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 |
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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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