Trial reportPhysiotherapy research international : the journal for researchers and clinicians in physical therapy2026
rTMS Over Dorsolateral Prefrontal Cortex Augments Dual-Task Training for Mobility, Balance and Cognition in Sub-Acute Stroke: A Randomized Controlled Trial.
Trial report in Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the effects of adding repetitive transcranial magnetic stimulation (rTMS) to dorsolateral prefrontal cortex (DLPFC) with dual-task (DT) exercise on DT mobility, balance and cognitive performance in individuals with sub-acute stroke.
methodsThirty sub-acute stroke patients [age, mean (SD) = 59.2 (7.9) years] were randomly assigned to the experimental group (N = 15), or the sham stimulation group (N = 15). 5 Hz rTMS (90% resting motor threshold, 1200 pulses/session) or sham stimulation was applied to the ipsilesional DLPFC, 1 session/day, 5 days/week for 2 weeks, followed by dual-task training. Two mobility tests [10 m walking and timed-up-and-go (TUG) test] and two cognitive tasks (serial 3 subtractions and verbal fluency) were assessed separately [that is, single-task (ST) condition] and concurrently (i.e., DT condition) before and after the intervention.
resultsThe experimental group had greater improvement in TUG time under both ST and DT conditions (p < 0.05), while the step length of the paretic leg during the 10 m walking test of the experimental group only showed better improvement under ST condition and in DT condition when performed with serial 3 subtractions task. Cadence changes did not reach significance in any DT condition. Greater increment in the DT cognitive performance was observed only when verbal fluency task performed with 10 m walking test in the experimental group. The experimental group had better gain in Montreal cognitive assessment, Mini balance evaluation systems test, and Activities-specific balance confidence scores than controls. DISCUSSION: The 2-week rTMS to DLPFC combined with DT training augments DT walking performance, and improves balance and cognitive function in mild to moderate motor and cognitive impairment individuals with sub-acute stroke. IMPLICATIONS OF PHYSIOTHERAPY PRACTICE: This combined intervention is a feasible, effective strategy to improve real-world mobility in sub-acute stroke rehabilitation.
trial registrationChinese Clinical Trial Registry platform (www.chictr.org.cn), with the registration number ChiCTR2200066237.
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