systematic Review of effect of Non-Invasive Brain Stimulation on Cognition Impairment after a Stroke and Traumatic Brain Injury

A Systematic Review of effect of Non-Invasive Brain Stimulation on Cognition Impairment after a Stroke and Traumatic Brain Injury

Effect of Robot-Assisted Training on Unilateral Spatial Neglect After Stroke: Systematic Review and Meta-Analysis of Randomized Controlled Trials

The effects of robot-assisted left-hand training on hemispatial neglect in older patients with chronic stroke

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