Effects of motor imagery-based neurofeedback training after bilateral repetitive transcranial magnetic stimulation on post-stroke upper limb motor function: an exploratory crossover clinical trial.
Francisco José Sánchez Cuesta, Yeray González-Zamorano, Marcos Moreno-Verdú and 5 others
PMID 38450442WHAT IT FOUND
In 20 post-stroke adults, adding motor imagery neurofeedback to bilateral rTMS was associated with better upper limb movement scores than rTMS alone, but the trial had carry-over, no blinding, and usual rehab continued.
Key findings
01The primary upper limb Fugl-Meyer score favoured therapy B at measurement 2, measurement 3, measurement 4 and measurement 5.
02Hand grip strength had no significant therapy factor difference, but measurement 2 and measurement 3 favoured therapy B.
03The FMA-UL was the only variable with a significant carry-over effect, p = 0.03.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
No evaluators, therapists or patients were blinded, and the study was not randomized double-blind. Only 20 participants completed the study, so the findings are exploratory. The FMA-UL had a significant carry-over effect, so the crossover comparison may be affected by the order of therapies. Therapy A and Therapy B did not have the same session count or duration, with 10 rTMS sessions over 2 weeks and 12 neurofeedback sessions over 4 weeks. Assessments were done after the intervention finished and repeated 6 times, so timing and learning effects may have influenced results. No corrections for multiple comparisons were applied. Participants continued usual rehabilitation, which varied among them and was not controlled.
Declared interests
The authors declared no conflicts of interest. Dr Romero was funded by the Spanish Ministry of Science and Innovation grant PID2020-113222RBC21/AEI/10.13039/501100011033.
The easy way to misread this
Do not conclude that motor imagery neurofeedback alone improved upper limb function. Therapy B also included bilateral rTMS, and the study did not separate the contribution of each component.