Stimulation In Chronic Patients Research Articles

Walking with rhythmic auditory stimulation in chronic patients after stroke: A pilot randomized controlled trial.

There is a lack of studies that evaluate the effects of different gait training (GT) interventions for patients after stroke in an outpatient setting. The aim of the present trial therefore was to evaluate the effects of two different outpatient GT programmes after chronic stroke. We randomly allocated patients into two groups of either a 4-week overground GT with rhythmic auditory stimulation (RAS, n=6) of 30min, three times a week over 4weeks or an overground GT without RAS (GT, n=6) with same duration and intensity. Primary outcomes were walking velocity and capacity; secondary outcomes were the Berg Balance Scale (BBS) and stride length before and after interventions and at 12weeks follow-up. Twelve patients after stroke (nine females; mean [SD] age 67 [9] years; duration of illness 67 [69] months; all left-sided strokes) were included. Patients improved their walking velocity from baseline until the end of GT (RAS: median difference 0.05m/s [interquartile range, IQR 0.06] and GT: 0.12m/s [0.29]) and walking capacity (RAS: median difference 14m [IQR 14] and GT: 41m [79]). However, RAS and GT did not differ significantly (p=.30 and p=.30, respectively). Patients improved from baseline until the end of intervention in BBS (RAS: median difference 4 points [IQR 4] and GT: 1 point [3]) and stride length (RAS: median difference 6.3cm [IQR 12.1] and GT: 5.5cm [8.8]). However, BBS and stride length did not differ significantly between groups (p=.08 and p=.58, respectively). Walking with rhythmic auditory stimulation in chronic patients after stroke does not provide a beneficial effect on walking when compared with walking without rhythmic auditory stimulation.

Effects of 10 Hz repetitive transcranial magnetic stimulation (rTMS) on clinical global impression in chronic schizophrenia

We conducted a randomized, sham-controlled repetitive transcranial magnetic stimulation (rTMS) study in chronic schizophrenia in-patients ( n = 35) to evaluate the therapeutic efficacy of 10 Hz stimulation. Patients, who were on stable antipsychotic treatment, were randomly assigned to the active or sham condition. In the active rTMS group, ten sessions with a total of 10,000 stimuli were applied over the left dorsolateral prefrontal cortex at 110% of motor threshold. The sham group received corresponding sham stimulation. Clinical improvement was measured by the Clinical Global Impression scale (primary outcome measure), the Global Assessment of Functioning Scale (GAF) and the Positive and Negative Symptom Scale (PANSS; secondary outcome measures). Between-group comparisons revealed no significant differences in clinical outcome variables. Only a subgroup of patients with pronounced negative symptoms developed some clinical improvement as indicated by significant changes in the GAF-scale. Besides there is some evidence for a more favourable clinical outcome within this subgroup after rTMS in the CGI-S and PANSS negative scale, too. In line with earlier investigations, our results suggest a moderate — potentially clinically relevant — treatment effect of prefrontal 10 Hz rTMS stimulation in chronic patients. However, in our study this beneficial effect was restricted to subjects with pronounced negative symptoms. Clinical trial registration information ClinicalTrial.gov Identifier: NCT00169689, http://www.clinicaltrials.gov.