Risultati per: Trattamento dell’osteoporosi in post-menopausa

Stroke, Volume 56, Issue Suppl_1, Page ATP314-ATP314, February 1, 2025. Introduction:Blood pressure (BP) control after a stroke is crucial in lowering the risk of stroke recurrence. Our prior work found that over 60% of patients recently discharged from a regional health system with stroke did not achieve BP control according to current guidelines. Less is known about the impact of insurance type and co-morbidities on post-stroke BP control.Objective:To analyze the relationship between insurance type, comorbidities and post-stroke BP control among patients within a regional health system.Methods:This report is an observational cohort study. Patients were admitted between 2013-2021 for ischemic and hemorrhagic stroke and had seen a PCP/PCAPP (primary care physician/primary care advance practice provider) in a regional health system or affiliated outpatient clinics using the EPIC electronic health record. We excluded patients who died during hospitalization, were lost to follow-up, or were on dialysis.Results:The analysis included 2,750 patients. Six months after hospital discharge, the insurance coverage among stroke survivors with uncontrolled BP ( >130/80 mm Hg) was 61.1% for public, 35.8% for private, 1.9% for other/unknown, and 1.3% for self-pay. In comparison, among those with controlled BP (

Stroke, Volume 56, Issue Suppl_1, Page A85-A85, February 1, 2025. Background:Systolic blood pressure (SBP) fluctuation is linked to increased death or disability in intracerebral hemorrhage (ICH) patients. We analyzed data from the Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH)-2 trial to explore whether the association between SBP fluctuation and 90-day outcomes varies with time from randomization.Methods:We calculated hourly SBP fluctuation based on the difference between maximum and minimum SBP during the first 24 hours post-randomization. Logistic regression models assessed the impact of SBP fluctuation on: 1) death or disability (modified Rankin scale [mRS] 4-6 at 90 days); 2) hematoma expansion ( >33% increase in volume on 24-hour CT scan); 3) neurological deterioration within 24 hours (defined as ≥2-point decrease on Glasgow Coma Scale or ≥4-point increase on NIH Stroke Scale); and 4) acute kidney injury (AKI) within 72 hours. Adjustments were made for baseline Glasgow Coma Scale score, intraventricular hemorrhage, hematoma volume, and maximum SBP.Results:The hourly SBP fluctuations according to 90-day outcomes (dichotomized into good outcome, mRS 0-3, and poor outcome, mRS 4-6) in 961 patients with ICH are presented in Figure. The SBP fluctuation at 5 hours (p=0.014) and 6 hours (p=0.014) post randomization were significantly associated with death or disability at 90 days, with positive, but not statistically significant associations observed at all other points up to 13 hours after randomization. Risk of neurological deterioration within 24 hours was highly associated with SBP fluctuation, with the largest association observed between 1 (p

Stroke, Volume 56, Issue Suppl_1, Page AWMP119-AWMP119, February 1, 2025. Introduction:About 65% of women in their reproductive years use contraception, with combined oral contraceptives (OC) being among the most popular. OC, which contain estrogen and progestin, are linked to a higher risk of stroke, particularly in the first year of use. This study aims to explore the mechanisms and effects of OC exposure on stroke outcomes.Methods:Adult female Sprague-Dawley rats (n= 6-8/group) were randomly assigned to receive either a placebo or OC by oral gavage for 12-14 estrous cycles. The animals were divided into two cohorts following treatment. In the first cohort, brain tissue was harvested to obtain an unbiased global metabolomic profile (Metabolon Inc.) This metabolomic analysis was supplemented with western blotting and enzyme activity measurements of key altered pathways. The second cohort underwent either transient middle cerebral artery occlusion (tMCAO; 90 min) or sham surgery and was observed for 21 days. During this post-tMCAO/sham period, cognition was assessed using the Morris water maze, followed by brain collection for histopathological and immunohistochemical analysis.Results:OC exposure significantly increased infarct volume and impaired cognition in rats compared to the placebo group. Metabolomic analysis revealed significant alterations in sphingolipid metabolism, particularly an increase in sphingosine 1-phosphate (S1P) levels (p

Stroke, Volume 56, Issue Suppl_1, Page A91-A91, February 1, 2025. The acute phase of ischemic stroke triggers a complex cascade of cellular responses in the brain and the immune system. Previous studies show that ischemic stroke induces microglial lipid accumulation from 3d to 7d after stroke, linked to pro-inflammatory activation. However, little is known about cellular lipid alterations in peripheral immunity acutely after stroke. We hypothesized that acute ischemic stroke would increase neutral lipid content (lipid droplets) in peripheral myeloid cells and promote immunosuppression phenotypes.To assess neutral lipid levels during the first week of stroke, we used the BODIPY493/503 dye probe and performed flow cytometry on human PBMCs of healthy volunteers (N=31), and ischemic stroke patients at 3d (N=43) and 7d (N=52). In time course experiments on C57BL/6 mice (1d, 3d and 7d post-MCAO), the same technique was performed using Staph A pHrodo bioparticles, BODIPY, LipiM and Bodipy-cholesterol probes to explore changes in neutral lipid level, lipid uptake, and phagocytic activity of leukocytes. We collected white adipose tissue (WAT)-conditioned PBS from sham and 1d post-MCAO mice to stimulate naive spleen cells and examine whether factors released from WAT alter lipid content and phagocytosis.In human PBMCs, we found a significant increase in neutral lipids across innate and adaptive cells for up to 7d post-stroke (p

Stroke, Volume 56, Issue Suppl_1, Page A97-A97, February 1, 2025. Objective:To evaluate a potential relationship between post-stroke cognitive impairment (PSCI) and a radiographic measure of glymphatic function after intracerebral hemorrhage (ICH).Introduction:PSCI has been less studied in patients with ICH. Here we aim to evaluate the role of glymphatic function after ICH and its association with PSCI. Glymphatic cleanup occurs in the perivascular space (PVS) formed by astroglial end-feet loosely surrounding small arteries and veins. Here we applied non-invasive diffusion tensor imaging (DTI) to measure changes in brain diffusion due to dynamics changes of interstitial fluid (ISF) and CSF along the PVS. The application of DTI-along the perivascular space index (DTI-ALPSI) has been validated to evaluate glymphatic function. It computes the diffusivity ratio between projection and association fibers oriented orthogonally with the medullary veins at the level of the lateral ventricle body (Fig-1A).Methods:We serially imaged 18 patients with deep ICH at 9.3±9.1 (V1) and 109±28 (V2) days of onset on a 3T MRI system. Cognitive assessment was obtained via MoCA scores. Fractional anisotropy (FA) and mean diffusivity (MD) maps were registered to the T1W and SWI images. Three regions of interest (ROI), remote from a lesion, in the association and projection fibers, orthogonal to the medullary veins at PVS were used to compute diffusivity (Fig-1C). Using the equation shown, the DTI-ALPSI was calculated. DTI-ALPSI = Mean (Dx proj, Dx assoc) / Mean (Dy proj, Dz assoc)Using 3D-Flair images, hematoma (HV) and edema (EV) volumes were segmented. The ipsilesional DTI-ALPSI was correlated with MoCA, HV, and NIHSS. Contralesional DTI-ALPSI was used as a control. A non-linear regression model was used for statistical analysis.Results:We enrolled 12M/6F with an average age of 49.3±13.3y. Compared to the control, the ipsilesional DTI-ALPSI was significantly decreased (p=0.036) at V2. Temporally the MoCA scores were significantly increased (19±8.5 to 23±6.0, p

Stroke, Volume 56, Issue Suppl_1, Page AWP175-AWP175, February 1, 2025. Background:Post-stroke cognitive impairment (PSCI) is a condition characterized by cognitive decline that occurs after a stroke. PSCI affects up to 60% of stroke survivors. Early detection of those at high risk for PSCI is essential for timely intervention and personalized care. Electronic health records (EHRs) contain valuable data that can be leveraged by machine learning to predict PSCI, potentially enhancing patient outcomes. This study focuses on developing and validating machine learning models to predict PSCI, aiming to enable earlier diagnosis and improve post-stroke care.Methods:7956 all-type stroke patients (including Ischemic&Hemorrhagic stroke) treated between 2012 and 2021 were extracted from Emory Healthcare system. We employed multiple methods to predict PSCI, using ICD codes and prescribed medications that were available up to the discharge of index strokes. First, we utilized traditional machine learning methods, including Logistic Regression, Support Vector Machine, and Random Forest to develop models. Then, we developed hypergraph models to enhance prediction performance. Unlike traditional graphs that only capture pair-wise relationships between pairs of entities, hypergraphs can model the more complex higher-order relationships among multiple entities, by allowing a hyperedge (encounter) to connect multiple vertices (ICD and medications) simultaneously among patient visits and EHR medical features. Finally, we compared the performance across different methods and selected the best one for the PSCI prediction task. We compared their performance on four metrics: ACC (Accuracy, the proportion of correct predictions), AUC (Area Under the ROC Curve, measuring the model’s ability to distinguish between classes), AUPR (Area Under the Precision-Recall Curve, a comprehensive measure considering both precision and recall), and Macro-F1 (a balanced measure calculated by the harmonic mean of precision and recall).Results:We included 7956 all-type stroke patients (50% female, 56% non-white) in this analysis, where 1797 (23%) had diagnostic codes often used by clinicians at Emory to document PSCI. According to the performance, the hypergraph model was associated with higher ACC, AUC, AUPR, and Macro-F1 than other models.Conclusion:By comparing the results of various machine learning methods, we found that hypergraph model approaches outperform traditional machine learning methods in utilizing EHRs for predicting PSCI after a stroke.

Stroke, Volume 56, Issue Suppl_1, Page ATP305-ATP305, February 1, 2025. Introduction:Acute ischemic stroke (AIS) may be associated with feelings of anxiety and/or depression (A/D) in subsequent months. The purpose of this study was to determine the frequency of feelings of A/D after AIS longitudinally and to identify risk factors that may predict post-stroke feelings of A/D.Methods:Data were collected from patients with AIS at a stroke center from 2016-2022. Patients were excluded if

Stroke, Volume 56, Issue Suppl_1, Page AWMP106-AWMP106, February 1, 2025. Introduction:An elevated urinary albumin-to-creatinine ratio (UACR), a marker of renal dysfunction, has been linked to an increased incidence of stroke. However, the interplay between UACR and demographic factors such as age, obesity, ethnicity, or education remains underexplored.Methods:We conducted a post-hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, including patients with available data. Time-to-event models were developed to examine the relation between UACR and stroke risk during up to 10 years of follow-up, adjusting for variables such as gender, age, education, and race. Because the exposure of UACR had a right skew, we transformed it into top tertile versus lowest/middle tertile.Results:We included 9,025 ACCORD participants in our analyses. Baseline demographics are seen in Table 1. Those with elevated UACR (top tertile) had a higher incidence of stroke (4.6% vs 3.4%, p

Stroke, Volume 56, Issue Suppl_1, Page AWMP113-AWMP113, February 1, 2025. Introduction:Post-stroke brain stimulation is a promising neurorestorative approach, yet the molecular mechanisms driving recovery remain unclear. Our previous work demonstrated that post-stroke optogenetic stimulations of the ipsilesional primary motor cortex (iM1) promotes functional recovery. To understand the mechanisms driving post-stroke recovery, we investigated the transcriptome of iM1 in non-stimulated and stimulated mice using RNA sequencing.Methods:C57Bl6 male mice underwent stereotaxic surgery to express Channelrhodopsin in iM1 excitatory neurons, with optical fiber implanted in the same location. After 5-6 weeks, mice underwent transient middle cerebral artery occlusion (30 minutes). Stimulated mice received optogenetic stimulations from post-stroke days (PD) 5–14. Rotating beam test was performed at pre-stroke baseline, PD4, 7 and 14. iM1 from stimulated, non-stimulated stroke mice at PD 7&15, and sham mice were processed for RNA sequencing (n=4-5/group). Expression of cholesterol enzymes such as HMGCS1 was examined using quantitative PCR and immunohistochemistry. Cholesterol levels were visualized using filipin or BODIPY.Results:iM1 stimulations enhanced recovery at PD14, with longer distance traveled and faster speed on the rotating beam test (p

Stroke, Volume 56, Issue Suppl_1, Page ATP360-ATP360, February 1, 2025. Introduction:Infections account for one-third of stroke deaths. Kynurenine pathway metabolites can modulate the immune response in other contexts. We previously reported a preliminary univariate analysis that showed only significantly elevated kynurenine concentrations among patients who developed a post-stroke infection (PSI), but no differences in other pathway metabolites. This study further characterizes the association between kynurenine and PSI.Methods:Using whole blood samples from acute ischemic stroke patients in the University of Colorado Emergency Medicine Specimen Bank, high throughput mass spectrometry determined kynurenine concentrations. Multivariable linear regression modeled the association between kynurenine and characteristics that could predispose patients to a PSI or alter kynurenine levels (age, sex, NIHSS score, time from sample collection to last known well, and a history of smoking, foley placement or mechanical ventilation, dysphagia, diabetes mellitus, immunosuppression, and chronic kidney disease). Multivariable logistic regression modeled the association between kynurenine and PSI while controlling for the above covariables.Results:Of 75 patients, 32% developed a PSI. Those without a PSI were similar in mean age (64.7+/-12.1years) and race (72.6% white) compared to those with a PSI (age: 69.5+/-13years; 58.3% white). However, patients varied in terms of sex (without PSI: 37.3% female; with PSI: 62.5% female; p=0.04), immunosuppression (without PSI: 5.9% immunosuppressed; with PSI: 20.8% immunosuppressed; p=0.05), and median NIHSS (without PSI: 3.3, IQR 3-7; with PSI: 6.5, IQR 6-7; p=0.03). Only age (point estimate 0.02, p=0.04) and history of chronic kidney disease (point estimate 7.57, p

Stroke, Volume 56, Issue Suppl_1, Page ATP328-ATP328, February 1, 2025. Objective:The role of statins in the management of intracerebral hemorrhage (ICH) remains controversial. We evaluated the association between post-ICH statin continuation and the development of major adverse cardiovascular events (MACE) in a cohort of Medicare fee-for-service ICH survivors.Methods:We identified Medicare-insured patients discharged alive with radiologically confirmed ICH who were taking statin pre index ICH event from the registry of a large stroke-certified healthcare system serving a diverse metropolitan area in Texas, United States (2016-2020). We longitudinally followed the patients by linking the registry data to the Center for Medicare&Medicaid Service (CMS) claims data. We used multivariable logistic regression models to report the adjusted odds ratio (aOR) and 95% confidence interval (CI) of predictors of post-ICH statin continuation, as well as the association of post-ICH statin continuation with the development of MACE (a composite outcome, including any stroke, acute myocardial infarction [AMI], systemic embolism, or vascular death) within 1-year of follow-up. Model fit was assessed using the Hosmer-Lemeshow test.Results:Among 142 eligible pre-ICH statin users (median age [IQR]: 77.5 [72-86] years; 57.0% female; 66.0% non-Hispanic White [NHW]), 59 (41.6%) continued using statin post-ICH (median age [IQR]: 76 [73-85] years; 57.6% female; 69.5% non-Hispanic White [NHW]), and 9 (6.3%) experienced MACE within 365-days. Patients with diabetes (aOR, 95% CI: 2.99, 1.25-7.15) and those with a history of anticoagulant use (2.54, 1.00-6.43) were significantly more likely to continue using statin post-ICH. However, obesity (0.30, 0.11-0.85) and higher comorbidity burden, as measured by the Charlson Comorbidity Index (CCI) (0.78, 0.68 – 0.90), were associated with lower odds of post-ICH statin use. Conversely, a higher age-adjusted CCI was significantly associated with lower odds of post-ICH statin use (0.92, 0.86 – 0.98). Post-ICH Statin continuation (vs. discontinuation) was associated with a non-significant decrease in the odds of developing MACE (5.1% vs. 7.2%; aOR, 95% CI: 0.67, 0.12-3.80). All the multivariable logistic models had a Hosmer-Lemeshow test p-value > 0.05, indicating a good fit.Conclusions:Continuation of statin post-ICH was associated with a non-significant decrease in the odds of developing MACE. Results from ongoing large clinical trials will elucidate the risks and benefits of the use of statins among ICH survivors.

Stroke, Volume 56, Issue Suppl_1, Page ATP122-ATP122, February 1, 2025. Background:Classification of etiologic ischemic stroke subtype guides post-stroke care and secondary prevention. Etiologic ischemic stroke subtypes are often not clearly documented in post-stroke care plans especially when transferring from one facility to another. In 2021, AHA/ASA published updated secondary stroke prevention guidelines recommending identifying etiologic ischemic stroke subtypes when possible. The impact of this on post-stroke care is unknown.Methods:Charts of all patients ages 18 and up, admitted from 1/1/20 to 5/23/21 and from 1/1/22 to 5/23/23 to 3 long-term acute care (LTAC) facilities, on antiplatelet therapy, and with an ascertainable history of stroke within 90 days of admission, were retrospectively reviewed to assess for documentation of ischemic stroke subtype at discharge/transfer to an LTAC facility and to assess for appropriateness of secondary stroke prevention therapies. Care plans from those two time periods were compared to assess for any impact the 2021 guidelines may have had on discharge practices.Results:Subtypes were not defined for the majority of ischemic strokes. Classification by etiologic subtype was observed in 33% of cases. Classification by territory or location was more common (Fig. 1). One-quarter of patients were on dual antiplatelet therapy (DAPT) and 75% of patients were on single antiplatelet therapy (SAPT) with more patients on DAPT in the latter time period (Fig. 2A). Rationale for DAPT were not provided for the majority of patients and NIHSS and ABCD2 scored were also not commonly provided for patients on DAPT (Fig. 2B). Close to 90% of patients were treated with antihypertensives and statin therapy at discharge to LTAC; 71% of patients were treated with diabetic therapies at discharge; stroke education at discharge to LTAC was documented for 43% of patients; and LDL was documented in 56% of patients (Fig. 3).Conclusions:Etiologic ischemic stroke subtypes were not documented for the majority of patients transferred to LTACs. Despite recent guideline revisions, an increase in documentation of stroke subtype was not observed. Optimal secondary stroke prevention strategies were difficult to assess without this information including appropriate antiplatelet regimens. Our findings highlight the importance of the need to improve post-stroke care plans at discharge and transfer including documentation of etiologic ischemic stroke subtypes to facilitate optimal post-stroke care across all transitions.

Stroke, Volume 56, Issue Suppl_1, Page ATP115-ATP115, February 1, 2025. Background:Mechanical thrombectomy (MT) as treatment for acute ischemic stroke (AIS) has demonstrated superior functional outcomes compared to intravenous thrombolysis (IVT). Yet AIS survivors often experience a range of unstudied post-stroke complications which negatively affect patient reported outcomes. To inform clinical practice, we assessed 90-day differences in the medical management of common stroke post-complications among patients treated with MT vs. IVT.Methods:A retrospective cohort of hospitalized AIS patients treated with IVT or MT were identified from Electronic Medical Records of 92 large healthcare organizations (01/2015-09/2024). Matched propensity scores were used to adjust for baseline differences across 36 factors. Outcomes included the use of medication(s) for the management of fatigue, spasticity, mood, sleep, seizure, neurogenic bowel&neurogenic bladder. Pre-specified subgroup analyses included differences in post-stroke sequelae management stratified by NIHSS scores of ≤9 (mild AIS) or >9 (moderate/severe AIS)&differences in post-stroke sequelae between AIS patients treated with MT vs MT + IVT.Results:The final cohort consisted of n=87,819 AIS patients treated with either IVT (n=82,534) or MT (n=5,285). PS matching resulted in 5,285 matched pairs with good balance across all baseline covariates. At 90-days, AIS patients treated with MT were more likely to receive medications for spasticity (RR: 1.15, 95%CI: 1.01, 1.31), mood (RR: 1.06, 95%CI: 1.01, 1.13)&neurogenic bowel (RR: 1.11, 95%CI: 1.09, 1.14) (Table 1). Approximately 7% (n=6,344) of AIS patients had NIHSS scores – PS matching resulted in 877 matched pairs with NIHSS ≤9&848 matched pairs with NIHSS >9. Following stratification, AIS patients treated with MT were significantly more likely to receive treatment of neurogenic bowel&bladder (Table 2). For the MT vs MT + IVT comparison, patients treated with MT were 5% less likely to receive treatment for neurogenic bowel RR: 0.95 (95%CI: 0.92, 0.99) among 1,900 matched pairs (Table 3).Discussion:Using real world data, AIS patients treated with MT (vs IVT) were more likely to receive treatment for spasticity, mood&neurogenic bowel. Among patients with documented NIHSS scores, differences remained significant for treatment of neurogenic bowel and bladder after stratifying by stroke severity. Healthcare providers should screen for these post-stroke sequelae, which substantially affect quality of life for AIS survivors.

Stroke, Volume 56, Issue Suppl_1, Page ATP114-ATP114, February 1, 2025. Background and Aims:Globally, 87% of stroke patients are left with disability in low and middle-income countries. Continual rehabilitation is significant to maximize functional recovery. However, heterogeneity exists due to lack of guidelines, low prioritization of rehabilitation services, inadequate numbers of skilled rehabilitation specialists, limited health literacy, financial constraints and transportation limitations which leads to suboptimal rehabilitation. In this study we have presented tele-rehabilitation model of care for post stroke patients.Methods:IMPETUS stroke is an ongoing multicentric, prospective, multiphase, mixed-method, quasi- experimental implementation study intended to examine changes in a select set of stroke care-related indicators over time within 23 medical colleges in India. As a part of study, low cost model of tele-rehablitation services initiated using WhatsApp video communication. Periodic meetings with the collaborators and Rehabilitation teams had been done to outline the different strategies. Audio-visual training materials such as rehabilitation video and teaching manual are used as a study tool. Short specific videos had been crafted and finalized with the rehabilitation experts and collaborators specifically directed towards the post stroke recovery rehabilitation. Feasibility assessment will be done based upon the caregiver responses on the Client Satisfaction Questionnaire . Barthel Index, Stroke Rehabilitation Assessment of Movemement (STREAM) assessment and Modified Rankin Scale (mRS) will be used to assess the motor and functional outcomes.Results:A total of 731 patients provided the telerehabilitation services through live WhatsApp video conferencing after discharge. Initial assessments were done using Barthel Index, Stroke Rehabilitation Assessment of Movement assessment and Modified Rankin Scale at the time of discharge. Tailor-made exercise programs were prepared for each patient based upon the impairments. Primary caregivers were trained through on-patient demonstration and rehabilitation videos. One on one interactive and guided sessions were conducted on the 7th, 15th, 30th day of discharge in one month and then every once in a month for the next 2 months. The patient outcome data will be presented.Conclusions:The aforementioned tele-rehabilitation model of care will help to optimize motor and functional outcomes of the patient. Understanding the limitations and success of these interventions will be helpful.

Stroke, Volume 56, Issue Suppl_1, Page ATP347-ATP347, February 1, 2025. Background:Stroke remains a leading cause of death globally, with significant sex differences in post-stroke outcomes. Additionally, post-stroke infections and sepsis are linked to differences in innate immune responses. The glycosidase, Chitotriosidase 1 (CHIT1), has emerged as an important regulator of innate immunity and lower levels of CHIT1 and chitinases-like proteins are associated with disease severity and progression including multiple sclerosis. However, whether CHIT1 plays a role in the response to acute ischemic stroke is unknown.Hypothesis:We hypothesized that sex-specific alterations in pro-inflammatory factors, including CHIT1, contribute to differential patterns of phagocytosis and post-stroke outcomes.Methods:We examined the effects of acute ischemic stroke (AIS) in older men and women, specifically circulatory cytokine production, circulatory phagocytosis assessment utilizing fluorescent bead engulfment assay, and if these correlated with post-stroke complications in peripheral blood mononuclear cells (PBMCs). We examined relationships with stroke severity, as measured by the NIH Stroke Scale (NIHSS) in patients with a NIHSS >6.Results:Our findings reveal that older women exhibit lower levels of CHIT1 activity correlating with poorer survival outcomes in AIS (p

Stroke, Volume 56, Issue Suppl_1, Page ATP113-ATP113, February 1, 2025. Background:Persistent gait impairments affect nearly half of stroke survivors six months post-stroke, despite standard rehabilitation. Intermittent theta burst stimulation (iTBS), a specialized form of repetitive transcranial magnetic stimulation (TMS), has shown promise in enhancing neural circuit activity and promoting long-term potentiation. While traditionally targeting the primary motor cortex, recent studies suggest that cerebellar iTBS may further improve gait and balance by modulating cerebello-cortical pathways.Aim:This meta-analysis aims to evaluate the efficacy of cerebellar iTBS in improving gait and balance in stroke patients.Methods:We conducted a systematic search in PubMed, Embase, and the Cochrane Library until August 2024, following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Included studies were peer-reviewed randomized controlled trials (RCTs) that assessed the effects of cerebellar iTBS on balance, assessed using the Berg Balance Scale; gait, measured through 3D gait analysis and the Timed Up and Go (TUG) test; and activities of daily living, assessed via the Barthel Index, in post-stroke patients with persistent gait and balance impairments. Meta-analyses were performed using a random-effects model.Results:Seven RCTs involving a total of 230 post-stroke patients (iTBS group, n=115) were included in this meta-analysis. The analysis revealed a significant improvement in balance (standardized mean difference [SMD] = 1.20, 95% confidence interval [CI] 0.12 to 2.29, p = 0.03). However, the TUG test did not demonstrate a significant change (SMD = 0.04, 95% CI: -0.37–0.46, p = 0.83), potentially reflecting variability in baseline gait performance. The 3D gait analysis showed a favorable but non-significant trend towards step length improvement (SMD = 0.71, 95% CI: -0.82–2.23, p = 0.37). Notably, a significant enhancement was observed in activities of daily living (SMD = 1.24, 95% CI: 0.49–1.98, p = 0.001).Conclusions:This meta-analysis suggests that cerebellar iTBS significantly enhances activities of daily living in post-stroke patients, with a potential but less consistent impact on balance and gait. These findings highlight the promise of cerebellar iTBS as an adjunctive therapy in stroke rehabilitation, though further high-quality RCTs are needed to clarify its specific therapeutic benefits.