Immediate effect of transcranial direct current stimulation combined with functional electrical stimulation on activity of the tibialis anterior muscle and balance of individuals with hemiparesis stemming from a stroke

Fruhauf, Aline Marina Alves; Politti, Fabiano; Corso, Simone Dal; Costa, G; Teodósio, Amanda da Conceição; Silva, Soraia Micaela; Corrêa, João Carlos Ferrari; Corrêa, Fernanda Ishida

doi:10.1589/jpts.29.2138

Cited by 22 publications

(28 citation statements)

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“…The allocation of the 36 participants (12 per group) will be randomized and counterbalanced using a randomization table in Excel TM with codes for the combinations of the two central (active or sham) and two peripheral (active or sham) stimulations [14]. A researcher not involved in the evaluations or treatment will be responsible for the randomized allocation of the participants to the three groups:…”

Section: Randomizationmentioning

confidence: 99%

“…The evaluation of the tibial anterior muscle will be made by electromyographic analysis and all individuals will be seated on a chair with a backrest, with knees flexed at 90 degrees and ankle in the neutral position [14]. Dynamic Balance analysis will be performed by Mini BESTest Scale (consists of 14 functional tasks).…”

Section: Assessment Proceduresmentioning

confidence: 99%

“…For each reading, the patient will perform three maximum voluntary isometric contractions of the TA (maximum active dorsiflexion) for 10 seconds following a verbal command, followed by rest for 2-3 minutes between each reading. Next, the participant will perform five consecutive concentric contractions (isotonic) of the TA three times, with 2-3 minutes of rest between each reading [14].…”

Section: Electromyography Of Tibialis Anterior Musclementioning

confidence: 99%

“…For both interventions, the patient will be seated on a chair with a backrest and knees flexed at 90° and ankle in the neutral position [14]. Treatment will consist of 10 sessions (five per week for two weeks).…”

Section: Assessment Interventionsmentioning

confidence: 99%

“…In a study involving 20 stroke survivors in the subacute phase, Sattler et al (2015) [13] evaluated the effect of anodal tDCS over M1 combined with PES over the radial nerve for five consecutive weeks and found a significant increase in motor function of the hand up to one month after treatment. However, Fruhauf et al (2018) [14] evaluated the immediate effect of tDCS combined with PES on the electrical activity of the paretic TA muscle and balance in 30 stroke survivors and found no effect after the administration of the two techniques combined. The researchers suggest that this may have occurred because only a single session was used, implying that longer treatment with the combination of the techniques could achieve different results.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating Electrical Activity of Tibialis Anterior Muscle and Balance in Hemiparetic Patients Following Central and Peripheral Electrical Stimulation - Protocol for a Randomized, Double-blinded, Clinical Trial

Fruhauf

Politti

Silva

et al. 2019

JAMMR

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Concomitant transcranial direct current stimulation (tDCS) is suggested to enhance the functional effects of other physical rehabilitation methods in individuals with motor impairment stemming from a chronic cerebrovascular disease. Thus, the primary aim of the proposed study is to analyze the electrical activity of the tibialis anterior (TA) muscle of the paretic limb in stroke survivors following an intervention involving the combination of tDCS over the motor cortex and peripheral electrical stimulation (PES) administered over the paretic TA. The secondary objective is to analyze the effect on dynamic balance. Methods: Thirty-six adult stroke survivors will be randomized into three groups: 1) Active tDCS + active PES; 2) Sham tDCS + active PES and 3) Active tDCS + sham PES. TDCS active will be positioned bilateral over the primary motor cortex of the damaged hemisphere (C1 or C2) and the cathode will be positioned over the primary motor cortex of the undamaged hemisphere (C1 or C2) with a current of 2 mA for 20 minutes. For sham tDCS, will follow the same standarts, however, the equipment will be switched on for only 20 seconds. PES will be administered to the paretic TA at 50 Hz for 30 minutes. Evaluations: the median frequency and root mean square (RMS) of the paretic TA will be analyzed using electromyography (EMG) and dynamic balance will be evaluated using the Mini-Balance Evaluation System (Mini-BESTest) at baseline (pre-intervention), after 10 treatment sessions at a frequency of five times a week for two weeks (post-intervention) and 30 days after the end of the interventions (follow up). Discussion: PES has proven to facilitate the conduction of sensory-motor afferences to the cerebral cortex in stroke survivors. Combining PES with tDCS, which has a direct effect on increasing cortical excitability, could favor motor acquisition and neuronal plasticity in this population.

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Section: Randomizationmentioning

confidence: 99%

Section: Assessment Proceduresmentioning

confidence: 99%

Section: Electromyography Of Tibialis Anterior Musclementioning

confidence: 99%

Section: Assessment Interventionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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