BACKGROUND AND PURPOSE: Evidence suggests that the use of stimulation to increase corticomotor excitability improves hand function in @entity1 with cervical @entity1566 . We assessed effects of a multiday application of 10-Hz repetitive transcranial magnetic stimulation (rTMS) applied to the corticomotor hand area combined with repetitive task practice (RTP) in @entity1 with @entity1688 and neurologically healthy @entity1 . METHODS: Using a double-blind, randomized, crossover design, 11 @entity1 with chronic @entity1688 and 10 neurologically healthy @entity1 received 3 sessions of 10-Hz rTMS+RTP and 3 sessions of sham-rTMS+RTP to the corticomotor hand region controlling the weaker hand. Repetitive transcranial magnetic stimulation was interleaved with RTP of a skilled motor task between pulse trains. Hand function (Jebsen-Taylor Hand Function Test, pinch, and grasp strength) and corticomotor excitability (amplitude of motor-evoked potential) were assessed before and after the rTMS+RTP and sham-rTMS+RTP phases. We assessed significance, using paired t tests on pre-post differences, and effect sizes, using the standardized response mean. RESULTS: RTMS+RTP was associated with larger effect sizes compared with sham-rTMS+RTP for improvement in Jebsen-Taylor Hand Function Test for both the trained hand (standardized response mean = 0.85 and 0.42, respectively) and non-trained hand (0.55 and 0.31, respectively), and for grasp strength of the trained hand in the group with cervical @entity1566 (0.67 and 0.39, respectively) alone. Effect sizes for all other measures were small and there were no statistical between-condition differences in the outcomes assessed. DISCUSSION AND CONCLUSIONS: Repetitive transcranial magnetic stimulation may be a valuable adjunct to RTP for improving hand function in @entity1 with @entity1688 . Higher stimulation dose (frequency, intensity, and the number of sessions) may be associated with larger effects. VIDEO ABSTRACT AVAILABLE: (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A82) for more insights from the authors.

Improvements in hand function in adults with chronic XXXX following a multiday 10-Hz repetitive transcranial magnetic stimulation intervention combined with repetitive task practice.

@entity1 :: ('9606', 'Species') :: ['participants', 'persons'] @entity1688 :: ('MESH:D011782', 'Disease') :: ['tetraplegia'] @entity1566 :: ('MESH:D013119', 'Disease') :: ['spinal cord injury']
@entity1688 :: (MESH:D011782,Disease) :: ['tetraplegia']
