tDCS does not enhance the effects of robot-assisted gait training in patients with subacute stroke

Background:Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique, which can modulate cortical excitability and combined with rehabilitation therapies may improve motor recovery after stroke. Objective:Our aim was to study the feasibility of a 4-week robotic gai...

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Detalles Bibliográficos
Autores: Kumru, Hatice, Cortés, Mar, León, Daniel, Elderg, Jessica, Laxe, Sara, Edwardsh, Dylan James, Tormos Muñoz, José María, Bernabeu, Montserrat, Pascual Leone, Álvaro
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Universidad Católica de Valencia San Vicente Mártir
Repositorio:RIUCV. Repositorio de la Universidad Católica de Valencia San Vicente Mártir
Idioma:inglés
OAI Identifier:oai:riucv.ucv.es:20.500.12466/3321
Acceso en línea:http://hdl.handle.net/20.500.12466/3321
Access Level:acceso abierto
Palabra clave:Robot-assisted gait training
Subacute stroke
Transcranial direct current stimulation
2490 Neurociencias
Descripción
Sumario:Background:Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique, which can modulate cortical excitability and combined with rehabilitation therapies may improve motor recovery after stroke. Objective:Our aim was to study the feasibility of a 4-week robotic gait training protocol combined with tDCS, and to study tDCS to the leg versus hand motor cortex or sham to improve walking ability in patients after a subacute stroke. Methods:Forty-nine subacute stroke patients underwent 20 daily sessions (5 days a week for 4 weeks) of robotic gait training combined with tDCS. Patients were assigned either to the tDCSleg group (n = 9), receiving 2 mA anodal tDCS over the motor cortex leg representation (vertex), or an active control group (n = 17) receiving anodal tDCS over the hand motor cortex area (tDCShand). In addition, we studied 23 matched patients in a control group receiving gait training without tDCS (notDCS). Study outcomes included gait speed (10-meter walking test), and quality of gait, using the Functional Ambulatory Category (FAC) before and after the 4-week training period. Results:Only one patient did not complete the treatment because he presented a minor side-effect. Patients in all three groups showed a significantly improvement in gait speed and FAC. The tDCSleg group did not perform better than the tDCShand or notDCS group. Conclusion:Combined tDCS and robotic training is a safe and feasible procedure in subacute stroke patients. However, adding tDCS to robot-assisted gait training shows no benefit over robotic gait training alone.