• Masahiro Abo, Wataru Kakuda, Ryo Momosaki, Hiroaki Harashima, Miki Kojima, Shigeto Watanabe, Toshihiro Sato, Aki Yokoi, Takuma Umemori, and Jinichi Sasanuma.
• Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan; Department of Rehabilitation Medicine, Tokyo General Hospital, Tokyo, Japan.
• Int J Stroke. 2014 Jul 1; 9 (5): 607-12.

BackgroundMany poststroke patients suffer functional motor limitation of the affected upper limb, which is associated with diminished health-related quality of life.AimsThe 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.MethodsIn 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.ResultsNo 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).ConclusionsThe 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.© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

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