Effect of transcranial magnetic stimulation on functional outcome in patients with incomplete spinal cord injury: A randomized controlled study

Ahmed M.El Saied, Abeer A. ELWishy, Waleed T. Mansour, Mahmoud Y. El Zanaty, Nagwa I. Rehab, Ahmed Abd El-Moneim Abd El-Hakim, Rania Elsayed Abdelaleem, Tarek M.Youssef

 

Ahmed M.El Saied, Abeer A. ELWishy, Waleed T. Mansour, Mahmoud Y. El Zanaty, Nagwa I. Rehab, Ahmed Abd El-Moneim Abd El-Hakim, Rania Elsayed Abdelaleem, Tarek M.Youssef – Effect of transcranial magnetic stimulation on functional outcome in patients with incomplete spinal cord injury: A randomized controlled study. Fizjoterapia Polska 2023; 23(2); 34-40

DOI: https://doi.org/10.56984/8ZG0DF2F4

 

Abstract
Background. Incomplete spinal cord injury is a common disorder leading to sensory or motor function loss.
Objective. This study aimed to investigate the effect of repetitive transcranial magnetic stimulation therapy (rTMS) on functional outcome in patients with incomplete spinal cord injury.
Design. A prospective randomized controlled trial. Setting. Agouza Rehabilitation Hospital Out clinic.
Methods. Forty male patients with chronic traumatic incomplete spinal cord injury aging from 25 to 45years. Patients were randomly divided into two equal groups (group A and group B).Group A was the study group that received rTMS in addition to designed physical therapy program including BWST training and Group B was the control group that received the same designed physical therapy program including BWST training. The functional gait was assessed using walking index for spinal cord injury (WISCI II) and gait speed was assessed using 10 m walk test. Measurements were performed before and after treatment and three months after end of the treatment as follow up.
Results. There was a statistically significant improvement in WISCI II and 10m walk test at post treatment and follow up compared with that pre-treatment in study group (P < 0.05). There was no statistically significant improvement in all outcome variables at post treatment and follow up compared with that pretreatment in control group (P > 0.05).There was a statistically significant improvement in patients who received rTMS with BWST compared with patients received BWST only in WISCI II and 10 m walk test at post treatment (p = 0.01 and p = 0.001 respectively) compared to pre treatment. The gained effect was lost at follow up measurement compared to post treatment in WISCI II and the gained effect was maintained at follow up measurement compared to post treatment in 10m walk test score.
Conclusion. It was proven that rTMS add a valuable effect for restoring function in patients with incomplete spinal cord injury, particularly in cases when the effect of BWST has reached a plateau.
Key words: Incomplete spinal cord injury, repetitive transcranial magnetic stimulation (rTMS), walking index for spinal cord injury (WISCI II), 10 m walk test, functional outcome
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Effects of low level laser therapy and median nerve mobilization after carpal tunnel release: A randomized controlled trial

Moussa A. Sharaf, Mona S. Faggal, Marwa S. Saleh, Nagwa I. Rehab

Moussa A. Sharaf, Mona S. Faggal, Marwa S. Saleh, Nagwa I. Rehab – Effects of low level laser therapy and median nerve mobilization after carpal tunnel release: A randomized controlled trial. Fizjoterapia Polska 2020; 20(5); 128-134

Abstract

Background. Although various rehabilitation methods have been used to enable patients to return to their normal activities after carpal tunnel release (CTR) such as low level laser therapy (LLLT) and median nerve mobilization, up till now, there is no evidence for the comparison of effects of these two techniques in patients with CTR. Purpose. To investigate and compare the effectiveness of LLLT and median nerve mobilization after CTR on the electrophysiological parameters of median nerve, pain, hand grip and pinch strength. Methods. Forty-five patients of both sexes with unilateral CTR participated in the study. They were randomly assigned into three equal groups. Group I received LLLT and group II received median nerve mobilization three sessions per week for five successive weeks. Group III was the control group. Electrophysiological parameters of the median nerve, visual analogue scale (VAS), hand grip and pinch strength were assessed pre, post-treatment and after three months (follow-up). Results. There was no significant difference between GI and GII in all variables at post-treatment and follow-up. However, there was significant difference in all variables at post-treatment in GI and GII as compared to GIII. At follow-up for all variables, there was no significant difference between GI and GIII (except for pain) with significant difference between GII and GIII. Conclusion. Both of neural mobilization and LLLT lead to better improvement in the electrophysiological parameters of the median nerve, pain and hand function after CTR (in favor of neural mobilization group). Also, median nerve mobilization is more effective on improving hand function than LLLT at follow-up.

Key words:
Carpal tunnel release, low level laser therapy, median nerve mobilization, electrophysiological parameters, hand grip, pinch strength
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