Category: Stroke; Neuroplasticity (includes neuroscience)
Research Objective(s). To test the safety, tolerability and efficacy of transcranial direct current stimulation (tDCS) combined with a progressive resistance training (PRT) program of the affected upper limb (aUL) in individuals in the chronic phase post-stroke.
Design. Pilot randomized controlled trial
Setting. General community
Participants (or Animals, Specimens, Cadavers) :
Participants. 14 volunteers (68.9 ± 10.0 years; time since stroke 70.9 ± 57.6 months) were randomly allocated into 2 groups: 1) real-tDCS + PRT and 2) sham-tDCS + PRT.
Interventions. PRT respected stroke guidelines and consisted in a strength training of the aUL (60 minutes, 3 times/week over 4 weeks). During each training, participants received either real- or sham-tDCS at 2mA, applied over the primary motor cortex with a bilateral montage (anode over the ipsilesional hemisphere), for the first 20 minutes or 30 seconds, respectively.
Main Outcome Measure(s) :
Main Outcome Measure(s). Safety and tolerability were evaluated by the number and characteristics of tDCS adverse events and dropout rates. Clinical assessments (Fugl-Meyer Assessment, Box and Block Test, Wolf Motor Function Test, grip strength, modified Ashworth Scale and Motor Activity Log) were performed by a blinded evaluator before and after the PRT.
Results. No dropout occurred and only mild skin tingling of similar intensity and frequency (p > 0.38) was reported during the administration of real and sham tDCS. Both groups improved on clinical tests and no significant difference was observed between groups (p> 0.17).
Conclusions. This pilot study highlights the safety and tolerability of repeated sessions of tDCS/PRT and positive effects of a PRT program on sensorimotor control of the aUL. However, further research in this field is needed to better assess the benefits of combining tDCS with rehabilitation.
Louis-David Beaulieu– Assistant Professor, University of Quebec in Chicoutimi, Saguenay, Quebec
Andréanne Blanchette– Associate professor, Laval University, Québec, Quebec
Catherine Mercier– Full professor, Laval University, Quebec, Quebec
Vincent Bernard-Larocque– Student, Sherbrooke University, Sherbrooke, Quebec
Marie-Hélène Milot– Associate professor, Sherbrooke University, Sherbrooke, Quebec