RecruitingNot ApplicableNCT06123650

Post Stroke Dysphagia: Effect of Adding rTMS to Conventional Therapy on the Prevalence of Pneumonia.

Post Stroke Dysphagia: Effect of Adding Brain Neuromodulation to Conventional Therapy on the Prevalence of Stroke Associated Pneumonia.

Sponsor

Cairo University

Enrollment

70 participants

Start Date

Mar 22, 2025

Study Type

INTERVENTIONAL

Conditions

Pneumonia Dysphagia Stroke, Acute

Summary

BACKGROUND: Dysphagia is one of the most life-threatening stroke complications. Dysphagic stroke patients are at increased risk of aspiration pneumonia. Pneumonia accounts for at least 10% of post stroke deaths within 30 days of hospitalization after stroke. rTMS is effective in improving post-stroke dysphagia and swallowing coordination after stimulation of the unaffected hemisphere, however it's efficacy on the prevalence of pneumonia has not yet been examined. Purpose of the study: To determine the effect of adding low frequency repetitive transcranial magnetic stimulation to conventional oropharyngeal physical therapy program on the prevalence of aspiration pneumonia in in patients with post stroke dysphagia.

Eligibility

Min Age: 49 YearsMax Age: 65 Years

Inclusion Criteria5

All the patients were diagnosed of stroke oropharyngeal dysphagia by a neurologist. Sever to moderate dysphagia (GUSS 0-14).
Severity of stroke ranged from mild to moderate according to NIHSS score (NIHSS less than or equal 16).
Patients' age ranged from 49 to 65 years old.
Patients had the ability to understand and follow instructions.
Patients were able to sit in upright position.

Exclusion Criteria7

History of previous stroke.
History of any swallowing problem.
History of any head and neck surgery or tumor that causes swallowing dysfunction.
Any lung disease or pneumonia on admission.
Patients with cognitive deficits or disturbed conscious level.
Patients on mechanical ventilator.
Patients with sensory or global aphasia.

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Interventions

DEVICERepetitve transcranial magnetic stimulation

The Magstim Rapid2 magnetic stimulator system (Model P/N 3576-23-09, Magstim Company, Whitland, UK) was used to deliver rTMS electrical currents via a figure of 8 coil applied to the scalp against the targeted contralesional motor " Hot spot" , at a depth of approximately 1 cm . The inhibitory rTMS will be applied to the intact cerebral hemisphere at 1 Hz with a train of 1200 for 5 consecutive days.

DEVICESham transcranial magnetic stimulation

Repetitive TMS via a sham Magstim coil (identical appearance and noise, but no active stimulation). Identical stimulation schedules as patients in study group.