scholarly journals Baseline Motor Impairment Predicts Transcranial Direct Current Stimulation Combined with Physical Therapy-Induced Improvement in Individuals with Chronic Stroke

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Adriana Baltar ◽  
Daniele Piscitelli ◽  
Déborah Marques ◽  
Lívia Shirahige ◽  
Kátia Monte-Silva
Keyword(s):  
Physical Therapy ◽  
Upper Limb ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Brain Lesion ◽  
Motor Impairment ◽  
Chronic Stroke ◽  
Stroke Severity ◽  
Direct Current Stimulation ◽  
Before And After

Transcranial direct current stimulation (tDCS) can enhance the effect of conventional therapies in post-stroke neurorehabilitation. The ability to predict an individual’s potential for tDCS-induced recovery may permit rehabilitation providers to make rational decisions about who will be a good candidate for tDCS therapy. We investigated the clinical and biological characteristics which might predict tDCS plus physical therapy effects on upper limb motor recovery in chronic stroke patients. A cohort of 80 chronic stroke individuals underwent ten to fifteen sessions of tDCS plus physical therapy. The sensorimotor function of the upper limb was assessed by means of the upper extremity section of the Fugl-Meyer scale (UE-FM), before and after treatment. A backward stepwise regression was used to assess the effect of age, sex, time since stroke, brain lesion side, and basal level of motor function on UE-FM improvement after treatment. Following the intervention, UE-FM significantly improved ( p < 0.05 ), and the magnitude of the change was clinically important (mean 6.2 points, 95% CI: 5.2–7.4). The baseline level of UE-FM was the only significant predictor ( R 2 = 0.90 , F 1 , 76 = 682.80 , p < 0.001 ) of tDCS response. These findings may help to guide clinical decisions according to the profile of each patient. Future studies should investigate whether stroke severity affects the effectiveness of tDCS combined with physical therapy.

scholarly journals Effectiveness of a combined transcranial direct current stimulation and virtual reality-based intervention on upper limb function in chronic individuals post-stroke with persistent severe hemiparesis: a randomized controlled trial

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Roberto Llorens ◽  
María Antonia Fuentes ◽  
Adrián Borrego ◽  
Jorge Latorre ◽  
Mariano Alcañiz ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Physical Therapy ◽  
Motor Function ◽  
Upper Limb ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Sensorimotor Function ◽  
Meaningful Improvement ◽  
Direct Current Stimulation ◽  
Post Stroke

Abstract Background Functional impairments derived from the non-use of severely affected upper limb after stroke have been proposed to be mitigated by action observation and imagination-based techniques, whose effectiveness is enhanced when combined with transcranial direct current stimulation (tDCS). Preliminary studies in mildly impaired individuals in the acute phase post-stroke show intensified effects when action is facilitated by tDCS and mediated by virtual reality (VR) but the effectiveness in cases of severe impairment and chronic stroke is unknown. This study investigated the effectiveness of a combined tDCS and VR-based intervention in the sensorimotor function of chronic individuals post-stroke with persistent severe hemiparesis compared to conventional physical therapy. Methods Twenty-nine participants were randomized into an experimental group, who received 30 minutes of the combined tDCS and VR-based therapy and 30 minutes of conventional physical therapy, or a control group, who exclusively received conventional physical therapy focusing on passive and active assistive range of motion exercises. The sensorimotor function of all participants was assessed before and after 25 one-hour sessions, administered three to five times a week, using the upper extremity subscale of the Fugl-Meyer Assessment, the time and ability subscales of the Wolf Motor Function Test, and the Nottingham Sensory Assessment. Results A clinically meaningful improvement of the upper limb motor function was consistently revealed in all motor measures after the experimental intervention, but not after conventional physical therapy. Similar limited effects were detected in the sensory function in both groups. Conclusion The combined tDCS and VR-based paradigm provided not only greater but also clinically meaningful improvement in the motor function (and similar sensory effects) in comparison to conventional physical therapy.

scholarly journals Effects of Cerebellar Transcranial Direct Current Stimulation (tDCS) on Timed Up and Go Test with Foot Placement in Chronic Stroke Patients

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Roghayeh Mohammadi ◽  
Zeinab Mahmoudi ◽  
Nahid Mahmoodian
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Foot Placement ◽  
Direct Current Stimulation ◽  
Functional Balance ◽  
Before And After ◽  
Cerebellar Tdcs

Objectives: The purpose of this study was to assess the effect of a single session of cerebellar anodal cerebellar transcranial direct current stimulation (tDCS) on timed up and go test (TUG) with foot placement in patients with chronic stroke. Methods: Twenty patients with chronic stroke participated in this clinical trial. TUG test was carried out with four different foot positions, 1- spontaneous foot positions (SP), 2- symmetrical foot positions (SYP), 3- asymmetrical foot positions (PBNP), paretic foot behind the non-paretic foot, and 4- asymmetrical foot positions (NPBP), nonparetic foot behind the paretic foot, before and after using tDCS. Anodal tDCS (1.5 mA) was applied over the cerebellum for 20 minutes. Results: The time of the TUG test was significantly different after using tDCS at all foot positions: SP (P = 0.012), SYP (P = 0.010), PBNP (P = 0.047), and NPBP (P = 0.037). Conclusions: It seems that cerebellar tDCS can be a useful method in improving functional balance in chronic stroke patients.

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