Efficacy of combined repetitive transcranial magnetic stimulation and virtual reality versus sham transcranial magnetic stimulation on hand function, grip strength, daily activities, and self efficacy in subacute hemiplegic stroke- a randomized placebo controlled trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 46
- Locations
- 1
- Primary Endpoint
- Hand held Dynamometer 6.Upper limb self efficacy questionnaire 5.The Motor Activity Log (MAL) modified ashworth scale
Study Overview
Brief Summary
Problem of the study
The study on the efficacy of combined repetitive transcranial magnetic stimulation (rTMS) and virtual reality (VR) exercises in motor recovery, grip strength, activity, and self-efficacy in subacute stroke patients addresses a critical gap in stroke rehabilitation. While individual therapies such as rTMS and VR exercises have shown promise in improving motor function and neuroplasticity, there is limited research on their combined effects in the subacute phase of stroke recovery. This period is crucial for maximizing recovery potential, as patients are often still undergoing significant neural plasticity. The need for this study arises from the potential of combining non-invasive brain stimulation (rTMS) with immersive, task-specific training (VR) to enhance motor recovery more effectively than either intervention alone. By examining outcomes like grip strength, functional activity, and self-efficacy, the study aims to provide insights into how these therapies can work synergistically to improve both physical and psychological aspects of rehabilitation, thereby advancing treatment strategies for subacute stroke patients.
Study Design
- Study Type
- Interventional
- Allocation
- Computer generated randomization
- Masking
- Participant Blinded
Eligibility Criteria
- Ages
- 45.00 Year(s) to 65.00 Year(s) (—)
- Sex
- All
Inclusion Criteria
- •Subjects with ischemic or haemorrhagic stroke diagnosed by a neurologist or a clinician confirmed by physical and radiological findings CT or MRI Subjects in the subacute phase of stroke greater than 3 months following stroke Both men and women aged from 45 to 65 years 9 Subjects should be maintain lumbricals position Tone measured through Modified Ashworth Scale should be greater than equal to 1 plus Patients with Brunnstrom stage for hand greater than equal to 410 MMSE score should be 25 or higher normal cognitive status Subjects who have provided a consent to participate in the study.
Exclusion Criteria
- •Subjects with traumatic brain injury TBI spinal cord injury SCI cancer patients Subjects with recent upper limb fractures serious orthopaedic conditions Subjects with intracranial metallic implants and pacemakers Subjects with epilepsy Enrolment in another clinical trial involving physiotherapy individuals suffering from unstable angina symptomatic heart failure or uncontrolled hypertension Recurrent and Acute stroke flaccid stage.
Outcomes
Primary Outcomes
Hand held Dynamometer 6.Upper limb self efficacy questionnaire 5.The Motor Activity Log (MAL) modified ashworth scale
Time Frame: Fugl-Meyer Upper Extremity (FMUE) | Hand held Dynamometer 6.Upper limb self efficacy questionnaire 5.The Motor Activity Log (MAL) modified ashworth scale | Baseline, 4 weeks , 6 weeks and 2 months
Fugl-Meyer Upper Extremity (FMUE)
Time Frame: Fugl-Meyer Upper Extremity (FMUE) | Hand held Dynamometer 6.Upper limb self efficacy questionnaire 5.The Motor Activity Log (MAL) modified ashworth scale | Baseline, 4 weeks , 6 weeks and 2 months
Secondary Outcomes
- Stroke Impact Scale(Baseline 4 weeks, 6 weeks & 2 months)