Effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke: a randomized controlled study
ObjectiveThis study aimed to explore the impacts of intermittent Theta burst stimulation (iTBS) and mirror image therapy (MT), both used separately and in combination with iTBS, on upper limb (UL) motor function, activities of daily living (ADL), and cortical excitability during the subacute phase o...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1548703/full |
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| author | Jing Zhou Jing Zhou Mo Chen LuJie Dong CaiXia Zheng Jiang Xu YangPu Zhang YaLi Liu |
| author_facet | Jing Zhou Jing Zhou Mo Chen LuJie Dong CaiXia Zheng Jiang Xu YangPu Zhang YaLi Liu |
| author_sort | Jing Zhou |
| collection | DOAJ |
| description | ObjectiveThis study aimed to explore the impacts of intermittent Theta burst stimulation (iTBS) and mirror image therapy (MT), both used separately and in combination with iTBS, on upper limb (UL) motor function, activities of daily living (ADL), and cortical excitability during the subacute phase of stroke.DesignRandomized controlled study.SettingInpatient rehabilitation centers of Tongji Hospital and Hubei Provincial Hospital of Integrated Chinese & Western Medicine.ParticipantsSeventy-one patients with upper limb (UL) disability.InterventionsPatients were randomly assigned to four groups. Three treatment groups received intermittent theta burst stimulation (iTBS), mirror therapy (MT), or a combination of both, in addition to routine rehabilitation. Therapy sessions were conducted five days per week for two weeks (10 working days).Main measuresThe assessments encompassed the National Institutes of Health Stroke Scale (NIHSS), upper limb Fugl-Meyer assessment (UL-FMA), modified Barthel index (MBI), Stroke-specific quality of life scale (SS-QOL), resting motor threshold (RMT), and motor evoked potential (MEP).ResultsThe combined treatment group showed significant improvements in UL-Fugl-Meyer Assessment (UL-FMA) scores compared with the control and MT groups (p < 0.05). Significant differences in Modified Barthel Index (MBI) and Stroke-Specific Quality of Life Scale (SS-QOL) scores were observed among the four groups (p < 0.05). On the contralesional side, the iTBS group demonstrated increased resting motor threshold (RMT), prolonged motor evoked potential (MEP) latency, and reduced MEP amplitude. In contrast, the MT group showed decreased RMT and MEP latency, along with increased MEP amplitude (p < 0.05).ConclusionThe addition of iTBS or combined therapy to conventional rehabilitation improved UL motor function and activities of daily living (ADL) in patients with stroke. The iTBS group exhibited inhibitory effects on contralesional hemisphere excitability, while the MT group showed facilitative effects. These excitability changes were less pronounced in the combined treatment group.Clinical trial registrationIdentifier ChiCTR1800015528. |
| format | Article |
| id | doaj-art-4fcb5a8839704f2c9fa387690e929b2c |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-4fcb5a8839704f2c9fa387690e929b2c2025-08-20T03:50:17ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.15487031548703Effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke: a randomized controlled studyJing Zhou0Jing Zhou1Mo Chen2LuJie Dong3CaiXia Zheng4Jiang Xu5YangPu Zhang6YaLi Liu7Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Rehabilitiation, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan, ChinaDepartment of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Rehabilitiation, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan, ChinaDepartment of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaObjectiveThis study aimed to explore the impacts of intermittent Theta burst stimulation (iTBS) and mirror image therapy (MT), both used separately and in combination with iTBS, on upper limb (UL) motor function, activities of daily living (ADL), and cortical excitability during the subacute phase of stroke.DesignRandomized controlled study.SettingInpatient rehabilitation centers of Tongji Hospital and Hubei Provincial Hospital of Integrated Chinese & Western Medicine.ParticipantsSeventy-one patients with upper limb (UL) disability.InterventionsPatients were randomly assigned to four groups. Three treatment groups received intermittent theta burst stimulation (iTBS), mirror therapy (MT), or a combination of both, in addition to routine rehabilitation. Therapy sessions were conducted five days per week for two weeks (10 working days).Main measuresThe assessments encompassed the National Institutes of Health Stroke Scale (NIHSS), upper limb Fugl-Meyer assessment (UL-FMA), modified Barthel index (MBI), Stroke-specific quality of life scale (SS-QOL), resting motor threshold (RMT), and motor evoked potential (MEP).ResultsThe combined treatment group showed significant improvements in UL-Fugl-Meyer Assessment (UL-FMA) scores compared with the control and MT groups (p < 0.05). Significant differences in Modified Barthel Index (MBI) and Stroke-Specific Quality of Life Scale (SS-QOL) scores were observed among the four groups (p < 0.05). On the contralesional side, the iTBS group demonstrated increased resting motor threshold (RMT), prolonged motor evoked potential (MEP) latency, and reduced MEP amplitude. In contrast, the MT group showed decreased RMT and MEP latency, along with increased MEP amplitude (p < 0.05).ConclusionThe addition of iTBS or combined therapy to conventional rehabilitation improved UL motor function and activities of daily living (ADL) in patients with stroke. The iTBS group exhibited inhibitory effects on contralesional hemisphere excitability, while the MT group showed facilitative effects. These excitability changes were less pronounced in the combined treatment group.Clinical trial registrationIdentifier ChiCTR1800015528.https://www.frontiersin.org/articles/10.3389/fneur.2025.1548703/fullstrokemirror therapytheta burst stimulationupper limb functionmotor evoked potential |
| spellingShingle | Jing Zhou Jing Zhou Mo Chen LuJie Dong CaiXia Zheng Jiang Xu YangPu Zhang YaLi Liu Effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke: a randomized controlled study Frontiers in Neurology stroke mirror therapy theta burst stimulation upper limb function motor evoked potential |
| title | Effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke: a randomized controlled study |
| title_full | Effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke: a randomized controlled study |
| title_fullStr | Effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke: a randomized controlled study |
| title_full_unstemmed | Effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke: a randomized controlled study |
| title_short | Effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke: a randomized controlled study |
| title_sort | effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke a randomized controlled study |
| topic | stroke mirror therapy theta burst stimulation upper limb function motor evoked potential |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1548703/full |
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