The effects of repetitive transcranial magnetic stimulation on unilateral neglect of acute stroke patients: A randomised controlled trial

Background: Rehabilitation of the unilateral neglect of acute stroke patients represents a major challenge. Objectives: This study aimed to evaluate the effects of repetitive transcranial magnetic stimulation on the functional recovery of stroke patients with unilateral neglect. Methods: Twenty patients with stroke were randomly assigned to two groups: a repetitive transcranial magnetic stimulation group (experimental) and a control group. The stroke patients in the experimental group underwent repetitive transcranial magnetic stimulation therapy and comprehensive rehabilitation therapy. The stroke patients in the control group underwent sham magnetic stimulation therapy and comprehensive rehabilitation therapy. The patients in both groups received therapy 5 days per week for 4 weeks. The Motor Free Visual Perception Test (MVPT), Line Bisection Test (LBT), Albert Test (AT), and Star Cancellation Test (SCT) were assessed before and after the 4-week therapy period. Results: The experimental group showed a significant increase in the MVPT, LBT, AT, and SCT values compared with the preintervention values (p < 0.05). Furthermore, the control group showed a significant increase in the MVPT, LBT, and AT results compared with the preintervention results (p < 0.05). A significant difference in the post-training gains for the MVPT (8.9 +/- 2.5 vs. 4.8 +/- 3.0), LBT (+/- 19.3 +/- 7.5 vs. +/- 6.5 +/- 9.5), AT (13.1 +/- 8.0 vs. 4.0 +/- 1.9), and SCT (-13.6 +/- 6.9 vs. +/- 4.5 +/- 6.9) were observed between the experimental group and the control group (p < 0.05). In addition, the effect size for gains in the experimental and control groups was very large in MVPT and AT (effect size Z 3.25 and 2.90), respectively, and the effect size for gains in the experimental and control groups was small in LBT and SCT (effect size Z 0.22 and 0.23, respectively). Conclusion: The current study findings indicated that repetitive transcranial magnetic stimulation may be beneficial in decreasing the unilateral neglect of stroke patients. Copyright (C) 2015, Hong Kong Physiotherapy Association Ltd. Published by Elsevier ( Singapore) Pte Ltd. All rights reserved.