10-Day Theta Burst Stimulation Intervention Facilitates the Clinical Rehabilitation of Patients After an Isolated Limb Fracture: A Longitudinal SHAM-Controlled Pilot Study.

Abstract

We investigated if theta burst stimulation could enhance recovery by reducing key symptoms when implemented acutely postfracture in participants with an isolated upper limb fracture. This was a pilot study with a randomized matched pair, sham-controlled, participant-blind design of a 10-day prolonged continuous theta burst stimulation protocol. Two main groups were included: I) participants with isolated upper limb fracture receiving active theta burst stimulation and II) patients with isolated upper limb fracture receiving SHAM/placebo. Another group (III) of healthy individuals was the reference group. Disability and pain intensity were collected through questionnaires (disabilities of the Arm, Shoulder, and Hand as well as numerical rating scale (NRA)) at three time points (baseline; 72 hrs after intervention, 3 mos after injury). Group III completed the baseline assessment. Seventy-nine participants were enrolled. Individuals in the ACTIVE and SHAM groups had similar baseline measures. For disability, the interaction between intervention and time approached significance (F = 2.33; P = 0.11), whereas it was significant for pain (F = 3.42; P = 0.04). At 3 mos after injury, the ACTIVE group reported reduced disability (F = 4.71; P = 0.04) and pain (F = 5.84; P = 0.02) at 3 mos after injury compared to the SHAM group, with clinical measures from ACTIVE group being like controls. In isolated upper limb fracture patients, a 10-day theta burst stimulation intervention implemented acutely posttrauma had beneficial effects on symptoms of functional recovery and pain at 3 mos after trauma.