Repetitive Transcranial Magnetic Stimulation Coupled With Visual-Feedback Cycling Exercise Improves Walking Ability...

Area of Science:

• Neurorehabilitation
• Motor Recovery
• Clinical Neuroscience

Background:

• Stroke survivors often experience persistent gait abnormalities, impacting mobility and increasing fall risk.
• Abnormal gait patterns include diminished walking ability and stability, significantly affecting daily life.
• Understanding mechanisms for motor cortex recovery is crucial for effective rehabilitation.

Purpose of the Study:

• To assess the effects of repetitive transcranial magnetic stimulation (rTMS) combined with cycling exercise on walking ability and stability in stroke patients.
• To explore potential mechanisms of motor cortex recovery influenced by this combined intervention.

Main Methods:

• A double-blinded randomized pilot trial involving 32 stroke patients divided into real-rTMS and sham-rTMS groups during cycling exercise.
• Intervention consisted of 10 sessions over two weeks, with assessments of lower extremity function (FMA-LE), balance (BBS), and walking tests (2MWT).
• Cortical excitability was measured using motor evoked potentials (MEPs); cycling exercise performance was also evaluated.

Main Results:

• The real-rTMS group demonstrated significant improvements in lower extremity function (FMA-LE) and balance (BBS) compared to the sham group.
• Walking and balance abilities, along with motor asymmetry during cycling, improved significantly in the real-rTMS group.
• Increased elicitation of ipsilesional motor evoked potentials (MEPs) was observed in the real-rTMS group, correlating with functional gains.

Conclusions:

• Combining rTMS with cycling exercise is an effective strategy for improving walking ability and stability in stroke survivors.
• The observed benefits are likely linked to rTMS-induced modulation of motor cortex excitability.
• This approach offers a promising avenue for neurorehabilitation in post-stroke recovery.