Adjunct Low Frequency Repetitive Transcranial Magnetic Stimulation With Physiotherapy Enhance Upper Extremity Function Restoration
Stroke
About this trial
This is an interventional treatment trial for Stroke
Eligibility Criteria
Inclusion Criteria:
- First-ever stroke
- Age >60
- muscle strength > grade 2 and < grade 5 based on manual muscle testing of hand / fingers of the affected upper limb
- > 1 month and < 6 months after the onset of stroke
Exclusion Criteria:
- Substantial cognitive impairment with Mini Mental State Test >24
- Diagnosis of mental illness
- Pathological conditions referred to as contra-indications for rTMS in guideline suggested by Wassermann (eg. Cardiac pacemaker, intracranial implants, implanted medication pumps, epilepsy)
- Unstable cardio-pulmonary conditions -
Sites / Locations
- Queen Elizabeth Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
(1) rTMS- PT Ex Group
(2) Placebo- PT Ex Group
1 Hz low frequency rTMS over contra-lesional M1 region for 1200 pulse (20 minutes) at 90% resting motor threshold (rMT) will conduct for 10 consecutive sessions (5 days per week for 2 weeks) and immediately followed by 30- minutes structured physiotherapy upper limb training. After the 10 sessions of brain stimulation, the 30-minute structured physiotherapy upper limb training program will continue for another 12 weeks (2 sessions per week)
placebo stimulation over contra-lesional M1 region will be conducted for 10 consecutive sessions (5 sessions per week for 2 weeks) of and immediately followed by 30- minutes of structured physiotherapy upper limb training. Then, the structured physiotherapy upper limb training will continue for another 12 weeks (2 sessions per week).