CLINICAL TRIAL article
Front. Neurol.
Sec. Neurorehabilitation
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1548703
This article is part of the Research TopicNew approaches for central nervous system rehabilitation - Volume IIView all 8 articles
Effects of mirror therapy combined with theta burst stimulation on motor recovery of upper limbs after stroke: a randomized controlled study
Provisionally accepted
- 1Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, Hubei Province, China
- 2Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China, Wu Han, China
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Objective: This study aimed to explore the impacts of intermittent Theta burst stimulation (iTBS) and mirror image therapy (MT), both used separately and in combination with iTBS, on upper limb (UL) motor function, activities of daily living (ADL), and cortical excitability during the subacute phase of stroke.Design: Randomized controlled study.Setting: Inpatient rehabilitation centers of Tongji Hospital and Hubei Provincial Hospital of Integrated Chinese & Western Medicine.Participants：Seventy-one patients with upper limb (UL) disability.Interventions：Patients were randomly assigned to four groups. Three treatment groups received intermittent theta burst stimulation (iTBS), mirror therapy (MT), or a combination of both, in addition to routine rehabilitation. Therapy sessions were conducted five days per week for two weeks (10 working days).Main measures: The assessments encompassed the National Institutes of Health Stroke Scale (NIHSS), upper limb Fugl-Meyer assessment (UL-FMA), modified Barthel index (MBI), Stroke-specific quality of life scale (SS-QOL), resting motor threshold (RMT), and motor evoked potential (MEP).Results: The combined treatment group showed significant improvements in UL-Fugl-Meyer Assessment (UL-FMA) scores compared with the control and MT groups (p<0.05). Significant differences in Modified Barthel Index (MBI) and Stroke-Specific Quality of Life Scale (SS-QOL) scores were observed among the four groups (p<0.05). On the contralesional side, the iTBS group demonstrated increased resting motor threshold (RMT), prolonged motor evoked potential (MEP) latency, and reduced MEP amplitude. In contrast, the MT group showed decreased RMT and MEP latency, along with increased MEP amplitude (p<0.05).Conclusions: The addition of iTBS or combined therapy to conventional rehabilitation improved UL motor function and activities of daily living (ADL) in patients with stroke. The iTBS group exhibited inhibitory effects on contralesional hemisphere excitability, while the MT group showed facilitative effects. These excitability changes were less pronounced in the combined treatment group.Trial registration: The research protocol gained approval from the Ethical Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (approval certificate number TJ-IRB20180306).Keywords:stroke, mirror therapy, theta burst stimulation, upper limb function, motor evoked potential
Keywords: Stroke, mirror therapy, theta burst stimulation, Upper Limb function, motor evoked potential
Received: 20 Dec 2024; Accepted: 01 Jul 2025.
Copyright: © 2025 Zhou, Chen, Dong, Zheng, Xu, Zhang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Pu Yang Zhang, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, 430015, Hubei Province, China
Li Ya Liu, Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China, Wu Han, China
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