PMID- 33193036
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201117
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 11
DP  - 2020
TI  - Prediction of Motor Recovery in the Upper Extremity for Repetitive Transcranial 
      Magnetic Stimulation and Occupational Therapy Goal Setting in Patients With 
      Chronic Stroke: A Retrospective Analysis of Prospectively Collected Data.
PG  - 581186
LID - 10.3389/fneur.2020.581186 [doi]
LID - 581186
AB  - Recovery from motor paralysis is facilitated by affected patients' recognition of 
      the need for and practice of their own exercise goals. Neurorehabilitation has 
      been proposed and used for the treatment of motor paralysis in stroke, and its 
      effect has been verified. If an expected score for the neurorehabilitation effect 
      can be calculated using the Fugl-Meyer Motor Assessment (FMA), a global 
      assessment index, before neurorehabilitation, such a score will be useful for 
      optimizing the treatment application criteria and for setting a goal to enhance 
      the treatment effect. Therefore, this study verified whether the responsiveness 
      to a treatment method, the NovEl intervention using repetitive transcranial 
      magnetic stimulation and occupational therapy (NEURO), in patients with 
      post-stroke upper extremity (UE) motor paralysis could be predicted by the 
      pretreatment FMA score. No control group was established in this study for NEURO 
      treatment. To analyze the recovery of the motor function in the UE, delta-FMA was 
      calculated from the pre- and post-FMA scores obtained during NEURO treatment. The 
      probability of three levels of treatment responsiveness was evaluated in 
      association with delta-FMA score (<5, 5 </= delta-FMA <10, and >/=10 as 
      non-responders; responders; and hyper-responders, respectively) according to the 
      reported minimal clinically important difference (MCID). The association of the 
      initial FMA scores with post-FMA scores, from the status of the treatment 
      responsiveness, was determined by multinomial logistic regression analysis. 
      Finally, 1,254 patients with stroke, stratified by FMA scores were analyzed. 
      About 45% of the patients who had FMA scores ranging from 30 to 40 before 
      treatment showed improvement over the MCID by NEURO treatment (odds ratio = 0.93, 
      95% CI = 0.92-0.95). Furthermore, more than 25% of the patients with more severe 
      initial values, ranging from 26 to 30, improved beyond the MCID calculated in the 
      acute phase (odds ratio = 0.87, 95% CI = 0.85-0.89). These results suggest that 
      the evaluated motor function score of the UE before NEURO treatment can be used 
      to estimate the possibility of a patient recovering beyond MCID in the chronic 
      phase. This study provided clinical data to estimate the effect of NEURO 
      treatment by the pretreatment FMA-UE score.
CI  - Copyright (c) 2020 Hamaguchi, Yamada, Hada and Abo.
FAU - Hamaguchi, Toyohiro
AU  - Hamaguchi T
AD  - Department of Rehabilitation Medicine, The Jikei University School of Medicine, 
      Tokyo, Japan.
AD  - Department of Rehabilitation, Graduate School of Health Sciences, Saitama 
      Prefectural University, Koshigaya, Japan.
FAU - Yamada, Naoki
AU  - Yamada N
AD  - Department of Rehabilitation Medicine, The Jikei University School of Medicine, 
      Tokyo, Japan.
FAU - Hada, Takuya
AU  - Hada T
AD  - Department of Rehabilitation Medicine, The Jikei University School of Medicine, 
      Tokyo, Japan.
FAU - Abo, Masahiro
AU  - Abo M
AD  - Department of Rehabilitation Medicine, The Jikei University School of Medicine, 
      Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20201020
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC7606467
OTO - NOTNLM
OT  - motor paralysis
OT  - occupational therapy
OT  - prediction
OT  - stroke
OT  - transcranial magnetic stimulation
EDAT- 2020/11/17 06:00
MHDA- 2020/11/17 06:01
PMCR- 2020/10/20
CRDT- 2020/11/16 08:46
PHST- 2020/07/08 00:00 [received]
PHST- 2020/09/03 00:00 [accepted]
PHST- 2020/11/16 08:46 [entrez]
PHST- 2020/11/17 06:00 [pubmed]
PHST- 2020/11/17 06:01 [medline]
PHST- 2020/10/20 00:00 [pmc-release]
AID - 10.3389/fneur.2020.581186 [doi]
PST - epublish
SO  - Front Neurol. 2020 Oct 20;11:581186. doi: 10.3389/fneur.2020.581186. eCollection 
      2020.