Effect of Cathodal Transcranial Direct Current Stimulation for Lower Limb Subacute Stroke Rehabilitation.

IF 3 4区 医学 Q2 NEUROSCIENCES Neural Plasticity Pub Date : 2023-01-01 DOI:10.1155/2023/1863686
Qian Duan, Wenying Liu, Jinhui Yang, Ben Huang, Jie Shen
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Abstract

Methods: A pilot double-blind and randomized clinical trial. Ninety-one subjects with subacute stroke were treated with cathodal/sham stimulation tDCS based on CGR (physiotherapy 40 min/d and occupational therapy 20 min/d) once daily for 20 consecutive working days. Computer-based stratified randomization (1 : 1) was employed by considering age and sex, with concealed assignments in opaque envelopes to ensure no allocation errors after disclosure at the study's end. Patients were evaluated at T0 before treatment, T1 immediately after the posttreatment assessment, and T2 assessment one month after the end of the treatment. The primary outcome index was assessed: lower limb Fugl-Meyer motor score (FMA-LE); secondary endpoints were other gait assessment and relevant stroke scale assessment.

Results: Patients in the trial group performed significantly better than the control group in all primary outcome indicators assessed posttreatment T1 and at follow-up T2: FMA-LE outcome indicators between the two groups in T1 (P = 0.032; effect size 1.00, 95% CI: 0.00 to 2.00) and FMA-LE outcome indicators between the two groups in T2 (P = 0.010; effect size 2.00, 95% CI: 1.00 to 3.00).

Conclusion: In the current pilot study, ctDCS plus CGR was an effective treatment modality to improve lower limb motor function with subacute stroke. The effectiveness of cathodal tDCS in poststroke lower limb motor dysfunction is inconclusive. Therefore, a large randomized controlled trial is needed to verify its effectiveness.

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经颅阴极直流电刺激对下肢亚急性脑卒中康复的影响。
方法:采用双盲随机临床试验。91例亚急性脑卒中患者采用基于CGR的阴极/假刺激tDCS治疗(物理治疗40 min/d,职业治疗20 min/d),每天1次,连续20个工作日。采用基于计算机的分层随机化(1:1),考虑年龄和性别,并将分配隐藏在不透明的信封中,以确保在研究结束时披露后不会出现分配错误。分别于治疗前T0、治疗后即刻T1、治疗结束1个月后T2进行评估。评估主要结局指标:下肢Fugl-Meyer运动评分(FMA-LE);次要终点是其他步态评估和相关脑卒中量表评估。结果:试验组患者在治疗后T1和随访T2时评估的所有主要结局指标均显著优于对照组,T1时两组间FMA-LE结局指标比较(P = 0.032;效应值1.00,95% CI: 0.00 ~ 2.00),两组间T2期FMA-LE结局指标差异(P = 0.010;效应值2.00,95% CI: 1.00 ~ 3.00)。结论:在目前的初步研究中,ctDCS + CGR是改善亚急性脑卒中患者下肢运动功能的有效治疗方式。阴极tDCS治疗脑卒中后下肢运动功能障碍的有效性尚无定论。因此,需要大规模的随机对照试验来验证其有效性。
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来源期刊
Neural Plasticity
Neural Plasticity NEUROSCIENCES-
CiteScore
6.80
自引率
0.00%
发文量
77
审稿时长
16 weeks
期刊介绍: Neural Plasticity is an international, interdisciplinary journal dedicated to the publication of articles related to all aspects of neural plasticity, with special emphasis on its functional significance as reflected in behavior and in psychopathology. Neural Plasticity publishes research and review articles from the entire range of relevant disciplines, including basic neuroscience, behavioral neuroscience, cognitive neuroscience, biological psychology, and biological psychiatry.
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