24 results found
Ma W, Nemdharry S, Cancino EE, et al., 2023, Influence of coil orientation on corticospinal excitability of trunk muscles during postural and volitional tasks in healthy adults, FRONTIERS IN HUMAN NEUROSCIENCE, Vol: 17, ISSN: 1662-5161
van Helden JFL, Martinez-Valdes E, Strutton PH, et al., 2022, Reliability of high-density surface electromyography for assessing characteristics of the thoracic erector spinae during static and dynamic tasks, Journal of Electromyography and Kinesiology, Vol: 67, ISSN: 1050-6411
PURPOSE: To establish intra- and inter-session reliability of high-density surface electromyography (HDEMG)-derived parameters from the thoracic erector spinae (ES) during static and dynamic goal-directed voluntary movements of the trunk, and during functional reaching tasks. METHODS: Twenty participants performed: 1) static trunk extension, 2) dynamic trunk forward and lateral flexion, and 3) multidirectional functional reaching tasks on two occasions separated by 7.5 ± 1.2 days. Muscle activity was recorded bilaterally from the thoracic ES. Root mean square (RMS), coordinates of the barycentre, mean frequency (MNF), and entropy were derived from the HDEMG signals. Reliability was determined with intraclass correlation coefficient (ICC), coefficient of variation, and standard error of measurement. RESULTS: Good-to-excellent intra-session reliability was found for all parameters and tasks (ICC: 0.79-0.99), whereas inter-session reliability varied across tasks. Static tasks demonstrated higher reliability in most parameters compared to functional and dynamic tasks. Absolute RMS and MNF showed the highest overall reliability across tasks (ICC: 0.66-0.98), while reliability of the barycentre was influenced by the direction of the movements. CONCLUSION: RMS and MNF derived from HDEMG show consistent inter-session reliability in goal-directed voluntary movements of the trunk and reaching tasks, whereas the measures of the barycentre and entropy demonstrate task-dependent reliability.
Jones EJ, Chiou S-Y, Atherton PJ, et al., 2022, Ageing and exercise-induced motor unit remodelling, JOURNAL OF PHYSIOLOGY-LONDON, Vol: 600, Pages: 1839-1849, ISSN: 0022-3751
Chiou SY, Clarke E, Lam C, et al., 2022, Effects of Arm-Crank Exercise on Fitness and Health in Adults With Chronic Spinal Cord Injury: A Systematic Review, FRONTIERS IN PHYSIOLOGY, Vol: 13
Rowland RS, Jenkinson N, Chiou S-Y, 2021, Age-Related Differences in Corticospinal Excitability and Anticipatory Postural Adjustments of the Trunk, FRONTIERS IN AGING NEUROSCIENCE, Vol: 13, ISSN: 1663-4365
Goodyear VA, Boardley I, Chiou S-Y, et al., 2021, Social media use informing behaviours related to physical activity, diet and quality of life during COVID-19: a mixed methods study., BMC Public Health, Vol: 21
BACKGROUND: This mixed methods study explored how social media use informed physical activity and diet-related behaviours, and self-perceived Quality of Life (QoL) during COVID-19, and assessed the contextual factors that drive social media use for health-related behaviour change in diverse groups. During the COVID-19 lockdown periods there were reported changes to social media use and health behaviours, and this gave an opportunity to investigate potential relationships. METHODS: An explanatory sequential research design of two parts was used: (1) An online survey that assessed social media use in relation to physical activity levels, diet quality and QoL (n = 786; Mage 45.1 ± 19.1 (range 16-88) years; Female =69%); (2) 20 purposive focus groups (n = 69; Mage = 52.88 ± 18.45 years, Female n = 68%) to understand the contextual factors that drive social media use for health-related behaviour change. Descriptive and thematic analysis were conducted. RESULTS: Participants in this study reported that social media facilitated the self-management of behaviours related to physical activity, diet and QoL, through access to information to inform workouts and dietary quality, and the opportunities for interaction with peers, family members and within social groups. Contextual factors including work, home and lifestyle arrangements, pre-existing health-related knowledge and behaviours, and the perceived value of social media for health influenced the relationship between social media use and self-reported outcomes. Social media influencers, peers/family members, and official organisations influenced the application of health-related information accessed via social media. CONCLUSIONS: The evidence shows that participants were critical users of social media and were able to use social media to derive benefit for their health and wellbeing. Detailed guidance for those who use
Papi E, Chiou S-Y, McGregor A, 2020, A feasibility and acceptability study on the use of a smartphone application to facilitate balance training in the ageing population, BMJ Open, Vol: 10, ISSN: 2044-6055
Objectives This study aims to investigate the feasibilityand acceptability of using an app-based technology totrain balance in the older population.Design Prospective feasibility study.Setting The study was conducted in a university settingand participants’ homes.Participants Thirty-five volunteers ≥55 years old wererecruited.InterventionParticipants were asked to follow a balanceexercise programme 7 days a week for 3 weeks using aphone application. Seventeen participants trained for afurther 3 weeks.Outcome measuresPostural sway measures duringquiet standing with feet at shoulder width apart andfeet together, one leg standing and tandem stancewere measured at baseline, and at the end of the 3and 6 training weeks; the International Physical ActivityQuestionnaire (IPAQ) assessed participants’ physicalactivity level before training; and app acceptability wasrecorded using a user experience questionnaire.ResultsParticipants on the 3 and 6-week programmeon average completed 20 (±5) and 38 (±11) days oftraining, respectively, and all scored moderate to high onthe IPAQ. Between baseline and the 3-week assessments,statistically significant improvements were observedfor anteroposterior sway, mediolateral sway, sway areaduring tandem stance, for anteroposterior sway duringone leg standing and for sway area during feet togetherstance. Improvements were observed at 6 week comparedwith baseline but those between 3 and 6 weeks werenot significant. Based on the questionnaire, participantsreported that the app is an appropriate tool for balancetraining (77%), they reported benefits from the training(50%) and found it easy to fit it into daily routine (88%).Conclusion The high level of adherence andimprovements observed in the analysed measuresdemonstrate the feasibility of using an app to train balancein moderately to highly physically active older participants.This demonstrates that given appropriate tools the olderpopulation is positive towards and r
Chiou S-Y, Strutton PH, 2020, Crossed corticospinal facilitation between arm and trunk muscles correlates with trunk control after spinal cord injury, Frontiers in Human Neuroscience, Vol: 14, Pages: 1-11, ISSN: 1662-5161
Objective: To investigate whether crossed corticospinal facilitation between arm and trunk muscles is preserved following spinal cord injury (SCI) and to elucidate these neural interactions for postural control during functional arm movements.Methods: Using transcranial magnetic stimulation (TMS) in 22 subjects with incomplete SCI motor evoked potentials (MEPs) in the erector spinae (ES) muscle were examined when the contralateral arm was at rest or performed 20% of maximal voluntary contraction (MVC) of biceps brachii (BB) or triceps brachii (TB). Trunk function was assessed with rapid shoulder flexion and forward-reaching tasks.Results: MEP amplitudes in ES were increased during elbow flexion in some subjects and this facilitatory effect was more prominent in subjects with thoracic SCI than in the subjects with cervical SCI. Those who showed the increased MEPs during elbow flexion had faster reaction times and quicker anticipatory postural adjustments of the trunk in the rapid shoulder flexion task. The onset of EMG activity in ES during the rapid shoulder flexion task correlated with the trunk excursion in forward-reaching.Conclusions: Our findings demonstrate that crossed corticospinal facilitation in the trunk muscles can be preserved after SCI and is reflected in trunk control during functional arm movements.
Chiou S-Y, Morris L, Gou W, et al., 2020, Motor cortical circuits contribute to crossed facilitation of trunk muscles induced by rhythmic arm movement, SCIENTIFIC REPORTS, Vol: 10, ISSN: 2045-2322
Zou L, Loprinzi PD, Yu JJ, et al., 2019, Superior Effects of Modified Chen-Style Tai Chi versus 24-Style Tai Chi on Cognitive Function, Fitness, and Balance Performance in Adults over 55, BRAIN SCIENCES, Vol: 9
Chiou S-Y, Strutton PH, Perez MA, 2018, Crossed corticospinal facilitation between arm and trunk muscles in humans, Journal of Neurophysiology, Vol: 120, Pages: 2595-2602, ISSN: 0022-3077
A voluntary contraction of muscles with one arm increases corticospinal excitability of projections to the contralateral resting arm, a phenomenon known as crossed facilitation. Although many motor tasks engage simultaneous activation of the arm and trunk, interactions between corticospinal projections targeting these segments remain largely unknown. Using transcranial magnetic stimulation over the trunk representation of the primary motor cortex we examined motor evoked potentials (MEPs) in the resting erector spinae (ES) muscle when the contralateral arm remained at rest or performed 20% of isometric maximal voluntary contraction (MVC) into index finger abduction, thumb abduction, elbow flexion and elbow extension. We found that MEP size in the ES increased during all voluntary contractions, with greater facilitation occurring during elbow flexion and index finger abduction. To further examine the origin of changes in MEP size we measured short-interval intracortical inhibition (SICI) and cervicomedullary MEPs (CMEPs) in the ES muscle during elbow flexion and index finger abduction and when the arm remained at rest. Notably, SICI decreased and CMEPs remained unchanged in the ES during both voluntary contractions compared with rest, suggesting a cortical origin for the effects. Our findings reveal crossed facilitatory interactions between trunk extensor and proximal and distal arm muscles, particularly for elbow flexor and index finger muscles, likely involving cortical mechanisms. These interactions might reflect the different role of these muscles during functionally relevant arm and trunk movements.
Zou L, Yeung A, Li C, et al., 2018, Effects of Mind-Body Movements on Balance Function in Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 15
Chiou S-Y, Hurry M, Reed T, et al., 2018, Cortical contributions to anticipatory postural adjustments in the trunk, JOURNAL OF PHYSIOLOGY-LONDON, Vol: 596, Pages: 1295-1306, ISSN: 0022-3751
Voluntary limb movements are associated with increases in trunk muscle activity, some of which occur within a time window considered too fast to be induced by sensory feedback; these increases are termed anticipatory postural adjustments (APAs). Although it is known that the function of APAs is to maintain postural stability in response to perturbations, excitability of the corticospinal projections to the trunk muscles during the APAs remains unclear. Thirty‐four healthy subjects performed rapid shoulder flexion in response to a visual cue in standing and lying positions. Transcranial magnetic stimulation (TMS) was delivered over the trunk motor cortex to examine motor evoked potentials (MEPs) in erector spinae (ES) and in rectus abdominis (RA) muscles at several time points prior to the rise in electromyographic activity (EMG) of anterior deltoid (AD) muscle. TMS was also used to assess short‐interval intracortical inhibition (SICI) and cervicomedullary MEPs (CMEPs) in ES in the standing position. MEPs in ES were larger at time points closer to the rise in AD EMG in both standing and lying positions, whereas MEPs in RA did not differ over the time course examined. Notably, SICI was reduced at time points closer to the rise in AD EMG, with no change in CMEPs. Our results demonstrate that increasing excitability of corticospinal projections to the trunk muscles prior to a voluntary limb movement is likely to be cortical in origin and is muscle specific.
Chiou S, Koutsos E, Georgiou P, et al., 2018, Association between spectral characteristics of paraspinal muscles and functional disability in low back pain patients: a cohort study, BMJ Open, Vol: 8, ISSN: 2044-6055
Objectives. Characteristics of muscle activity, represented by surface electromyography (EMG), have revealed differences between patients with low back pain and healthy adults; how they relate to functional and clinical parameters remains unclear. The purpose of the current study was to examine the correlation between frequency characteristics of EMG (analysed using continuous wavelet transform (CWT) analysis) and patients’ self-rated score of disability. Design and setting. This is a case control study with fifteen patients with mechanical low back pain (LBP) without radicular symptoms. Patients were recruited from the orthopaedic clinic at Charing Cross Hospital. Ten healthy adults were recruited from the staff working in the hospital and associated university. Patients completed the Roland-Morris Disability Questionnaire (RMDQ) and bilateral EMG activity was obtained from erector spinae at vertebral levels L4 and T12. Subjects performed 3 brief maximal isometric voluntary contractions (MVCs) of the back extensors and the torque was measured using a dynamometer. CWT was applied to the EMG signals of each muscle in a 200ms window centred around the peak torque obtained during the MVCs. The ratio (low/high frequencies) of the energy, the peak power, and the frequency of the peak power were calculated for each recording site, averaged and correlated with the individual’s RMDQ score. Results. Patients had lower peak power (T12 and L4) and lower frequency of the peak power (at T12) than the healthy adults. Additionally, RMDQ positively correlated to the average ratio of energy at T12 (rho=0.63; p=0.012), i.e. greater self-rated disability corresponded to a dominant distribution of energy in the lower frequencies. Conclusion. The current findings reveal alterations in EMG profile and its association with self-related back pain disability, suggesting that spectral characteristics of EMG reflect muscle function.
Chiou SY, Hellyer PJ, Sharp DJ, et al., 2017, Relationships between the integrity and function of lumbar nerve roots as assessed by diffusion tensor imaging and neurophysiology, NEURORADIOLOGY, Vol: 59, Pages: 893-903, ISSN: 0028-3940
PurposeDiffusion tensor imaging (DTI) has shown promise in the measurement of peripheral nerve integrity, although the optimal way to apply the technique for the study of lumbar spinal nerves is unclear. The aims of this study are to use an improved DTI acquisition to investigate lumbar nerve root integrity and correlate this with functional measures using neurophysiology.MethodsTwenty healthy volunteers underwent 3 T DTI of the L5/S1 area. Regions of interest were applied to L5 and S1 nerve roots, and DTI metrics (fractional anisotropy, mean, axial and radial diffusivity) were derived. Neurophysiological measures were obtained from muscles innervated by L5/S1 nerves; these included the slope of motor-evoked potential input-output curves, F-wave latency, maximal motor response, and central and peripheral motor conduction times.ResultsDTI metrics were similar between the left and right sides and between vertebral levels. Conversely, significant differences in DTI measures were seen along the course of the nerves. Regression analyses revealed that DTI metrics of the L5 nerve correlated with neurophysiological measures from the muscle innervated by it.ConclusionThe current findings suggest that DTI has the potential to be used for assessing lumbar spinal nerve integrity and that parameters derived from DTI provide quantitative information which reflects their function.
Chiou S-Y, Wang R-Y, Liao K-K, et al., 2016, Facilitation of the Lesioned Motor Cortex During Tonic Contraction of the Unaffected Limb Corresponds to Motor Status After Stroke, Journal of Neurologic Physical Therapy, Vol: 40, Pages: 15-21, ISSN: 1557-0576
Background and Purpose: Contraction of the muscles of the unaffected hand is associated with enhanced activation of lesioned motor cortex (ie, crossed facilitation) in some individuals after stroke. However, the association between crossed facilitation and motor function status remains unclear. We investigated whether existence of crossed facilitation corresponds to motor status of the affected upper limb after stroke.Methods: Data were collected from 58 participants with unilateral stroke. The Fugl-Meyer assessment of upper extremity (FMA-UE) was used to evaluate motor status. Motor-evoked potentials (MEPs) were elicited from the abductor pollicis brevis (ABP) of the affected side under 3 conditions: rest, tonic contraction of the ABP of the unaffected side, or tonic contraction of the tibialis anterior of the unaffected side.Results: In 28 of the 58 participants, MEPs could be elicited from the affected ABP at rest; these participants also exhibited crossed facilitation during contraction on the unaffected side. Participants with MEPs at rest exhibited higher FMA-UE scores (53.04 ± 2.59) compared with participants with absent MEP (19.83 ± 1.60; Z = −6.21). Seven participants with no MEPs at rest had MEPs with crossed facilitation; their FMA-UE scores were higher compared with the 23 who had no ABP MEP under any condition (Z = −2.66). FMA-UE scores were positively correlated with the amount of crossed facilitation during the APB task (r = 0.68) and the tibialis anterior task (r = 0.54).Discussion and Conclusions: In some participants, MEPs in the affected hand muscle were enhanced by tonic contraction of the muscles on the unaffected side even if no MEP could be evoked at rest. The degree of crossed facilitation in the affected hand muscle was correlated with the level of motor function of the affected upper limb, and the FMA-UE score could classify the presence/absence of crossed facilitation.
Chiou S-Y, Gottardi SE, Hodges PW, et al., 2016, Corticospinal Excitability of Trunk Muscles during Different Postural Tasks, PLoS One, Vol: 11, ISSN: 1932-6203
Evidence suggests that the primary motor cortex (M1) is involved in both voluntary, goal-directed movements and in postural control. Trunk muscles are involved in both tasks, however, the extent to which M1 controls these muscles in trunk flexion/extension (voluntary movement) and in rapid shoulder flexion (postural control) remains unclear. The purpose of this study was to investigate this question by examining excitability of corticospinal inputs totrunk muscles during voluntary and postural tasks. Twenty healthy adults participated. Transcranial magnetic stimulation was delivered to the M1 to examine motor evoked potentials (MEPs) in the trunk muscles (erector spinae (ES) and rectus abdominis (RA)) during dynamic shoulder flexion (DSF), static shoulder flexion (SSF), and static trunk extension (STE). The level of background muscle activity in the ES muscles was matched across tasks. MEP amplitudes in ES were significantly larger in DSF than in SSF or in STE; however, this was not observed for RA. Further, there were no differences in levels of muscleactivity in RA between tasks. Our findings reveal that corticospinal excitability of the ES muscles appears greater during dynamic anticipatory posture-related adjustments than during static tasks requiring postural (SSF) and goal-directed voluntary (STE) activity. These results suggest that task-oriented rehabilitation of trunk muscles should be considered for optimal transfer of therapeutic effect to function.
Chiou SY, Jeevathol A, Odedra A, et al., 2015, Voluntary activation of trunk extensors appears normal in young adults who have recovered from low back pain, European Journal of Pain, Vol: 19, Pages: 1506-1515, ISSN: 1090-3801
BackgroundLow back pain (LBP) is associated with alterations in control of trunk movements and changes within central nervous system (CNS). Evidence shows that some of these alterations within the CNS are reversible when the symptoms are relieved, whereas other shows the opposite. Therefore, the purpose of the current study was to investigate whether alterations in voluntary activation (VA) of central neural drive, as assessed using twitch interpolation to measure VA, are present in subjects with a history of low back pain (HLBP), who are free from pain at the time of experiment.MethodsTwelve adults with HLBP and 12 controls participated. Bilateral electromyographic recordings were obtained from erector spiane muscles at two vertebral levels (T12 and L4) and from rectus abdominis. Participants performed a series of brief isometric back extensions (50–100% maximum voluntary contraction) during which transcranial magnetic stimulation was delivered. The sizes of the evoked (superimposed) twitches were measured using dynamometry and VA was derived. The amplitude of motor evoked potentials (MEPs) and duration of cortical silent period (CSP) in erector spinae muscles were calculated; questionnaires were used to evaluate disability, levels of physical activity, quality of life and pain.ResultsThe level of VA was not significantly different between HLBP and control groups. Additionally, there were no between‐group differences in the time‐to‐peak amplitudes of the twitches, MEP amplitudes or duration of CSP.ConclusionsThe ability to voluntarily activate back extensor muscles maximally does not appear to be impaired in subjects with a history of LBP during pain‐free episodes.
Chiou SY, Wang RY, Roberts RE, et al., 2014, Fractional Anisotropy in Corpus Callosum Is Associated with Facilitation of Motor Representation during Ipsilateral Hand Movements, PLOS One, Vol: 9, ISSN: 1932-6203
BACKGROUND: Coactivation of primary motor cortex ipsilateral to a unilateral movement (M1(ipsilateral)) has been observed, and the magnitude of activation is influenced by the contracting muscles. It has been suggested that the microstructural integrity of the callosal motor fibers (CMFs) connecting M1 regions may reflect the observed response. However, the association between the structural connectivity of CMFs and functional changes in M1(ipsilateral) remains unclear. The purpose of this study was to investigate the relationship between functional changes within M1(ipsilateral) during unilateral arm or leg movements and the microstructure of the CMFs connecting both homotopic representations (arm or leg). METHODS: Transcranial magnetic stimulation was used to assess changes in motor evoked potentials (MEP) in an arm muscle during unilateral movements compared to rest in fifteen healthy adults. Functional magnetic resonance imaging was then used to identify regions of M1 associated with either arm or leg movements. Diffusion-weighted imaging data was acquired to generate CMFs for arm and leg areas using the areas of activation from the functional imaging as seed masks. Individual values of regional fractional anisotropy (FA) of arm and leg CMFs was then calculated by examining the overlap between CMFs and a standard atlas of corpus callosum. RESULTS: The change in the MEP was significantly larger in the arm movement compared to the leg movement. Additionally, regression analysis revealed that FA in the arm CMFs was positively correlated with the change in MEP during arm movement, whereas a negative correlation was observed during the leg movement. However, there was no significant relationship between FA in the leg CMF and the change in MEP during the movements. CONCLUSIONS: These findings suggest that individual differences in interhemispheric structural connectivity may be used to explain a homologous muscle-dominant effect within M1(ipsilateral) hand representat
Chiou SY, Shih YF, Chou LW, et al., 2014, Impaired neural drive in patients with low back pain, European Journal of Pain, Vol: 18, Pages: 794-802, ISSN: 1090-3801
BackgroundControl of trunk movement relies on the integration between central neuronal circuits and peripheral skeletomuscular activities and it can be altered by pain. There is increasing evidence that there are deficits within the central nervous system controlling the trunk muscles in people with low back pain (LBP). However, it is unclear how LBP impacts upon neural drive to back muscles at different levels of voluntary contraction. Therefore, the purpose of this study was to investigate if neural drive is impaired in these patients.MethodsSeventeen patients with LBP and 11 healthy controls were recruited. Bilateral electromyographic (EMG) recordings were obtained from the erector spinae (ES) muscles at two vertebral levels (T12 and L4). Participants performed a series of brief isometric back extensions (50–100% maximum voluntary contraction – MVC), during which transcranial magnetic stimulation was delivered. The size of the evoked (superimposed) twitch was measured using dynamometry.ResultsThe size of the superimposed twitch decreased linearly with increasing contraction strength in the controls; however, this linear relationship was not observed in the patients. Additionally, patients had larger superimposed twitches and longer time‐to‐peak amplitudes during MVCs than those observed in controls. Furthermore, patients had lower MVC and root‐mean‐square EMG activity of ES muscles during MVCs.ConclusionsA decline of central neural drive to the back muscles at high level of voluntary contraction was observed in patients with LBP. These results suggest that it might be pertinent to include neuromuscular facilitation programmes and therapeutic exercise utilizing high voluntary contractions for patients with LBP.
Chiou S-Y, Wang R-Y, Liao K-K, et al., 2013, Homologous Muscle Contraction during Unilateral Movement Does Not Show a Dominant Effect on Leg Representation of the Ipsilateral Primary Motor Cortex, PLOS One, Vol: 8, ISSN: 1932-6203
Co-activation of homo- and heterotopic representations in the primary motor cortex (M1) ipsilateral to a unilateral motor task has been observed in neuroimaging studies. Further analysis showed that the ipsilateral M1 is involved in motor execution along with the contralateral M1 in humans. Additionally, transcranial magnetic stimulation (TMS) studies have revealed that the size of the co-activation in the ipsilateral M1 has a muscle-dominant effect in the upper limbs, with a prominent decline of inhibition within the ipsilateral M1 occurring when a homologous muscle contracts. However, the homologous muscle-dominant effect in the ipsilateral M1 is less clear in the lower limbs. The present study investigates the response of corticospinal output and intracortical inhibition in the leg representation of the ipsilateral M1 during a unilateral motor task, with homo- or heterogeneous muscles. We assessed functional changes within the ipsilateral M1 and in corticospinal outputs associated with different contracting muscles in 15 right-handed healthy subjects. Motor tasks were performed with the right-side limb, including movements of the upper and lower limbs. TMS paradigms were measured, consisting of short-interval intracortical inhibition (SICI) and recruitment curves (RCs) of motor evoked potentials (MEPs) in the right M1, and responses were recorded from the left rectus femoris (RF) and left tibialis anterior (TA) muscles. TMS results showed that significant declines in SICI and prominent increases in MEPs of the left TA and left RF during unilateral movements. Cortical activations were associated with the muscles contracting during the movements. The present data demonstrate that activation of the ipsilateral M1 on leg representation could be increased during unilateral movement. However, no homologous muscle-dominant effect was evident in the leg muscles. The results may reflect that functional coupling of bilateral leg muscles is a reciprocal movement.
Chiou S-Y, Wang R-Y, Liao K-K, et al., 2013, Co-activation of primary motor cortex ipsilateral to muscles contracting in a unilateral motor task, CLINICAL NEUROPHYSIOLOGY, Vol: 124, Pages: 1353-1363, ISSN: 1388-2457
Yang Y-R, Tseng C-Y, Chiou S-Y, et al., 2013, Combination of rTMS and Treadmill Training Modulates Corticomotor Inhibition and Improves Walking in Parkinson Disease: A Randomized Trial, NEUROREHABILITATION AND NEURAL REPAIR, Vol: 27, Pages: 79-86, ISSN: 1545-9683
Lin K-P, Liao K-K, Lai K-L, et al., 2012, Effect of Transcranial Magnetic Stimulation to Motor Cortex on Pain Perception and Nociceptive Reflex, CHINESE JOURNAL OF PHYSIOLOGY, Vol: 55, Pages: 163-168, ISSN: 0304-4920
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