뇌졸중 환자의 상지 운동 기능 장애에 대한 특정 작업 중재와 동기화된 경두개 자기 자극 (rTMS)

실험적: 온라인 자극

5 Hz RTM은 환자가 운동 작업을 수행 할 때 영향을받는 반구의 1 차 운동 피질에 적용됩니다.

장치: 온라인 자극

5 Hz RTM은 환자가 운동 작업을 수행 할 때 영향을받는 반구의 1 차 운동 피질에 적용됩니다.

활성 비교기: 오프라인 자극

5 Hz RTM이 영향을받는 반구의 1 차 운동 피질에 적용한 후, 환자는 운동 작업을 수행합니다.

장치: 오프라인 자극

5 Hz RTM이 영향을받는 반구의 1 차 운동 피질에 적용한 후, 환자는 운동 작업을 수행합니다.

가짜 비교기: 가짜 자극

Sham RTM은 환자가 운동 작업을 수행 할 때 영향을받는 반구의 1 차 운동 피질에 적용됩니다.

장치: 가짜 자극

Sham RTM은 환자가 운동 작업을 수행 할 때 영향을받는 반구의 1 차 운동 피질에 적용됩니다.

Mean Change in FM-UE From Baseline

The Fugl-Meyer Assessment (FMA) is a stroke-specific, performance-based impairment index. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with post-stroke hemiplegia. It is applied clinically and in research to determine disease severity, describe motor recovery, and to plan and assess treatment.

The Fugl-Meyer Assessment - Upper Extremity (FMA-UE) is the upper limb motor domain includes items assessing movement, coordination, and reflex action of the shoulder, elbow, forearm, wrist, hand. It ranges from 0 (hemiplegia) to 66 points (normal motor performance).

FM-UE scale was assessed by site raters who were masked to the intervention).

기본 작업의 평균 완료 시간

기본 작업의 평균 완료 시간은 각 개입 전에 환자가 기본 운동 작업을 완료하는 데 걸린 시간(초)을 나타냅니다.

Mean Change in ARAT score from Baseline

The Action Research Arm Test (ARAT) is a 19 item observational measure used by physical therapists and other health care professionals to assess upper extremity performance (coordination, dexterity and functioning) in stroke recovery, brain injury and multiple sclerosis populations. The ARAT was originally described by Lyle in 1981 as a modified version of the Upper Extremity Function Test and was used to examine upper limb functional recovery post damage to the cortex.

ARAT score was assessed by site raters who were masked to the intervention.

Mean Change in WMFT score from Baseline

The WMFT is used to assess the upper limb motor function of patients and serves as an effective supplement to the FMA-UE. By timing single-joint movements, multi-joint movements, and functional activities, as well as evaluating movement quality and speed, it can quantitatively assess the upper limb motor ability of stroke patients. It is more sensitive to patients with mild to moderate stroke, and its grading is relatively detailed, which can sensitively reflect the subtle changes in patients' motor function during evaluation.

The WMFT consists of 15 items, among which items 1-6 are simple joint movements, and items 7-15 are complex functional actions. This scale can not only evaluate impairments but also assess the effect of training on disabilities. The WMFT has good validity and reliability and can be used to evaluate the upper limb function of stroke patients.

WMFT score was assessed by site raters who were masked to the intervention.

Mean Change in MBI score from Baseline

The Barthel Index for activities of daily living was introduced in 1965 by Barthel and Mahoney to be used in the assessment of the degree of assistance required by patients with stroke (other neuromuscular or musculoskeletal disorders or oncology patients) with regards to 10 items of mobility and self-care (ADL).

MBI score was assessed by site raters who were masked to the intervention.

Mean Change in PSQI score from Baseline

The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report questionnaire that assesses sleep quality over a one-month time interval.

The PSQI is commonly used in both clinical and research settings to evaluate various aspects of sleep. It is a valuable tool for assessing sleep quality as it captures multiple dimensions of sleep, including both subjective experiences and objective parameters. It allows researchers and healthcare providers alike to obtain a comprehensive understanding of an individual's sleep patterns and disturbances and inform treatment decisions and interventions for sleep disorders.

PSQI score was assessed by site raters who were masked to the intervention).

Motor Evoked Potential (MEP) - Resting Motor Threshold (RMT)

Resting motor threshold is an objective measure of cortical excitability. Numerous studies indicate that the success of motor recovery after stroke is significantly determined by the direction and extent of cortical excitability changes.

MRI changes

multi-modal MRI scanned, including structural MRI, resting-fMRI, task-fMRI, and DTI

Adverse events

adverse events such as headache, sleep disturbance, etc