Background Intermittent theta-burst stimulation (iTBS) has been suggested to improve poststroke rehabilitation. The cerebellum is considered crucial for motor control. However, the effects of cerebellar iTBS with routine physical therapy on balance and motor recovery in subacute and chronic stroke patients have not been explored. Objective To measure the short-term effects of cerebellar iTBS with physiotherapy on the balance and functional outcomes in subacute and chronic stroke patients with hemiparesis. Methods Thirty hemiparetic patients were recruited for this randomized, double-blinded, sham-controlled trial, and randomized into either the treatment or sham group. Both groups participated in physiotherapy 5 times per week for 2 weeks, and cerebellar iTBS or sham iTBS was performed daily, immediately before physiotherapy. The primary outcome was the Berg balance scale (BBS) score. Secondary outcomes included the trunk impairment scale (TIS) score, Fugl-Meyer assessment scale score for lower extremities (FMA-LE), Barthel index (BI), and corticospinal excitability, as measured by transcranial magnetic stimulation. The outcomes were measured before and 1 week and 2 weeks after the intervention. Results Compared with those at baseline, significant increases were identified in all clinical scores (BBS, TIS, FMA-LE, and BI) in both groups after the 2-week intervention. The BBS and TIS scores improved more in the iTBS group than in the sham group. Conclusions Cerebellar iTBS with physiotherapy promotes balance and motor recovery in poststroke patients. Therefore, this method can be used in low-cost, fast, and efficient protocols for stroke rehabilitation (Chinese Clinical Trial Registry: ChiCTR1900026450).

中文翻译：

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亚急性和慢性中风患者的小脑 Theta-Burst 刺激联合物理治疗：一项试验性随机对照试验

背景 间歇性 theta-burst 刺激 (iTBS) 已被建议用于改善卒中后康复。小脑被认为对运动控制至关重要。然而，尚未探讨小脑 iTBS 与常规物理治疗对亚急性和慢性卒中患者平衡和运动恢复的影响。目的 评估小脑 iTBS 联合理疗对亚急性和慢性脑卒中偏瘫患者平衡和功能结局的短期影响。方法 本次随机、双盲、假对照试验招募了 30 名偏瘫患者，并随机分为治疗组或假手术组。两组均每周进行 5 次理疗，共 2 周，在理疗前每天进行小脑 iTBS 或假 iTBS。主要结果是伯格平衡量表（BBS）评分。次要结果包括躯干损伤量表 (TIS) 评分、下肢 Fugl-Meyer 评估量表评分 (FMA-LE)、Barthel 指数 (BI) 和皮质脊髓兴奋性，通过经颅磁刺激测量。在干预前、干预后 1 周和 2 周测量结果。结果 与基线相比，干预 2 周后，两组的所有临床评分（BBS、TIS、FMA-LE 和 BI）均显着增加。与假手术组相比，iTBS 组的 BBS 和 TIS 评分提高更多。结论 小脑iTBS联合理疗可促进卒中后患者的平衡和运动功能恢复。因此，该方法可用于低成本、快速、