May Dual Transcranial Direct Current Stimulation Enhance the Efficacy of Robot-Assisted Therapy for Promoting Upper Limb Recovery in Chronic Stroke?
| العنوان: | May Dual Transcranial Direct Current Stimulation Enhance the Efficacy of Robot-Assisted Therapy for Promoting Upper Limb Recovery in Chronic Stroke? |
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| المؤلفون: | Giovanni Morone, Fioravante Capone, Marco Iosa, Alessandro Cruciani, Matteo Paolucci, Alex Martino Cinnera, Gabriella Musumeci, Nicoletta Brunelli, Carmelina Costa, Stefano Paolucci, Vincenzo Di Lazzaro |
| المصدر: | Neurorehabilitation and Neural Repair. 36:800-809 |
| بيانات النشر: | SAGE Publications, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Upper Extremity, Stroke, Humans, Robotics, Prospective Studies, General Medicine, Transcranial Direct Current Stimulation |
| الوصف: | Objective To assess whether dual transcranial direct current stimulation (tDCS) may enhance the efficacy of exoskeleton robotic training on upper limb motor functions in patients with chronic stroke. Methods A prospective, bi-center, double-blind, randomized clinical trial study was performed. Patients with moderate-to-severe stroke (according to The National Institute of Health Stroke Scale) were randomly assigned to receive dual or sham tDCS immediately before robotic therapy (10 sessions, 2 weeks). The primary outcome was the Fugl–Meyer for Upper Extremity, assessed before, after, and at the 12-week follow-up. Neurophysiological evaluation of corticospinal projections to upper limb muscles was performed by recording motor evoked potentials (MEPs). ClinicalTrials.gov-NCT03026712. Results Two hundred and sixty individuals were tested for eligibility, of which 80 were enrolled and agreed to participate. Excluding 14 dropouts, 66 patients were randomly assigned into the 2 groups. Results showed that chronic patients were stable before treatment and significantly improved after that. The records within subject improvements were not significantly different between the 2 groups. However, a post-hoc analysis subdividing patients in 2 subgroups based on the presence or absence of MEPs at the baseline showed a significantly higher effect of real tDCS in patients without MEPs when compared to patients with MEPs ( F = 4.6, P = .007). Conclusion The adjunction of dual tDCS to robotic arm training did not further enhance recovery in the treated sample of patients with chronic stroke. However, a significant improvement in the subgroup of patients with a severe corticospinal dysfunction (as suggested by the absence of MEPs) suggests that they could benefit from such a treatment combination. |
| تدمد: | 1552-6844 1545-9683 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::51d104c5a6a2b875c0c166c367e5e6dcTest https://doi.org/10.1177/15459683221138743Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....51d104c5a6a2b875c0c166c367e5e6dc |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15526844 15459683 |
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