Timing-dependent effects of transcranial direct current stimulation with mirror therapy on daily function and motor control in chronic stroke: a randomized controlled pilot study.
Journal Volume
101
Journal Issue
2020
Pages
1
Date Issued
2020
Author(s)
Abstract
Background: The timing of transcranial direct current stimulation (tDCS) with neurorehabilitation interventions may affect its modulatory effects. Motor function has been reported to be modulated by the timing of tDCS; however, whether the timing of tDCS would also affect restoration of daily function and upper extremity motor control with neurorehabilitation in stroke patients remains largely unexplored. Mirror therapy (MT) is a potentially effective neurorehabilitation approach for improving paretic arm function in stroke patients. This study aimed to determine whether the timing of tDCS with MT would influence treatment effects on daily function, motor function and motor control in individuals with chronic stroke. Methods: This study was a double-blinded randomized controlled trial. Twenty-eight individuals with chronic stroke received one of the following three interventions: (1) sequentially combined tDCS with MT (SEQ), (2) concurrently combined tDCS with MT (CON), and (3) sham tDCS with MT (SHAM). Participants received interventions for 90 min/day, 5 days/week for 4 weeks. Daily function was assessed using the Nottingham Extended Activities of Daily Living Scale. Upper extremity motor function was assessed using the Fugl-Meyer Assessment Scale. Upper extremity motor control was evaluated using movement kinematic assessments. Results: There were significant differences in daily function between the three groups. The SEQ group had greater improvement in daily function than the CON and SHAM groups. Kinematic analyses showed that movement time of the paretic hand significantly reduced in the SEQ group after interventions. All three groups had significant improvement in motor function from pre-intervention to post-intervention. Conclusion: The timing of tDCS with MT may influence restoration of daily function and movement efficiency of the paretic hand in chronic stroke patients. Sequentially applying tDCS prior to MT seems to be advantageous for enhancing daily function and hand movement control, and may be considered as a potentially useful strategy in future clinical application. Trial registration: ClinicalTrials.gov Identifier: NCT02827864. Registered on 29th June, 2016. ? 2020 The Author(s).
Subjects
Activities of daily living; Mirror therapy; Stroke; Timing-dependent effect; Transcranial direct current stimulation; Upper extremity kinematics
SDGs
Other Subjects
adult; article; clinical article; controlled study; double blind procedure; female; hand function; human; kinematics; male; motor control; motor performance; movement time; Nottingham extended activities of daily living scale; pilot study; randomized controlled trial; stroke patient; transcranial direct current stimulation; upper limb; aged; biomechanics; cerebrovascular accident; convalescence; daily life activity; middle aged; multimodality cancer therapy; pathophysiology; physiotherapy; pilot study; procedures; stroke rehabilitation; transcranial direct current stimulation; upper limb; Activities of Daily Living; Adult; Aged; Biomechanical Phenomena; Combined Modality Therapy; Female; Humans; Male; Middle Aged; Physical Therapy Modalities; Pilot Projects; Recovery of Function; Stroke; Stroke Rehabilitation; Transcranial Direct Current Stimulation; Upper Extremity
Publisher
Journal of NeuroEngineering and Rehabilitation
Type
journal article