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.

AIMS:

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: Masahiro Abo, Wataru Kakuda, Ryo Momosaki, Hiroaki Harashima, Miki Kojima, Shigeto Watanabe, Toshihiro Sato, Aki Yokoi, Takuma Umemori, Jinichi Sasanuma
• Journal: International journal of stroke : official journal of the International Stroke Society (Int J Stroke) Vol. 9 Issue 5 Pg. 607-12 (Jul 2014) ISSN: 1747-4949 [Electronic] United States
• PMID: 24015934 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

Topics

• Activities of Daily Living
• Combined Modality Therapy (methods)
• Disability Evaluation
• Exercise Therapy (methods)
• Female
• Humans
• Male
• Middle Aged
• Motor Activity
• Occupational Therapy (methods)
• Paresis (etiology, physiopathology, rehabilitation)
• Stroke (complications)
• Transcranial Magnetic Stimulation (methods)
• Treatment Outcome
• Upper Extremity (physiopathology)