Effects on Decreasing Upper-Limb Poststroke Muscle Tone Using Transcranial Direct Current Stimulation: A Randomized Sham-Controlled Study

Wu, Dongyu; Qian, Long; Zorowitz, Richard D.; Zhang, Lei; Qu, Yi; Yuan, Ying

doi:10.1016/j.apmr.2012.07.022

Cited by 95 publications

(98 citation statements)

References 22 publications

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“…Data of the FMA impairment outcome measure in relation to the effect of UE rehabilitation with real tDCS (anodal and/or cathodal or bihemispheric) versus sham tDCS or no stimulation as reported in the study of Lee and Chun (2014), were inputted in the program and meta-analysed. Studies reporting only the medians of the selected outcomes were not included in the meta-analyses (Wu et al, 2013). All outcome measures were analysed as continuous variables, using the mean, standard deviation and number of participants at immediate post-intervention, short-term (1-12 weeks) or long-term follow-up (>12 weeks).…”

Section: Data Synthesis and Analysesmentioning

confidence: 99%

“…Combined over studies included in the meta-analysis, 164 (44%) participants had cortico-subcortical or cortical strokes and 49 (11%) participants had subcortical stroke. Three studies did not describe the location of the strokes (Lindenberg et al, 2010;Wu et al, 2013;Viana et al, 2014). Four studies involved 65 (18%) participants with chronic stroke (Lindenberg et al, 2010;Bolognini et al, 2011;Nair et al, 2011;Viana et al, 2014), four studies involved 263 (71%) participants in the sub-acute stage (Kim et al, 2010;Hesse et al, 2011;Wu et al, 2013;Lee and Chun, 2014) and one study involved 40 (11%) people with acute stroke (Khedr et al, 2013).…”

Section: Main Characteristics Of the Rct'smentioning

confidence: 99%

“…Four studies involved 65 (18%) participants with chronic stroke (Lindenberg et al, 2010;Bolognini et al, 2011;Nair et al, 2011;Viana et al, 2014), four studies involved 263 (71%) participants in the sub-acute stage (Kim et al, 2010;Hesse et al, 2011;Wu et al, 2013;Lee and Chun, 2014) and one study involved 40 (11%) people with acute stroke (Khedr et al, 2013). One hundred and forty-five (39%) participants had moderate UE impairments (Kim et al, 2010;Lindenberg et al, 2010;Bolognini et al, 2011;Nair et al, 2011;Lee and Chun, 2014;Viana et al, 2014) and 226 (61%) participants had severe UE impairments (Hesse et al, 2011;Khedr et al, 2013;Wu et al, 2013) at baseline based on the FMA or MRC Scale (shoulder) (Lum et al, 2002).…”

Section: Main Characteristics Of the Rct'smentioning

confidence: 99%

“…Eight studies used the FMA as an outcome measure of UE motor impairments (Kim et al, 2010;Lindenberg et al, 2010;Bolognini et al, 2011;Hesse et al, 2011;Nair et al, 2011;Wu et al, 2013;Lee and Chun, 2014;Viana et al, 2014) and one study used the Medical Research Council scale (Khedr et al, 2013). Only two studies explored the neurophysiological effects of tDCS, using measures of Resting and Active Motor Threshold (Khedr et al, 2013), motor evoked potential amplitude (Bolognini et al, 2011) and transcallosal inhibition to transcranial magnetic stimulation (Bolognini et al, 2011).…”

Section: Outcome Measures and Timing Of Assessmentsmentioning

confidence: 99%

“…Two studies employed functional MRI of brain activity as an outcome measure (Lindenberg et al, 2010;Nair et al, 2011). The Barthel Index or Modified Barthel Index and Motor Activity Log were utilised as measures of activities of daily living (Kim et al, 2010;Hesse et al, 2011;Bolognini et al, 2011;Khedr et al, 2013;Wu et al, 2013;Lee and Chun, 2014).…”

Section: Outcome Measures and Timing Of Assessmentsmentioning

confidence: 99%

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Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: A review and meta-analysis

Triccas

Burridge

Hughes

et al. 2016

Clinical Neurophysiology

112

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h i g h l i g h t stDCS and rehabilitation had small non-significant effect on upper extremity impairments. Varied tDCS and rehabilitation programmes were identified in selected studies. Future research needs to further analyse tDCS and therapy interventions in stroke. a b s t r a c tObjective: To systematically review the methodology in particular treatment options and outcomes and the effect of multiple sessions of transcranial direct current stimulation (tDCS) with rehabilitation programmes for upper extremity recovery post stroke. Methods: A search was conducted for randomised controlled trials involving tDCS and rehabilitation for the upper extremity in stroke. Quality of included studies was analysed using the Modified Downs and Black form. The extent of, and effect of variation in treatment parameters such as anodal, cathodal and bi-hemispheric tDCS on upper extremity outcome measures of impairment and activity were analysed using meta-analysis. Results: Nine studies (371 participants with acute, sub-acute and chronic stroke) were included. Different methodologies of tDCS and upper extremity intervention, outcome measures and timing of assessments were identified. Real tDCS combined with rehabilitation had a small non-significant effect of +0.11 (p = 0.44) and +0.24 (p = 0.11) on upper extremity impairments and activities at post-intervention respectively. Conclusion: Various tDCS methods have been used in stroke rehabilitation. The evidence so far is not statistically significant, but is suggestive of, at best, a small beneficial effect on upper extremity impairment. Significance: Future research should focus on which patients and rehabilitation programmes are likely to respond to different tDCS regimes.

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Section: Data Synthesis and Analysesmentioning

confidence: 99%