Efficacy of Excitatory iTBS on Lower Limb Recovery in iSCI Patients

Study DesignProspective Study.ObjectiveSpinal cord injury leads to severe limitations in autonomy including locomotor function. Intermittent theta burst stimulation (iTBS) has shown promising therapeutic effects on various neuropsychiatric disorders. We analyzed the efficacy of excitatory iTBS on motor and walking functions in patients with incomplete spinal cord injury (iSCI).MethodsThe prospectively selected iSCI patients were divided into the iTBS (n = 69) and sham-iTBS (n = 69) groups, and underwent iTBS and sham-iTBS treatment, respectively, followed by conventional physiotherapy. Clinical assessments were conducted on the muscle strength of quadriceps, gluteus maximus, hamstring, tibialis anterior and gastrocnemius muscle, lower extremity motor score (LEMS), walking speed (WS), stride length (SL), Berg balance scale (BBS), Holden walking ability scale (HWAS) score, the static eyes-open and eyes-closed center of gravity locus length, and the modified Barthel index (MBI) score.ResultsThere were no significant differences among all patients in baseline data. After 9-week treatment, all the patients had notably elevated muscle strength levels of quadriceps, gluteus maximus, hamstring, tibialis anterior and gastrocnemius, WS, SL, and HWAS, BBS, LEMS and MBI scores, as well as decreased static eyes-open and eyes-closed center of gravity locus length, with the changes more remarkable in the patients treated with iTBS. The total effective rate for patients treated with iTBS was 86.96%, which was apparently higher than that of patients treated with sham-iTBS.ConclusionExcitatory iTBS significantly improved lower limb strength and walking function in iSCI patients.