Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS) for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients
Introduction. Spasticity is a disabling symptom resulting from reorganization of spinal reflexes no longer inhibited by supraspinal control. Several studies have demonstrated interest in repetitive transcranial magnetic stimulation in spastic patients. We conducted a prospective, randomized, double-...
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Wiley
2014-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2014/389350 |
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| author | Luc Terreaux Raphael Gross Fabien Leboeuf Hubert Desal Olivier Hamel Jean Paul Nguyen Chantal Pérot Kévin Buffenoir |
| author_facet | Luc Terreaux Raphael Gross Fabien Leboeuf Hubert Desal Olivier Hamel Jean Paul Nguyen Chantal Pérot Kévin Buffenoir |
| author_sort | Luc Terreaux |
| collection | DOAJ |
| description | Introduction. Spasticity is a disabling symptom resulting from reorganization of spinal reflexes no longer inhibited by supraspinal control. Several studies have demonstrated interest in repetitive transcranial magnetic stimulation in spastic patients. We conducted a prospective, randomized, double-blind crossover study on five spastic hemiparetic patients to determine whether this type of stimulation of the premotor cortex can provide a clinical benefit. Material and Methods. Two stimulation frequencies (1 Hz and 10 Hz) were tested versus placebo. Patients were assessed clinically, by quantitative analysis of walking and measurement of neuromechanical parameters (H and T reflexes, musculoarticular stiffness of the ankle). Results. No change was observed after placebo and 10 Hz protocols. Clinical parameters were not significantly modified after 1 Hz stimulation, apart from a tendency towards improved recruitment of antagonist muscles on the Fügl-Meyer scale. Only cadence and recurvatum were significantly modified on quantitative analysis of walking. Neuromechanical parameters were modified with significant decreases in Hmax /Mmax and T/Mmax ratios and stiffness indices 9 days or 31 days after initiation of TMS. Conclusion. This preliminary study supports the efficacy of low-frequency TMS to reduce reflex excitability and stiffness of ankle plantar flexors, while clinical signs of spasticity were not significantly modified. |
| format | Article |
| id | doaj-art-10b8132b122a47199328c7fb78e2bd09 |
| institution | Kabale University |
| issn | 2356-6140 1537-744X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-10b8132b122a47199328c7fb78e2bd092025-02-03T01:26:17ZengWileyThe Scientific World Journal2356-61401537-744X2014-01-01201410.1155/2014/389350389350Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS) for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic PatientsLuc Terreaux0Raphael Gross1Fabien Leboeuf2Hubert Desal3Olivier Hamel4Jean Paul Nguyen5Chantal Pérot6Kévin Buffenoir7Department of Neurosurgery and Neurotraumatology, CHU de Nantes, 1, place Alexis Ricordeau, 44093 Nantes, FranceMovement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, Hôpital Saint Jacques, CHU Nantes, 1, place Alexis Ricordeau, 44093 Nantes, FranceMovement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, Hôpital Saint Jacques, CHU Nantes, 1, place Alexis Ricordeau, 44093 Nantes, FranceDepartment of Neuroradiology, CHU de Nantes, 1, place Alexis Ricordeau, 44093 Nantes, FranceDepartment of Neurosurgery and Neurotraumatology, CHU de Nantes, 1, place Alexis Ricordeau, 44093 Nantes, FranceDepartment of Neurosurgery and Neurotraumatology, CHU de Nantes, 1, place Alexis Ricordeau, 44093 Nantes, FranceUMR CNRS 7338 Biomécanique et Bioingénierie, Université de Technologies de Compiègne, BP 20529, 60205 Compiègne, FranceDepartment of Neurosurgery and Neurotraumatology, CHU de Nantes, 1, place Alexis Ricordeau, 44093 Nantes, FranceIntroduction. Spasticity is a disabling symptom resulting from reorganization of spinal reflexes no longer inhibited by supraspinal control. Several studies have demonstrated interest in repetitive transcranial magnetic stimulation in spastic patients. We conducted a prospective, randomized, double-blind crossover study on five spastic hemiparetic patients to determine whether this type of stimulation of the premotor cortex can provide a clinical benefit. Material and Methods. Two stimulation frequencies (1 Hz and 10 Hz) were tested versus placebo. Patients were assessed clinically, by quantitative analysis of walking and measurement of neuromechanical parameters (H and T reflexes, musculoarticular stiffness of the ankle). Results. No change was observed after placebo and 10 Hz protocols. Clinical parameters were not significantly modified after 1 Hz stimulation, apart from a tendency towards improved recruitment of antagonist muscles on the Fügl-Meyer scale. Only cadence and recurvatum were significantly modified on quantitative analysis of walking. Neuromechanical parameters were modified with significant decreases in Hmax /Mmax and T/Mmax ratios and stiffness indices 9 days or 31 days after initiation of TMS. Conclusion. This preliminary study supports the efficacy of low-frequency TMS to reduce reflex excitability and stiffness of ankle plantar flexors, while clinical signs of spasticity were not significantly modified.http://dx.doi.org/10.1155/2014/389350 |
| spellingShingle | Luc Terreaux Raphael Gross Fabien Leboeuf Hubert Desal Olivier Hamel Jean Paul Nguyen Chantal Pérot Kévin Buffenoir Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS) for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients The Scientific World Journal |
| title | Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS) for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients |
| title_full | Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS) for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients |
| title_fullStr | Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS) for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients |
| title_full_unstemmed | Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS) for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients |
| title_short | Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS) for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients |
| title_sort | benefits of repetitive transcranial magnetic stimulation rtms for spastic subjects clinical functional and biomechanical parameters for lower limb and walking in five hemiparetic patients |
| url | http://dx.doi.org/10.1155/2014/389350 |
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