PTOTRCTJournal of rehabilitation medicine2023

Cerebral Theta-Burst Stimulation Combined with Physiotherapy in Patients with Incomplete Spinal Cord Injury: A Pilot Randomized Controlled Trial.

Xiaojun Feng, Tingting Wang, Yan Jiang and 5 others

PMID 36779636

WHAT IT FOUND

Nine weeks of cerebral theta-burst stimulation added to standard physiotherapy improved lower limb muscle strength, walking speed, stride length, and daily living ability in 38 patients with incomplete spinal cord injury more than sham stimulation.

Key findings

01Patients receiving active cerebral theta-burst stimulation alongside standard physiotherapy showed greater improvement in lower extremity motor scores than those receiving sham stimulation.

02The active stimulation group demonstrated significantly greater improvements in walking speed and stride length compared to the sham group after 9 weeks.

03Active stimulation led to greater improvements in walking ability and activities of daily living than the sham condition.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study was a pilot trial with a small sample size of 38 patients, which limits the generalizability of the findings. All participants received a complex package of standard rehabilitation treatments, including electroacupuncture, biofeedback, and robot training, in addition to physiotherapy. The contribution of the theta-burst stimulation alone cannot be isolated from these concurrent interventions. The study assessed only short-term outcomes immediately after the 9-week intervention, with no long-term follow-up to determine if the gains in strength and walking ability were maintained. The underlying mechanism was not investigated, as corticospinal excitability was not measured.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not assume the improvement is due to theta-burst stimulation alone. All patients received a comprehensive standard rehabilitation program including physiotherapy, electroacupuncture, and robot training, so the specific contribution of the stimulation cannot be separated from the other treatments.

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