Effects of Transcranial Direct Current Stimulation With Sensory Modulation on Stroke Motor Rehabilitation: A Randomized Controlled Trial
Journal
Archives of Physical Medicine and Rehabilitation
Journal Volume
98
Journal Issue
12
Pages
2477-2484
Date Issued
2017
Author(s)
Abstract
Objective To test whether a multistrategy intervention enhanced recovery immediately and longitudinally in patients with severe to moderate upper extremity (UE) paresis. Design Double-blind, randomized controlled trial with placebo control. Setting Outpatient department of a local medical center. Participants People (N=25) with chronic stroke were randomly assigned to 1 of 2 groups: a transcranial direct current stimulation with sensory modulation (tDCS-SM) group (n=14; mean age ± SD, 55.3±11.4y) or a control group (n=11; mean age ± SD, 56.9±13.5y). Interventions Eight-week intervention. The tDCS-SM group received bilateral tDCS, bilateral cutaneous anesthesia, and high repetitions of passive movements on the paretic hand. The control group received the same passive movements but with sham tDCS and sham anesthesia. During the experiment, all participants continued their regular rehabilitation. Main Outcome Measures Voluntary UE movement, spasticity, UE function, and basic activities of daily living. Outcomes were assessed at baseline, at postintervention, and at 3- and 6-month follow-ups. Results No significant differences were found between groups. However, there was a trend that the voluntary UE movement improved more in the tDCS-SM group than in the control group, with a moderate immediate effect (partial η2 [ηp2]=.14, P=.07) and moderate long-term effects (3-mo follow-up: ηp2=.17, P=.05; 6-mo follow-up: ηp2=.12, P=.10). Compared with the control group, the tDCS-SM group had a trend of a small immediate effect (ηp2=.02–.04) on reducing spasticity, but no long-term effect. A trend of small immediate and long-term effects in favor of tDCS-SM was found on UE function and daily function recovery (ηp2=.02–.09). Conclusions Accompanied with traditional rehabilitation, tDCS-SM had a nonsignificant trend of having immediate and longitudinal effects on voluntary UE movement recovery in patients with severe to moderate UE paresis after stroke, but its effects on spasticity reduction and functional recovery may be limited. ? 2017 American Congress of Rehabilitation Medicine
SDGs
Other Subjects
adult; Article; cerebrovascular accident; clinical article; controlled study; daily life activity; double blind procedure; female; follow up; human; intention to treat analysis; male; motor control; outcome assessment; outpatient department; paresis; passive movement; randomized controlled trial; spasticity; stroke rehabilitation; therapy effect; transcranial direct current stimulation; treatment duration; upper limb; aged; chronic disease; convalescence; middle aged; paralysis; procedures; stroke rehabilitation; transcranial direct current stimulation; Activities of Daily Living; Adult; Aged; Chronic Disease; Double-Blind Method; Female; Humans; Male; Middle Aged; Paralysis; Recovery of Function; Stroke Rehabilitation; Transcranial Direct Current Stimulation; Upper Extremity
Type
journal article