Cerebral Vascular Accident Clinical Trial
Official title:
Efficacy of Repetitive Transcranial Magnetic Stimulation and Virtual Cycling Training on Upper Limb Function in Patients With Stroke
Stroke is the major cause of motor impairment and physical disabilities in the adult population. Spasticity and loss of dexterity are the common problems in stroke. Recently, current interventions, such as cycling training, virtual reality (VR) and repetitive transcranial magnetic stimulation (rTMS), were used for the treatment of upper extremity (UE) dysfunction in patients with stroke. However, few studies investigated the effects of the combinations of different treatment strategies using by integrating brain imaging and motor control studies. This project proposes different novel treatment strategies in the treatment of UE dysfunction in patients with stroke: combined inhibitory/facilitatory rTMS, VR-based cycling training (VCT), and combined rTMS and VCT. We hypothesize that the treatment effect of the combined protocol (optimal rTMS protocol and VCT) is more effective than single treatment due to integration of central and peripheral effects. Different treatment protocols will induce different changes in the brain reorganization and motor control, which further improve motor function, activity, participation, and health related quality of life (HRQOL).
This study aims to 1. identify the immediate effects of different treatment protocols in for
UE training in these patients through brain image, motor control and clinical measures; 2. to
determine the maintaining therapeutic effects; 3. to elucidate the most optimal treatment
protocols; 4. to determine the neuro-motor control mechanism underlying clinical improvement;
5. to determine the clinimetric properties of the brain imaging and motor control measure
that are responsive and valid for detecting changes after treatment protocol intervention,
and 6. to identify clinical predictors influencing the outcome for treatment protocols.
The research will offer valuable motor control biomarkers for outcome prediction and
targeting patients who benefit from new protocols. This project is significant for the
translational and evidence-based medicine on stroke neurorehabilitation.
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