Article

This pilot double-blind sham-controlled randomized trial aimed to
determine if the addition of anodal tDCS on the affected hemisphere or cathodal
tDCS on unaffected hemisphere to modified constraint-induced movement therapy
(mCIMT) would be superior to constraints therapy alone in improving upper limb
function in chronic stroke patients. METHODS:
Twenty-one patients with chronic
stroke were randomly assigned to receive 12 sessions of either (i) anodal, (ii)
cathodal or (iii) sham tDCS combined with mCIMT. Fugl-Meyer assessment (FMA),
motor activity log scale (MAL), and handgrip strength were analyzed before,
immediately, and 1 month (follow-up) after the treatment. Minimal clinically
important difference (mCID) was defined as an increase of >/=5.25 in the upper
limb FMA. RESULTS: An increase in the FMA scores between the baseline and
post-intervention and follow-up for active tDCS group was observed, whereas no
difference was observed in the sham group. At post-intervention and follow-up,
when compared with the sham group, only the anodal tDCS group achieved an
improvement in the FMA scores. ANOVA showed that all groups demonstrated similar
improvement over time for MAL and handgrip strength. In the active tDCS groups,
7/7 (anodal tDCS) 5/7 (cathodal tDCS) of patients experienced mCID against 3/7 in
the sham group. CONCLUSION: The results support the merit of association of mCIMT
with brain stimulation to augment clinical gains in rehabilitation after stroke.
However, the anodal tDCS seems to have greater impact than the cathodal tDCS in
increasing the mCIMT effects on motor function of chronic stroke patients.
Implications for Rehabilitation The association of mCIMT with brain stimulation
improves clinical gains in rehabilitation after stroke.
The improvement in motor
recovery (assessed by Fugl-Meyer scale) was only observed after anodal tDCS. The
modulation of damaged hemisphere demonstrated greater improvements than the
modulation of unaffected hemispheres.

Langue : ANGLAIS