Effect of Combined Repetitive Transcranial Magnetic Stimulation and Virtual Reality on Hand Function, Grip Strength, Daily Activities, and Self-Efficacy in Subacute Hemiplegic Stroke: A Randomized Placebo-Controlled Trial

Not yet recruiting

Conditions: Other specified disorders of nervous system in diseases classified elsewhere,

Registration Number: CTRI/2025/03/083495

Lead Sponsor: Ravi Nair Physiotherapy College

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.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 46

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.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Fugl-Meyer Upper Extremity (FMUE)	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
Hand held Dynamometer 6.Upper limb self efficacy questionnaire 5.The Motor Activity Log (MAL) modified ashworth scale	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 Outcome Measures

Name	Time	Method
Stroke Impact Scale	Baseline 4 weeks, 6 weeks & 2 months

Trial Locations

Locations (1): Aacharya vinoba bhave rural Hospital
🇮🇳
Wardha, MAHARASHTRA, India
Aacharya vinoba bhave rural Hospital
🇮🇳Wardha, MAHARASHTRA, India
Sakshi Ravindra Borkute
Principal investigator
09307434589
sakshiborkute2000@gmail.com