Date of Completion

2020

Document Type

Thesis

Degree Name

Bachelor of Science in Physical Therapy

Keywords

Repetitive transcranial magnetic stimulation, Physical Therapy, Scoping Review

Abstract

Emerging technologies such as TMS bring the possibility of improving a patient's recovery rate by altering brain activity and performance, even in stroke’s latter stages. However, evidence focusing on TMS adjunct to PT are insufficient and mostly unavailable as there is poor heterogeneity of existing studies in terms of protocols, sample sizes, and research gaps. This paper aims to explore and map the extent of current evidence regarding the use of TMS when applied to chronic stroke patients undergoing physical therapy. Searching was conducted using systematic search terms on SCOPUS, PUBMED, MEDLINE (EBSCO), COCHRANE, CINAHL (EBSCO), BIOMED CENTRAL, and HERDIN. Quantitative studies and single case reports were included which recorded results of TMS alongside PT, describing key concepts narratively. Articles from 2015-2020, which used TMS adjunct to PT focusing on chronic stroke patients, were selected and screened for eligibility as to title and abstract prior to full text, following JBI’s guidelines for scoping reviews. Data was extracted for a narrative account presented in tables and charts. Searching was conducted from January 26, 2021 to February 2, 2021. Of 1988 articles, 382 duplicates were removed, title and abstract screening removed 1606, of which 161 were procured for full-text review & 18 remained for final review. Studies from East Asia were most evident. Impairments mainly targeted upper limb motor function. PT interventions mostly focused on mobility, balance and UE motor training, while LE and trunk PT interventions were least utilized. Tests and measures were diverse, & no optimal protocol was present. Studies about TMS with PT are scarce to generalize its current evidence. Small sample sizes were identified in most studies, while some lacked outcome predictors, control groups, and follow-up assessments. Moreover, TMS application lacks optimal conditions due to poor homogeneity of population characteristics and wide heterogeneity of treatment protocols among the literature.

First Advisor

Jorell Victor Angeles

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