Effect of Transcranial Direct Current Stimulation on Balance and Stroke Specific Quality of Life In Stroke Patients

Halisha Shah, Shilpa Khandare, Trupti Siddapur, Soumik Basu, T. Palekar
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Abstract

Introduction: Stroke is the leading cause of disability which requires rehabilitation. It is defined asobstruction or restriction of blood supply to the brain, usually because a blood vessel supplying brain is burstor blocked by a clot; causing damage to the cells of brain. This in turn may result in physical and/or mentaldisabilities. Upper limb functions are most commonly impaired following stroke; which also deterioratesactivities of daily living. tDCS is a novice approach which can improve upper limb function by modulatingcortical neuronal excitability.Objective: To investigate the effect of cathodal, anodal and sham tDCS on balance and stroke specificquality of life in stroke patients.Method: 30 stroke patients meeting inclusion criteria were randomly allocated into three groups. Group A,B and C received cathodal tDCS, anodal tDCS and sham tDCS respectively. The intensity of the current was2mA given for 20 minutes along with all the upper limb active and fine motor exercises. It was given for 12sessions in 3 weeks. Berg balance scale and stroke specific quality of life questionnaire was taken to assesslower limb function respectively. It was taken before and after the 3 weeks.Result: paired t test showed that the balance improved before and after treatment with cathodal (0.003)and anodal (0.000) tDCS and sham stimulation (0.917). and also for SSQOL cathodal and anodal showedimprovement in quality of life but sham stimulation showed no improvement. (0.173). Kruskal Wallis Testshowed significant difference in between the groups (p<0.05) which showed balance improved more inanodal tDCS than cathodal and sham. Also cathodal tDCS balance compared to sham tDCS. but in SSQOLthere was no significant improvement seen in all three groups.Conclusion: Both cathodal and anodal tDCS improve balance over sham tDCS. Improvement of balancewith anodal tDCS was better than cathodal tDCS. There was no change in SSOL.
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经颅直流电刺激对脑卒中患者平衡及脑卒中特异性生活质量的影响
中风是导致残疾的主要原因,需要康复治疗。它被定义为大脑血液供应的阻塞或限制,通常是因为供应大脑的血管被血栓堵塞;对大脑细胞造成损害的。这反过来可能导致身体和/或精神残疾。上肢功能最常在中风后受损;这也恶化了日常生活的活动。tDCS是一种通过调节皮层神经元兴奋性来改善上肢功能的新方法。目的:探讨阴极、阳极和假tDCS对脑卒中患者平衡和脑卒中特异性生活质量的影响。方法:30例符合入选标准的脑卒中患者随机分为3组。A组、B组、C组分别行正极tDCS、阳极tDCS和假性tDCS。电流强度为2ma,持续20分钟,同时进行所有上肢活动和精细运动练习。在3周内给药12次。采用Berg平衡量表和卒中特异性生活质量问卷分别评估肢体功能。它是在3周前后服用的。结果:配对t检验显示,tDCS正极刺激(0.003)、正极刺激(0.000)和假刺激(0.917)治疗前后平衡性均有改善。而对于SSQOL,阴极和阳极刺激显示生活质量的改善,而假刺激没有改善。(0.173)。Kruskal Wallis测试结果显示各组间差异有统计学意义(p<0.05),表明平衡对正极tDCS的改善作用强于正极和假手术。还有阴极tDCS平衡与假tDCS的比较。但在ssqol方面,三组均未见明显改善。结论:与假性tDCS相比,阴极和阳极tDCS均能改善平衡性。阳极tDCS对平衡的改善效果优于阴极tDCS。ssl无明显变化。
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