Enhancing the Response to Rehabilitation After Stroke Using Repetitive Transcranial Magnetic Stimulation (rTMS)


Phase 2 Results N/A

Eligibility Criteria

Inclusion Criteria

- first clinical stroke involving the middle cerebral artery confirmed by CT or MRI scan during acute care at the MUHC, or second stroke involving the same hemisphere when there were no clinical residual effects from the first stroke;
- cortical or subcortical stroke resulting in hemiparesis;
- at least 3 months post-stroke;
- discharged from standard rehabilitation;
- able to provide informed consent, to follow instructions and participate in therapy, as evidenced by Mini Mental State Exam score > 14;
- able to understand instructions in English or French.

Exclusion Criteria

- minimal or no residual upper extremity motor impairment;
- severe upper extremity motor impairment as indicated by inability to produce any voluntary contraction of intrinsic hand muscles; severe cognitive impairment in language or attention sufficient to impair communication during the consenting or intervention procedures (score < 14 on the Mini Mental Status Exam);
- other central nervous system disorder or peripheral neuropathy of the upper extremity;
- pain, spasticity, or other complications that would prevent participation in the intervention;
- history of seizure confirmed by interview and medical chart review;
- comorbidity such as Parkinson's disease, osteoarthritis, or cancer, precluding full participation in the assessments and in the experimental intervention;
- other conditions that increase the risk of side effects due to rTMS procedures: metal in cranium, intracardiac line, increased intracranial pressure, pregnancy, cardiac pacemaker, medication pump, tricyclic antidepressants, neuroleptics, history of seizure in the immediate family