[Abstract] Effectiveness of a single session of dual-transcranial direct current stimulation in combination with upper limb robotic-assisted rehabilitation in chronic stroke patients: a randomized, double-blind, cross-over study

Abstract

 

The impact of transcranial direct current stimulation (tDCS) is controversial in the neurorehabilitation literature. It has been suggested that tDCS should be combined with other therapy to improve their efficacy.

To assess the effectiveness of a single session of upper limb robotic-assisted therapy (RAT) combined with real or sham-tDCS in chronic stroke patients. Twenty-one hemiparetic chronic stroke patients were included in a randomized, controlled, cross-over double-blind study.

Each patient underwent two sessions 7 days apart in a randomized order: (a) 20 min of real dual-tDCS associated with RAT (REAL+RAT) and (b) 20 min of sham dual-tDCS associated with RAT (SHAM+RAT). Patient dexterity (Box and Block and Purdue Pegboard tests) and upper limb kinematics were evaluated before and just after each intervention. The assistance provided by the robot during the intervention was also recorded. Gross manual dexterity (1.8±0.7 blocks, P=0.008) and straightness of movement (0.01±0.03, P<0.05) improved slightly after REAL+RAT compared with before the intervention. There was no improvement after SHAM+RAT. The post-hoc analyses did not indicate any difference between interventions: REAL+RAT and SHAM+RAT (P>0.05). The assistance provided by the robot was similar during both interventions (P>0.05).

The results showed a slight improvement in hand dexterity and arm movement after the REAL+RAT tDCS intervention. The observed effect after a single session was small and not clinically relevant. Repetitive sessions could increase the benefits of this combined approach.

 

via Effectiveness of a single session of dual-transcranial direc… : International Journal of Rehabilitation Research

[Conference Paper Abstract] Effectiveness of dual-tDCS in combination with upper limb robotic-assisted rehabilitation: a randomised, double-blind, cross-over study

Background: The impact of transcranial Direct Current Stimulation (tDCS) is controversial in the neurorehabilitation literature. It has been suggested that tDCS should be combined with other therapy to improve their efficacy.

Aim: To assess the effectiveness of upper limb robotic-assisted therapy (RAT) combined with real or sham-tDCS in chronic stroke patients.

Methods: Twenty-one hemiparetic stroke patients were included in a randomised, controlled, double-blind, cross-over study. Each patient underwent two therapy sessions seven days apart in a randomised order: (1) 20 minutes of real dual-tDCS associated with RAT (REAL+RAT) and (2) 20 minutes of sham dual-tDCS associated with RAT (SHAM+RAT). Patient dexterity (Box & Block and Purdue Pegboard tests) and upper limb kinematics were evaluated before and just after each intervention. The assistance provided by the robot during the intervention was also recorded.

Results: Gross manual dexterity (1.8 +/- 0.7 blocks, p=0.008) and straightness of movement (0.01 +/- 0.03, p<0.05) improved slightly after REAL+RAT compare to before the intervention. There was no improvement after SHAM+RAT. The post-hoc analyses did not objectify difference between interventions: REAL+RAT and SHAM+RAT (p>0.05). The assistance provided by the robot was similar during the two interventions (p>0.05).

Conclusion: The results demonstrated a slight improvement in hand dexterity and arm movement after the REAL+RAT tDCS intervention. The observed effect after one session was small and not clinically relevant, but repetitive sessions could increase the benefits of this combined approach.

Source: Effectiveness of dual-tDCS in combination with upper limb robotic-assisted rehabilitation: a randomised, double-blind, cross-over study | DIAL.pr – BOREAL