Article

The purpose of this study was to examine the effects of combined
therapy using transcranial direct current stimulation (tDCS) with robot-assisted
arm training (AT) for impairment of the upper limb in chronic stroke patients,
and to clarify whether differences exist in the effect of anodal tDCS on the
affected hemisphere (tDCS(a) + AT) and cathodal tDCS on the unaffected hemisphere
(tDCS(c) + AT). METHODS: Subjects in this randomized, double-blinded, crossover
study comprised 18 chronic stroke patients with moderate-to-severe arm paresis.
Each patient underwent 2 different treatments: tDCS(a) + AT; and tDCS(c) + AT.
Each intervention was administered for 5 days, and comprised AT with 1 mA of tDCS
during the first 10 min. Outcomes were identified as changes in Fugl-Meyer
Assessment (FMUL), modified Ashworth scale (MAS) and Motor Activity Log (MAL) for
the upper limb. RESULTS: Both interventions showed significant improvements in
FMUL and MAS, but not in MAL. Distal spasticity was significantly improved with
tDCS(c) + AT compared with tDCS(a) + AT for right hemispheric lesions (median -1
vs 0), but not for left hemispheric lesions. CONCLUSION: Although this study
demonstrated that combined therapy could achieve limited effects in the
hemiplegic arm of chronic stroke patients, a different effect of polarity of tDCS
was seen for patients with right hemispheric lesions.

Langue : ANGLAIS