Reach-to-Grasp Training in Individuals with Chronic Stroke Augmented by Low-Frequency Repetitive Transcranial Magnetic Stimulation
Parinya Vongvaivanichakul MSc*, Jarugool Tretriluxana PhD*, Sunee Bovonsunthonchai PhD*, Narawut Pakaprot PhD**, Wipawee Laksanakorn MD***
Affiliation : * Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand ** Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Rehabilitation Department, Golden Jubilee Medical Center, Mahidol University, Nakhon Pathom, Thailand
Objective : The present study investigated the immediate effects of low frequency repetitive transcranial magnetic stimulation
(LF-rTMS) combined with reach-to-grasp (RTG) training of the paretic hand in individuals with chronic stroke.
Material and Method: Fourteen participants were randomly assigned to receive LF-rTMS or sham stimulation conditions.
All participants underwent RTG training after the stimulation. Corticospinal excitability (CE) of the non-lesioned hemisphere,
the total time of the wolf motor function test (WMFT) for dexterity tasks, maximum aperture, and movement time of RTG
actions were evaluated at baseline, after the stimulation, and after RTG training.
Results : Significant differences between interaction (group x time) were found in the total time of WMFT. The CE of non-
lesioned hemisphere diminished after LF-rTMS and showed moderate correlation with the reduction in time of RTG actions
after the stimulation. The total time of WMFT and RTG actions reduced after motor training only in the LF-rTMS group. No
change was observed in maximum aperture in either group.
Conclusion : The application of LF-rTMS combined with RTG training enhanced the training effect as evidenced by faster
movement for the dexterity tasks of the paretic hand than RTG training alone. The findings suggested the benefit of LF-rTMS
for enhancing the training effects in stroke rehabilitation.
Keywords : Non-invasive brain stimulation, Motor training, Stroke
