Robotic-assisted gait training combined with transcranial direct current stimulation in chronic stroke patients: A pilot double-blind, randomized controlled trial

Autor: Youbin Yi, Han Gil Seo, Kwang Dong Kim, Byung Mo Oh, Woo Hyung Lee, Seung Hak Lee
Rok vydání: 2017
Předmět:
Male
030506 rehabilitation
medicine.medical_specialty
medicine.medical_treatment
Pilot Projects
Transcranial Direct Current Stimulation
Functional Laterality
law.invention
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Developmental Neuroscience
Randomized controlled trial
Gait training
Double-Blind Method
law
medicine
Humans
Stroke
Gait
Postural Balance
Aged
Aged
80 and over
Leg
Rehabilitation
Transcranial direct-current stimulation
business.industry
Motor Cortex
Stroke Rehabilitation
Recovery of Function
Middle Aged
medicine.disease
Evoked Potentials
Motor
Exercise Therapy
Paresis
medicine.anatomical_structure
Treatment Outcome
Neurology
Berg Balance Scale
Chronic Disease
Physical therapy
Female
Neurology (clinical)
0305 other medical science
business
030217 neurology & neurosurgery
Motor cortex
Zdroj: Restorative neurology and neuroscience. 35(5)
ISSN: 1878-3627
Popis: Background Although robotic-assisted gait training (RAGT) is becoming a standard method in stroke rehabilitation, its effect on chronic stroke patients is uncertain. Objective This study aimed to investigate whether anodal transcranial direct current stimulation (tDCS) enhances the effect of RAGT on functional ambulation in chronic stroke patients. Methods Chronic hemiplegic stroke patients with a Functional Ambulatory Category (FAC) score≤4 were randomly assigned to either the RAGT with anodal tDCS (Anodal) group the sham tDCS (Sham) group. The patients were provided with RAGT for 45 min after allocated tDCS on the leg motor cortex in the impaired hemisphere for 20 min every weekday for 2 weeks. The primary outcome measure was the FAC, and the secondary outcome measures included 10-m walking test, 6-min walking test, Berg Balance Scale, Fugl-Meyer assessment of the lower extremity, Medical Research Council Scale, and motor-evoked potential (MEP) parameters. They were evaluated before treatment (T0), immediately after treatment (T1), and 4 weeks after the end of treatment (T2). Results Twenty-one patients were finally included. The percentage of participants who achieved improvement in the FAC score was greater in the Anodal group than in the Sham group, and the difference was significant at T2 (66.7% vs. 12.5%, p = 0.024). In secondary outcome measures, the Anodal group showed greater improvement in the 6-min walking test than the Sham group at T2 (56.49±38.87 vs. 23.59±17.00, p = 0.038). The changes in the MEP parameters were not significantly different between the two groups. Conclusion This pilot study suggested that anodal tDCS on the leg motor cortex in the impaired hemisphere may facilitate the effect of RAGT on functional ambulation in chronic stroke patients. Larger clinical trials will be needed to confirm the effect of RAGT combined with tDCS in chronic stroke patients based on the present study.
Databáze: OpenAIRE
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