Affiliation:
1. Physical Therapy Center Faculty of Physical Therapy Mahidol University Bangkok Thailand
2. Parkinson Movement and Research Collaboration Laboratory Faculty of Physical Therapy Mahidol University Nakhon Pathom Thailand
3. Functional Neuroimaging Cognitive and Mobility Laboratory Department of Radiology University of Michigan Ann Arbor Michigan USA
Abstract
AbstractBackgroundParkinson's disease (PD) is a neurodegenerative disorder characterized by motor impairments, especially in the area of gait disturbances. Physiotherapy, with a focus on task‐specific training, has demonstrated a level of efficacy as regards alleviating symptoms and enhancing functional capabilities in individuals with PD. Repetitive Transcranial Magnetic Stimulation (rTMS) has emerged as a potential therapeutic intervention for improving motor functions in individuals with PD.AimsThis review article aims to investigate the effects of combining rTMS with task‐specific training on gait performance in individuals with PD.Materials and MethodsPubMed, Physiotherapy Evidence Database (PEDro), and Scopus were all searched for relevant studies. The focus of the search was on studies that investigated the efficacy of combining rTMS with task‐specific training to improve gait performance in individuals with PD.ResultsFour studies were identified as fulfilling the eligibility criteria and were included in the study. The combination of rTMS with specific treadmill training and weight‐bearing exercises can significantly enhance walking efficiency, including improvements in walking speed, self‐mobility, and step rate. In addition, the combination of rTMS and task‐specific training, such as treadmill‐based training, shows promise in enhancing gait performance in individuals with PD.Discussion and ConclusionHigh‐frequency rTMS targeting the primary motor cortex (or M1) can result in improved walking speed, self‐mobility, and step rate. However, limited research exists regarding low‐frequency stimulation of the supplementary motor area (SMA) in individuals with gait issues. Further research is required to determine the optimal parameters of rTMS, such as strength, frequency, and duration of stimulation and it is worth considering the incorporation of additional training modalities, including cognitive exercises.