ObjectiveTo observe the effects of accelerated cerebellar intermittent Theta burst stimulation (iTBS) combined with exercise therapy on balance and walking function of subacute stroke patients.MethodsA total of 90 stroke patients with balance and walking dysfunction who were hospitalized in the rehabilitation medicine department of the First Affiliated Hospital of Xinjiang Medical University from May 2023 to December 2024 were randomly divided into conventional stimulation group, accelerated stimulation group and sham stimulation group according to the random numbers generated by SPSS 27.0 software, with 30 cases in each group. The conventional stimulation group received cerebellar iTBS combined with exercise therapy, with cerebellar iTBS administered once daily, six days a week, for two consecutive weeks (totaling 12 sessions); exercise therapy was provided for 45 minutes each session, once daily, six days a week, for two consecutive weeks. The accelerated stimulation group first received one session of cerebellar iTBS, followed by exercise therapy, and then another session of cerebellar iTBS. The iTBS protocol and stimulation parameters were identical to those of the conventional stimulation group, with a 50-minute interval between the two sessions of cerebellar iTBS, administered twice daily, six days a week, for two consecutive weeks (totaling 24 sessions). The exercise therapy regimen was the same as that of the conventional stimulation group. The sham stimulation group received sham iTBS combined with exercise therapy. The sham iTBS protocol, stimulation parameters, and exercise therapy regimen were identical to those of the conventional stimulation group, with the exception that the coil was rotated by 90°, was oriented perpendicularly to the skull of the patient, preventing the magnetic stimulation from penetrating the skull and affecting the cerebellum. Before and after treatment, the Berg Balance Scale (BBS), static balance tests using the Pro-kin balance system center of pressure (COP) trajectory length and sway area under eyes open and closed conditions, and the Timed Up and Go Test (TUGT) were used to assess balance function; the 10-Meter Walking Test (10MWT) and the Tinetti Performance Oriented Mobility Assessment-Gait (POMA-G) were used to assess walking function. Adverse reactions such as headache, seizures, nausea, and dizziness during treatment were observed.Results(1) BBS score, COP trajectory length, COP sway area, and TUGT time: compared with those before treatment, BBS score in all three groups increased significantly after treatment (P0.05), COP trajectory length, COP sway area and TUGT time decreased significantly after treatment (P0.05). Compared with the sham stimulation group, BBS scores in the conventional stimulation group and the accelerated stimulation group were significantly higher after treatment (P0.05), and COP trajectory length and sway area under eyes-closed conditions were significantly shorter and smaller after treatment (P0.05); and TUGT time in the accelerated stimulation group was significantly shorter after treatment (P0.05). Compared with the conventional stimulation group, BBS score in the accelerated stimulation group was significantly higher (P0.05), TUGT time was significantly shorter after treatment (P0.05). (2) 10MWT gait speed and POMA-G scores: compared with those before treatment, the 10MWT gait speed performance and POMA-G scores in all three groups increased significantly after treatment (P0.05). Compared with the sham stimulation group, 10MWT gait speed performance was better and POMA-G scores was significantly higher in the conventional stimulation group and the accelerated stimulation group after treatment (P0.05). (3) Safety: no serious adverse reactions were observed during treatment in all three groups.ConclusionAccelerated cerebellar iTBS combined with exercise therapy can effectively improve balance and walking functions in patients with subacute stroke, and it is safe and worthy of clinical application.
Wusiman et al. (Sun,) studied this question.