Authors (including presenting author) :
Cheung NW(1), Leung YY(1),Yip WT(1), Wong KY(1), Leung YK(1)
Affiliation :
(1)Department of Physiotherapy, North Lantau Hospital, KWC
Introduction :
Promoting motor recovery after stroke is important to improve patients’ independence in daily living and quality of life. Motor recovery mainly depends on the neuroplasticity of the brain. Transcranial direct current stimulation (tDCS) is one of the possible methods to promote plastic change of the brain. It would modulate cortical excitability and resting potential of neurons by introduction of weak constant current to the cortex. tDCS could stimulate the upper limbs control area in the primary motor cortex and specifically targeted on the upper limbs training. When compared to other training methods, like robot-assisted therapy or virtual reality, tDCS is relatively safe, portable, economics and user friendly. Therefore, it is important to investigate the effectiveness and safety of tDCS on upper limbs rehabilitation after stroke.
Objectives :
To examine the effect of tDCS on the motor recovery of upper limbs after stroke and evaluate the safety of the application of tDCS.
Methodology :
8 patients with subacute stroke were recruited in this pilot study. Patients received 10 sessions (5 sessions/ week) of tDCS stimulation over two weeks. tDCS were implemented together with conventional physiotherapy training. Anodal stimulation was applied with dosage of 20 mA per minute. Primary outcome measures are (i) Box and Block Test (BBT) and (ii) hand grip strength. The outcomes were compared before and after the course of stimulation. Adverse reactions during treatment were also examined.
Result & Outcome :
8 patients, aged from 27 to 80, were recruited. Mean age of the subjects is 50.3 years old and 25 % of them are female. They showed beneficial change of affected upper limbs control after a course of tDCS stimulation. There was significant improvement of gross motor function over upper limbs, which was measured by BBT. The average number of cubes transported increased by 6.5 cubes and exceeded the minimal detectable change of 5.5 cubes. The hand grip strength showed no significant change. This result may reveal that tDCS is more effective for upper limbs control training than hand grip strengthening. No adverse reaction was detected.
This pilot study supported that tDCS can promote motor control after stroke. The application of tDCS is safe with no serious adverse effect found. Future study with the control group is needed to further evaluate the beneficial effect of tDCS.
