Combined Transcranial Direct Current Stimulation and Robot-Assisted Arm Training in Subacute Stroke Patients: An Exploratory, Randomized Multicenter Trial
By Hesse, Stefan; Waldner, Andreas; Mehrholz, Jan; Tomelleri, Christopher; Pohl, Michael; Werner, Cordula; Neurorehabilitation and Neural Repair, Volume 25, Number 9, pages 838-846Publication Date: November/December 2011
Study tested a combined intervention of transcranial direct current stimulation and bilateral robotic training for the improvement of functional use of the arm and hand in subacute stroke patients. The study randomized 96 participants into 3 groups. Participants had a mean age of 65 years and an ischemic supratentorial lesion of 3 to 8 weeks duration with severe impairment of motor control as evidenced by a Fugl-Meyer score (FMS) for the upper limb of less than 18. For 6 weeks, group A received anodal stimulation of the lesioned hemisphere, group B received cathodal stimulation of the nonlesioned side for 20 minutes a 2.0 milliamperes, and group C received sham stimulation. The electrodes were placed over the hand area and above the contralateral orbit. While receiving the stimulation, participants also practiced 400 repetitions each of 2 different bilateral movements on the Bi-Manu Track arm robot. The 3 groups were matched at onset. The FMS improved in all participants at 6 weeks. No between-group differences were found; initial versus finish FMS scores were 7.8 versus 19.1 in group A, 7.9 versus 18.8 in group B, and 8.2 versus 19.2 in group C. No significant changes between groups were present at 3 months. In summary, neither anodal nor cathodal transcranial direct current stimulation enhanced the effect of bilateral arm training in this exploratory trial of patients with cortical involvement and severe weakness. Study limitations and implications for future research are discussed.
Published by: Sage Publications (Website:http://www.sagepub.com)
American Society of Neurorehabilitation (Web Site: http://www.asnr.com )
