ArticleJournal of neuroengineering and rehabilitation2023
Testing spasticity mechanisms in chronic stroke before and after intervention with contralesional motor cortex 1 Hz rTMS and physiotherapy.
Article in Journal of neuroengineering and rehabilitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Global research trends in transcranial magnetic stimulation for stroke (1994-2023): promising, yet requiring further practice.Frontiers in neurology · 2024Pooled it
- Clinical efficacy evaluation of combined central and peripheral repetitive transcranial magnetic stimulation for elbow flexor (biceps Brachii) spasticity and upper limb motor function after stroke.Frontiers in neurology · 2026Trial
- Clinical Study on the Combined Therapy of Sinew Acupuncture and Low-Frequency Repetitive Transcranial Magnetic Stimulation for Hemiplegic Shoulder Pain.Brain and behavior · 2025Trial
- Homosynaptic Depression of the Soleus Predicts Post-Stroke Gait Speed.Restorative neurology and neuroscience · 2026Article
- Repetitive Transcranial Magnetic Stimulation for Spasticity in Stroke and Other Neuromotor Disorders: A Systematic Review of Randomized Clinical Trials.Journal of clinical medicine · 2026Review
- Pathophysiology and Management Strategies for Post-Stroke Spasticity: An Update Review.International journal of molecular sciences · 2025Review
- Article
- Modulation of cerebral cortex activity by acupuncture combined with continuous theta-burst stimulation in post-stroke upper limb spasticity: an fNIRS study.Frontiers in neurology · 2025Article
- Effectiveness of high-frequency repetitive transcranial magnetic stimulation combined with quadriceps strength training in the treatment of knee osteoarthritis: a randomized controlled trial.Therapeutic advances in musculoskeletal disease · 2025Article
- Ultrasound Imaging Comparison of Crural Fascia Thickness and Muscle Stiffness in Stroke Patients with Spasticity.Diagnostics (Basel, Switzerland) · 2024Article
- Non-Pharmacological Therapies for Post-Stroke Spastic Paralysis: A Bibliometric Analysis of Global Research from 2000 to 2024.Journal of multidisciplinary healthcare · 2024Review
- Brain state-dependent repetitive transcranial magnetic stimulation for motor stroke rehabilitation: a proof of concept randomized controlled trial.Frontiers in neurology · 2024Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies showed that repetitive transcranial magnetic stimulation (rTMS) reduces spasticity after stroke. However, clinical assessments like the modified Ashworth scale, cannot discriminate stretch reflex-mediated stiffness (spasticity) from passive stiffness components of resistance to muscle stretch. The mechanisms through which rTMS might influence spasticity are also not understood.
methodsWe measured the effects of contralesional motor cortex 1 Hz rTMS (1200 pulses + 50 min physiotherapy: 3×/week, for 4-6 weeks) on spasticity of the wrist flexor muscles in 54 chronic stroke patients using a hand-held dynamometer for objective quantification of the stretch reflex response. In addition, we measured the excitability of three spinal mechanisms thought to be related to post-stroke spasticity: post-activation depression, presynaptic inhibition and reciprocal inhibition before and after the intervention. Effects on motor impairment and function were also assessed using standardized stroke-specific clinical scales.
resultsThe stretch reflex-mediated torque in the wrist flexors was significantly reduced after the intervention, while no change was detected in the passive stiffness. Additionally, there was a significant improvement in the clinical tests of motor impairment and function. There were no significant changes in the excitability of any of the measured spinal mechanisms.
conclusionsWe demonstrated that contralesional motor cortex 1 Hz rTMS and physiotherapy can reduce the stretch reflex-mediated component of resistance to muscle stretch without affecting passive stiffness in chronic stroke. The specific physiological mechanisms driving this spasticity reduction remain unresolved, as no changes were observed in the excitability of the investigated spinal mechanisms.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.