Transcranial Direct Current Stimulation Combined Neuromuscular Electrical Stimulation on Motor Recovery in Stroke
Condition: Chronic Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      The purpose of this study was to investigate the effects of the combination treatment
      strategy. A randomized, double-blinded and sham-stimulation study was conducted. Twenty-six
      participants with chronic stroke (onset > 6 months) were assigned into one of three groups
      (tDCS combined with NMES, tDCS combined with sham NMES, or sham tDCS combined with sham NMES)
      by block randomization. In addition to conventional rehabilitation, all subjects received an
      additional protocol with a total of 15 sessions for 3 weeks (5 times per week, 30 minutes
      daily). The UE subscale of Fugl-Meyer assessment (UE-FMA) and Action Research Arm Test (ARAT)
      as primary outcome measures were assessed at beginning of the intervention, after 3-week of
      treatment, and one-month follow-up. No significant differences in the primary outcome
      measures at post-treatment and one-month follow-up were found among the tDCS combined with
      NMES group (n=9), tDCS combined with sham NMES group (n=9), and the sham tDCS combined with
      sham NMES group (n=8). However, significant changes in UE-FMA (from baseline to
      post-treatment, p= .02) and ARAT (from baseline to post-treatment, p= .04) score were found
      for the tDCS combined with NMES group. This preliminary study reveals that the tDCS combined
      with NMES appears to be beneficial to UE motor recovery after stroke but is not superior to
      the tDCS alone.
    

Detailed description: 
      Background and objectives: Previous studies have shown that transcranial direct current
      stimulation (tDCS) and Neuromuscular electrical stimulation (NMES) could be effective for
      promoting motor recovery of stroke patients. However, the effects of tDCS combined with NMES
      on upper extremity (UE) motor recovery in patients with stroke have not been investigated.
      The purpose of this study was to investigate the effects of the combination treatment
      strategy. Methods: A randomized, double-blinded and sham-stimulation study was conducted.
      Twenty-six participants with chronic stroke (onset > 6 months) were assigned into one of
      three groups (tDCS combined with NMES, tDCS combined with sham NMES, or sham tDCS combined
      with sham NMES) by block randomization. In addition to conventional rehabilitation, all
      subjects received an additional protocol with a total of 15 sessions for 3 weeks (5 times per
      week, 30 minutes daily). The UE subscale of Fugl-Meyer assessment (UE-FMA) and Action
      Research Arm Test (ARAT) as primary outcome measures were assessed at beginning of the
      intervention, after 3-week of treatment, and one-month follow-up. Results: Most of the
      participants had mild to moderate disability in activity of daily living. No significant
      differences in the primary outcome measures at post-treatment and one-month follow-up were
      found among the tDCS combined with NMES group (n=9), tDCS combined with sham NMES group
      (n=9), and the sham tDCS combined with sham NMES group (n=8). However, significant changes in
      UE-FMA (from baseline to post-treatment, p= .02) and ARAT (from baseline to post-treatment,
      p= .04) score were found for the tDCS combined with NMES group. Conclusion: This preliminary
      study reveals that the tDCS combined with NMES appears to be beneficial to UE motor recovery
      after stroke but is not superior to the tDCS alone.
    

Intervention name(s): tDCS(Intelect Mobile Stimulation and Combination, DJO, France); NMES(Enraf Nonius, Endomed-182, Netherlands)
Intervention type(s): Combination Product; Combination Product
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Transcranial direct current stimulation; Neuromuscular electrical stimulation; Stroke; Rehabilitation