scholarly journals Experience of Using Amantadine Sulfate (PK-Merz) in Patients with Ischemic Stroke

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
Viktoria Anatoliivna Gryb ◽  
Ivan Ivanovych Titov ◽  
Galyna Stepanivna Chmyr ◽  
Galyna Ivanivna Khlibeychuk
Keyword(s):  
Ischemic Stroke ◽  
Combination Treatment ◽  
Neurological Deficit ◽  
Conventional Therapy ◽  
Main Group ◽  
Control Group ◽  
Dopamine Concentration ◽  
Significant Regression ◽  
Recovery Of Consciousness ◽  
Amantadine Sulfate

The article presents the results of combination treatment of patients with acute ischemic stroke (the NIH Stroke Scale – 12.04±0.57). The efficacy of conventional therapy (the control group) was compared with treatment regimen using amantadine sulfate (PK-Merz) (the main group). In patients undergoing combination treatment lost functions were restored quite promptly and 2 months after the observation their functional state was satisfactory (the NIH Stroke Scale: the main group – 2.49±0.78, the control group – 5.53±0.69, p=0.009); moreover, the subscale “language” differed significantly from that in patients receiving basic therapy only (р<0.05). Due to the blockade of NMDA receptors, which contributes to the reduction in the intensity of the “excitotoxicity cascade” preserving the penumbral area as well as due to the increase in dopamine concentration both by increasing the release and blocking the re-uptake in presynaptic nerve cells, the use of amantadine sulfate is a pathogenetically justified means of cerebroprotection in the acute phase of ischemic stroke. The use of PK-Merz is proven to contribute to rapid recovery of consciousness, significant regression of neurological deficit resulting in disability reduction.

scholarly journals The experience of application of prolonged craniopuncture in acute period of ischemic stroke

2020 ◽  
Vol 17 (3) ◽  
pp. 153-156
Author(s):  
Elena Evgenievna Molchanova
Keyword(s):  
Ischemic Stroke ◽  
Neurological Deficit ◽  
Classical Method ◽  
Main Group ◽  
Fear Of Failure ◽  
Control Group ◽  
Acute Period ◽  
Test Motivation ◽  
Level Of Motivation ◽  
Failure Monitoring

The purpose of this research was to study the effect of prolonged craniopuncture on the rate of regression of the neurological deficit, the degree of adaptation to daily life, and the level of motivation among patients in the acute period of ischemic stroke. All patients (60 people) were divided into 2 groups, identical by sex, age and severity of the stroke. In the main group of patients (n=30) prolonged scalp therapy was performed simultaneously with classical acupuncture. The peculiarity of this modification of craniopuncture is the use of seven main areas of the scalp with their symmetrical stimulation and duration of exposure for up to 4 hours. Patients of the control group (n=30) underwent acupuncture in combination with scalp therapy according to the classical method. Assessment of the severity of neurological deficit was carried out on the scale NIHSS, while Barthel ADL index was used to assess the patient's daily live activities after stroke. The level of motivation among the patients was studied by using the questionnaire test Motivation for Success and Motivation for Fear of Failure. Monitoring was carried out on the 1st and 15th day from the start of treatment. In the main group of patients, the reduction in the severity of the neurological deficit occurred on the 15th day according to the data NIHSS scale was 5.0 (64,9%), the Barthel index increased by 31.0 points (55,1%). In the control group, similar indicators were 3.5 (50,7%) (on the NIHSS scale) and 23.5 points (40,5%) (Barthel's index). Both groups of patients experienced an increase in the level of motivation and were already oriented to success, but in the main group, these changes appeared to be more significant. Thus, the use of prolonged craniopuncture significantly accelerates the restoration of lost functions and the adaptation of patients to everyday life, in comparison with the classical method of scalp therapy, and has a beneficial effect on increasing the level of patients motivation.

scholarly journals Mecobalamin and early functional outcomes of ischemic stroke patients with H-type hypertension

2018 ◽  
Vol 64 (5) ◽  
pp. 428-432
Author(s):  
Meixia Yuan ◽  
Beiyun Wang ◽  
Shijin Tan
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Carotid Artery ◽  
Conventional Therapy ◽  
Functional Outcomes ◽  
Inflammatory Factors ◽  
Control Group ◽  
Serum Homocysteine ◽  
The Difference ◽  
Hs Crp

SUMMARY OBJECTIVE To analyze the effect of mecobalamin on the early-functional outcomes of patients with ischemic stroke and H-type hypertension. METHODS From October of 2014 to October of 2016, 224 cases of ischemic stroke and H-type hypertension were selected. The patients were randomly divided into treatment control groups, with 112 patients in each group. The control group was treated with the conventional therapy. The observation group was treated with 500 µg of mecobalamin three times a day in addition to the conventional therapy. We compared serum homocysteine (Hcy), hs-CRP levels, carotid plaques, and NIHSS scores between the two groups on the 2nd day and at 4 weeks, 8 weeks, 3 months, and 6 months. RESULTS After 4 weeks, 8 weeks, 3 months and 6 months, the difference of serum Hcy level between the two groups was statistically significant (t = 4.049, 3.896, 6.052, 6.159, respectively. All P <0.05). After the treatment, at 4 weeks, 8 weeks, 3 months and 6 months, the levels of hs-CRP in the treatment group were significantly lower than those in the control group (t = 37.249, 28.376, 26.454, 20.522, respectively. All P <0.01). After 3 months and 6 months, the carotid artery plaques were significantly reduced in the treatment group compared to those in the control group (t = 2.309 and 2.434. All P <0.05). After 3 months and 6 months, the NIHSS score was significantly higher in the treatment group compared to those in the control group (t = 2.455 and 2.193. All P <0.05). CONCLUSION Mecobalamin can reduce the level of plasma homocysteine, then lead to reductions of levels of plasma inflammatory factors and volume of carotid artery plaques, resulting in more significant functional recovery.

scholarly journals Risk of Cardiovascular Complications in Patients with Persistent Atrial Fibrillation after Dissolution of a Thrombus in the Left Atrial Appendage

Kardiologiia ◽  
2021 ◽  
Vol 61 (5) ◽  
pp. 17-22
Author(s):  
E. S. Mazur ◽  
V. V. Mazur ◽  
N. D. Bazhenov ◽  
Yu. A. Orlov
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Cardiovascular Complications ◽  
Main Group ◽  
Atrial Appendage ◽  
Control Group

Aim      To compare the incidence of cardiovascular complications (CVC) in patients with persistent atrial fibrillation (AF) following thrombus dissolution in the left atrial appendage (LAA) and in patients with persistent AF without preceding LAA thrombosis.Material and methods  The main group included 43 patients who had been diagnosed with LAA thrombosis on the first examination, transesophageal echocardiography, and who showed dissolution of the thrombus on a repeated study performed after 7.1+2.0 weeks of the anticoagulant treatment. The control group consisted of 123 patients with a risk score >0 for men without LAA thrombosis and score >1 for women without LAA thrombosis according to the CHA2DS2‑VASc scale. The patients were followed up for 47.3±17.9 months. The following unfavorable outcomes were recorded: all-cause mortality, ischemic stroke or systemic thromboembolism, hemorrhagic stroke or severe bleeding, and myocardial infarction (MI).Results Unfavorable clinical outcomes were observed in 39.5 % of patients in the main group and in 3.3 % of patients in the control group (p<0.001). Furthermore, the incidence of ischemic stroke (relative risk (RR), 12.9; 95 % confidence interval (CI), 2.89–57.2), and MI (RR, 5.72; 95 % CI, 1.09–30.1) was higher in the main group. However, the number of MI cases in both groups and the number of stroke cases in the control group increased during the entire follow-up period, while the number of stroke cases rapidly increased only during the first year of follow-up.Conclusion      In patients with persistent AF, the risk of CVC after LAA thrombus dissolution remains significantly higher than in patients with AF without LAA thrombosis.

Experience of low-intensity LED radiation (LILEDR) in combination treatment of radiation-induced rectal injuries.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17514-e17514
Author(s):  
Olga G. Rodionova ◽  
Vitaliy I. Voshedskiy ◽  
Pavel G. Sakun ◽  
Elena A. Sheiko ◽  
Marina A. Gusareva ◽  
...  
Keyword(s):  
Exposure Time ◽  
Combination Treatment ◽  
Conservative Therapy ◽  
Radiation Treatment ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Main Group ◽  
Control Group ◽  
Rehabilitation Period ◽  
Radiation Induced

e17514 Background: Malignant pelvic tumors account for more than 25% of cancer incidence in Russia. Radiation therapy is the most common treatment for such patients; however, 10-15% of patients develop radiation-induced complications of the pelvic organs, and more effective treatments are required to manage these complications. Methods: The study included 30 patients with cervical cancer T3NхM0 after combination treatment. 7-10 months after combined radiation treatment (total radiation dose to the primary focus 80 Gy), patients developed erosive ulcerative radiation rectitis (RTOG grade 1 and 2). Patients were divided into 2 groups: main group (n = 15) – conservative treatment combined with LILEDR. Each course included 10 LILEDR sessions, the red spectrum λ = 640 nm on the cubital vein projection (exposure time 5 minutes, dose 6.86 J/cm2) and locally on the ulcerated zones (exposure time 3 minutes, dose 3.96 J/cm2). Patients received 2 LILEDR courses with a 1-month interval. The control group received only conservative therapy. Results: Main clinical manifestations of rectitis (tenesmus, bloody mucous discharge) disappeared in the main group already on the 3-4th day of the first course, epithelialization of ulcerative defects occurred in a shorter period of 7-10 days. Soft superficial scars not causing rectal stenosis formed at the site of the ulcer by the end of LILEDR courses. The control group showed long periods of the ulcer epithelialization up to 30 days, late remission and a lingering recurrent character of the disease. Conclusions: LILEDR in combination with the main conservative therapy allows rapid managing with the clinical symptoms of radiation rectitis and regression of disorders developed after the complex treatment, which improves the quality of life of patients and shortens the rehabilitation period.

Neurological disorders in animals with cerebral ischemia and diabetes mellitus and their correction by a new agonist gpr119 and its combinations with metformin and citicoline

2019 ◽  
pp. 96-104
Author(s):  
Д.А. Бакулин ◽  
Д.В. Куркин ◽  
Е.В. Волотова ◽  
Е.О. Логвинова ◽  
К.А. Авдиенко ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cerebral Ischemia ◽  
Glycemic Control ◽  
Brain Ischemia ◽  
Combination Treatment ◽  
Neurological Deficit ◽  
Neurological Disorders ◽  
Control Group ◽  
Gpr119 Agonist ◽  
Hypoglycemic Therapy

Сахарный диабет (СД) 2 типа значительно повышает риск развития инсульта и выбор гипогликемической терапии может оказать влияние не только на вероятность развития, но и на тяжесть течения нарушения мозгового кровообращения (НМК). Цель: оценить влияние комбинированного введения агониста GPR119 с метформином и цитиколином на выраженность психоневрологических нарушений у животных с НМК на фоне СД. Методика. Исследование проведено на крысах линии Wistar, которым моделировали фокальную ишемию ГМ на фоне 28 дневного стрептозотоцин-никотинамид-индуцированного СД. Агонист рецептора GPR119 (дипиарон) и его комбинацию с метформином вводили с первого дня развития СД, а цитиколин - после моделирования НМК. Психоневрологические нарушения оценивались с использованием шкал «Combs & D’Alecy» и «Garcia», и тестов «Открытое поле», «Ротарод», УРПИ и ТЭИ. Результаты и обсуждение. Введение метформина приводило к нормализации уровня гликемии, но не снижало выраженность неврологического дефицита при последующем моделировании НМК. По сравнению с контролем в группах, получавших дипиарон и в большей степени его комбинацию с метформином, помимо улучшения контроля гликемии наблюдалось значительное снижение объема инфаркта и отёка мозга, а также выраженности психоневрологических нарушений у выживших животных (p<0,05). Введение цитиколина без гипогликемической терапии не приводило к снижению уровня неврологического дефицита по сравнению с контрольной группой, при этом добавление цитиколина к гипогликемической терапии значимо не снижало тяжесть течения НМК. Заключение. Комбинированное введение агониста GPR119 и метформина животным с экспериментальной ишемией ГМ на фоне СД значительно повышает терапевтический потенциал обоих препаратов, обеспечивая лучший контроль уровня гликемии и снижая выраженность психоневрологического дефицита при моделировании НМК. Type 2 diabetes mellitus (DM2) significantly increases the risk of stroke, and the choice of hypoglycemic therapy may influence not only a probability of stroke but also severity of cerebrovascular disease. Objective: To evaluate the effect of combination treatment with a GPR119 agonist, metformin and citicoline on severity of neurological disorders in animals with stroke and diabetes. Cerebral ischemia was modeled by intraluminal occlusion of the middle cerebral artery (OMCA). Methods. The study was performed on Wistar rats with 28-day streptozotocin-nicotinamide-induced diabetes. The GPR119 receptor agonist (dipiaron) and its combination with metformin were administered starting from the first day of DM, and citicoline was administered after the induction of brain ischemia. Behavioral and neurological disorders were evaluated using the Combs & D’Alecy and Garcia scales, and the open field, Rotarod, and active and passive avoidance tests. Results. The metformin treatment normalized glycemia but did not alleviate severity of the neurological deficit induced by subsequent OMCA. The groups treated with dipiaron and its combination with metformin, in addition to improved glycemic control, showed significant decreases in brain infarction volume and edema and the severity of neurological disorders in surviving animals compared to the control (p<0.05). Administration of citicoline without the hypoglycemic therapy reduced the neurological deficit in comparison with the control group. Addition of citicoline to the hypoglycemic therapy did not significantly reduce the severity of brain ischemia. Conclusion. The combination treatment of animals with brain ischemia and diabetes with the GPR119 agonist and metformin significantly enhanced the therapeutic potential of both drugs evident as a better glycemic control and alleviated severity of the neurological deficit following OMCA.

scholarly journals Modern possibilities of a supporting therapy and correction of post-inflammatory skin changes in patients with acne

2021 ◽  
Vol 97 (4) ◽  
pp. 92-99
Author(s):  
Marina M. Tlish ◽  
Marina E. Shavilova
Keyword(s):  
Acne Vulgaris ◽  
Life Quality ◽  
Term Treatment ◽  
Main Group ◽  
Control Group ◽  
Skin Changes ◽  
Treatment Regimens ◽  
Long Term Treatment ◽  
Inflammatory Skin ◽  
Significant Regression

Background. Acne has a net detrimental effect on the quality of life of patients, which is due not only to long-term treatment and predominance of dermatosis on the face, but also due to substantial risk of development of enduring post-inflammatory skin changes. The main part of treatment methods for post-acne marks is currently aimed at correction of already formed rash, and not at prevention of its development. In this respect, studies aimed at development of new methods for prevention and treatment of post-inflammatory skin changes in acne are particularly topical. Aim. To evaluate clinical efficiency and tolerability of Postacnetin gel at prevention and correction of significant post-inflammatory skin changes in patients with severe forms of acne vulgaris. Methods. 60 patients with severe forms of acne were under observation and were prescribed isotretinoin and topical medications in accordance with the Federal Guidelines of Treatment. Depending on the planned supporting therapy, the patients were divided into main and control groups of 30 people. Patients of the control group used only adapalene cream after the end of the course of systemic treatment with isotretinoin. Patients of the main group were additionally prescribed Postacnetin gel 2 months before reaching the cumulated dose of isotretinoin, and were also recommended to use it within 4 months after termination of isotretinoin therapy alongside with the use of adapalene cream. The effect of Postacnetin gel on post-inflammatory skin changes was assessed over time by counting post-acne elements, mexametry data and results of assessment of cicatrical changes according to the scale of G. Goodmann et al. Tolerability of the therapy was studied by means of monitoring of adverse reactions and calculation of the dermatology life quality index (DLQI). Results. By the end of application of the systemic medication, persistent erythema developed less often in patients of the main group, and pigmentation and scars were clinically less severe according to the data of the mexametry and the scale of G. Goodman et al. Subsequent dynamic observation of patients of the main group revealed more significant regression of post-inflammatory changes in them. Thus, dark spots were less common in these patients in the 2nd and 4th months in comparison with the control group, and according to mexametry data, they were less severe. They also had lower severity of scars and level of the total index of the quantitative scale of G. Goodman et al. According to the results of monitoring of side effects and DLQI, both treatment regimens were well tolerated. Conclusion. The use of Postacnetin gel in the complex therapy of patients with severe forms of acne vulgaris is an effective method for prevention and correction of persistent post-inflammatory skin changes and is well tolerated by patients.

scholarly journals The role of neurotrophic proteins as prognostic markers of neurological, functional and cognitive impairments in the acute period of cerebral infarction in patients with sleep apnea

2021 ◽  
Vol 24 (3) ◽  
pp. 14-21
Author(s):  
Ekaterina V. Serebrova ◽  
Natalia N. Usova
Keyword(s):  
Sleep Apnea ◽  
Cerebral Infarction ◽  
Functional Outcome ◽  
Neurological Deficit ◽  
Prognostic Markers ◽  
Comparison Group ◽  
Cognitive Impairments ◽  
Main Group ◽  
Control Group ◽  
Acute Period

The objective: to evaluate the diagnostic efficacy of neurotrophic proteins BDNF, NGF, NT3 as prognostic markers of neurological, functional and cognitive impairments in the acute period of cerebral infarction in patients with and without sleep apnea. Materials and methods. 52 patients were examined in the first 72 hours from the onset of cerebral infarction (CI). The survey included an assessment on the NIHSS, mRs and MOSA scales (in the first 72 hours and after a month); study of the concentration of proteins BDNF, NGF, NT3 in plasma by enzyme immunoassay and respiratory polygraphy. The patients were divided into the main group (32 patients with sleep apnea (SA)) and the comparison group (20 patients without SA). The control group consisted of 32 patients without CI and SA. Results. In patients of main group at the end of the acute period of CI threshold concentrations of BDNF ≤1605.2 pg/ml (AUC - 80%), NGF ≤697.37 pg/ml (AUC - 78%) and NT3 ≤400.7 pg/ml (AUC - 70%) were established as effective prognostic markers of an unfavorable functional outcome (MRs≥3); BDNF ≤1994.8 pg/ml (AUC - 75%) - of severe neurological deficit (NIHSS> 4); BDNF ≤1724.7 pg/ml (AUC - 76%) and NGF ≤858.55 pg/ml (AUC - 73%) - of the presence of cognitive impairments (MOCA <26). In patients of the comparison group the threshold concentration of BDNF protein ≤1189.6 pg/ml was established as an effective prognostic marker of unfavorable functional outcome (AUC - 85%) and severe neurological deficit (AUC - 80%). Conclusion. Neurotrophic proteins have good indicators of diagnostic accuracy as prognostic markers of neurological, functional, and cognitive impairments at the end of the acute period of CI in patients with and without SA.

scholarly journals Study of the new 4-phenylpyrrolidinone-2 derivative pharmacokinetics and neuroprotective effect in the ischemic stroke animal model

2020 ◽  
pp. 49-56
Author(s):  
D.A. Borozdenko ◽  
D.N. Lyakhmun ◽  
Ya.V. Golubev ◽  
D.V. Tarasenko ◽  
N.M. Kiseleva ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Brain Tissue ◽  
Neurological Deficit ◽  
Neuroprotective Effect ◽  
Control Group ◽  
Horizontal Activity ◽  
Distribution In Blood ◽  
Hole Board Test ◽  
Brain Artery ◽  
The Brain

The development of methods of drug therapy and rehabilitation in different periods of ischemic cerebral lesion is currently an urgent problem. Our study was aimed to investigate the pharmacokinetics and anti-ischemic effect of the new 4-phenylpyrrolidone-2 derivative in rats. To study the drug pharmacokinetics, the Wistar rats were once administered with the substance at a dose of 250 mg/kg, then, the substance distribution in blood and cerebral cortex was evaluated. Elimination half-life value was determined, which was 83.2 min. The substance remained in the brain tissue for 24 hours. To assess the anti-ischemic effect, the stroke was modeled by endovascular middle brain artery transition occlusion, and the drug was administered intravenously for 5 days at two doses, 250 and 125 mg/kg. After that the lesion focus volume was evaluated by MRI, as well as the neurological deficit severity, locomotor and explorative behavior. The studied drug significantly decreased the neurological deficit in model animals compared to control group (1.72 vs 4.4, p < 0.05). According to the MRI data, the effect on the ischemic focus was negligible, while the explorative behavior significantly increased under the influence of the 4-phenylpyrrolidone-2 derivative (hole board test, horizontal activity 12.1 ± 6.8, 22.5 ±10.5, p < 0.05). The data obtained allow us to conclude that the studied substance penetrates the blood-brain barrier (BBB), and accumulates in the brain tissue promoting the neurological deficit correction and increasing the explorative behavior in the ischemic stroke model animals.

scholarly journals Neglect syndrome after ischemic stroke: diagnosis, treatment options

2019 ◽  
Vol 27 (2 (99)) ◽  
pp. 8-14
Author(s):  
Tetiana Nasonova ◽  
Tetiana Kolosova ◽  
Danylo Briakin ◽  
Natalia Mykhailovska ◽  
Igor Kurochkin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Group Treatment ◽  
Recovery Period ◽  
Main Group ◽  
Spatial Neglect ◽  
Third Party ◽  
Control Group ◽  
Visual Spatial

The purpose of the study: the study of clinical efficacy and safety of the Neuromidin® in the rehabilitation period in patients with primary ischemic stroke, its eff ect on motor, cognitive function, level of household adaptation, depending on the presence or absence of neglekt syndrome and "push-syndrome". 60 patients aged 49 to 82 years in the recovery period of ischemic stroke were examined (30 patients — the main group: treatment with the addition of Neuromidin®; 30 patients — control group: standard treatment without adding Neuromidin®). Investigation of motor, cognitive, and sensitive disorders was carried out with the use of clinical scales. The effectiveness of the treatment was evaluated in the absence of signs of neglekt syndrome and "push-syndrome", reduction of motor and cognitive impairment. Patients with neglekt syndrome showed greater dependence on third-party care and more severe cognitive impairment than in patients who had not been diagnosed neglekt syndrome. After treatment, the majori ty of patients achieved elimination of neglekt syndrome, but in the group where patients received Neuromidin®, the number of such patients was higher. In addition, patients in the main group improved cognitive function. The use of Neuromidin® in complex rehabilitation measures in patients with ischemic stroke contributes to the restoration of lost functions, reduces the phenomena of visual-spatial neglect, positively affects self-care and improves the quality of life of patients and their relatives.

Effect of High Frequency Transcranial Magnetic Stimulation (TMS) on Extensor Digitorum Communis Muscle Strength in Ischemic Stroke Patients

2020 ◽  
Vol 2 (1) ◽  
pp. 16
Author(s):  
Bastianus Alfian Juatmadja ◽  
Meisy Andriana ◽  
Rwahita Satyawati
Keyword(s):  
Ischemic Stroke ◽  
Transcranial Magnetic Stimulation ◽  
Muscle Strength ◽  
Conventional Therapy ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Intervention Group ◽  
Extensor Digitorum ◽  
Control Group ◽  
Extensor Digitorum Communis

Abstract Background: Stroke may disrupt a patient’s motor function, consequently affecting the quality of life. A stroke surviving brain has the ability to repair itself through neuroplasticity mechanism. Transcranial Magnetic Stimulation (TMS) is a non-invasive device which can be used to stimulate the lesioned part of the brain in hope of triggering neuroplasticity.Aims: To find prove of the repetitive Transcranial Magnetic Stimulation (rTMS) effect on extensor digitorum communis muscle strength improvement in ischemic stroke patients.Methods: Subjects suitable with the inclusion criteria (N=18) were divided into two groups,  control group and intervention group. The control group underwent conventional therapy exclusively every day for 5 days in a row, while the intervention group underwent rTMS therapy and conventional therapy every day for 5 days in a row. Extensor digitorum communis muscle strength was measured using surface electromyography (sEMG) before and after treatment.Result: Significant increase of sEMG numbers were found on control group (p=0,003) and intervention group (p=0,001). The increase from the intervention group was not different when compared to the control group (p=0,067).Conclusion: TMS can increase extensor digitorum communis muscle strength but with no difference with a conventional therapy.

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