Effect of iTBS and rTMS Combined with Robotic Rehabilitation on Ambulation and Lower Extremity Motor Function in Chronic SCI Patients
In brief
Brain stimulation plus robotic rehab improved leg scores by 4 to 5 points
In this 30-person trial, patients with chronic incomplete spinal cord injury had median lower-extremity motor score gains of 4 points with repetitive stimulation and 5 with theta-burst stimulation, versus no gain with sham at four weeks. Independence and walking outcomes also favored active treatment, but differences versus sham varied by outcome, and neither active approach outperformed the other.
- Journal
- American journal of physical medicine & rehabilitation (Q1)
- Published
- 7 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Ayse Naz Kalem Ozgen, Gokhan Yardimci, Bilge Yilmaz
- PMID
- 42839316
- DOI
- 10.1097/PHM.0000000000003167
Why clinicians should know about it
- Picked for Rehabilitation (paper of the day, 8 October 2026): Both rTMS and iTBS improved lower‑extremity function
Abstract
OBJECTIVE: To investigate the effectiveness of intermittent theta-burst stimulation (iTBS) and repetitive transcranial magnetic stimulation (rTMS) combined with robotic rehabilitation on ambulation and lower-extremity motor function in patients with spinal cord injury (SCI). DESIGN: This study was a single center, single blind, randomized controlled trial. A total of 30 patients with chronic incomplete SCI were randomly assigned in a 1:1:1 ratio to one of three intervention groups: high-frequency rTMS, iTBS, or sham iTBS. All interventions were administered in combination with robotic rehabilitation. Assessments were performed at baseline, post-treatment, and 4-week follow-up. RESULTS: Significant between-group differences were observed at 4 weeks for LEMS, SCIM III, and 10 MWT. Median improvements were 4.0, 5.0, and 0.0 for LEMS (P=.017, q=.050); 3.0, 5.0, and 0.0 for SCIM III (P=.016, q=.050); and 6.6, 5.7, and 0.7 for 10 MWT (P=.005, q=.046) in the rTMS, iTBS, and sham groups, respectively. No significant differences were observed between the active protocols, and no intervention-related adverse events occurred. CONCLUSIONS: Both rTMS and iTBS combined with robotic rehabilitation were associated with improvements in lower-extremity function, although differences versus sham varied across outcomes. No significant differences were observed between the two active protocols.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.