Jesper Mortensen1,2, Krystian Figlewski2, Henning Andersen2,3. 1. a Department of Public Health , University of Copenhagen , Copenhagen , Denmark . 2. b Hammel Neurorehabilitation Centre and University Research Clinic , Hammel , Denmark , and. 3. c Department of Neurology , Aarhus University Hospital , Aarhus , Denmark.
Abstract
PURPOSE: To investigate the combined effect of transcranial direct current stimulation (tDCS) and home-based occupational therapy on activities of daily living (ADL) and grip strength, in patients with upper limb motor impairment following intracerebral hemorrhage (ICH). METHODS: A double-blind randomized controlled trial with one-week follow-up. Patients received five consecutive days of occupational therapy at home, combined with either anodal (n = 8) or sham (n = 7) tDCS. The primary outcome was ADL performance, which was assessed with the Jebsen-Taylor test (JTT). RESULTS: Both groups improved JTT over time (p < 0.01). The anodal group improved grip strength compared with the sham group from baseline to post-assessment (p = 0.025). However, this difference was attenuated at one-week follow-up. There was a non-significant tendency for greater improvement in JTT in the anodal group compared with the sham group, from baseline to post-assessment (p = 0.158). CONCLUSIONS: Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is a promising add-on intervention regarding training of upper limb motor impairment. It is well tolerated by patients and can easily be applied for home-based training. Larger studies with long-term follow-up are needed to further explore possible effects of tDCS in patients with ICH. IMPLICATIONS FOR REHABILITATION: Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is well tolerated by patients and can easily be applied for home-based rehabilitation.
RCT Entities:
PURPOSE: To investigate the combined effect of transcranial direct current stimulation (tDCS) and home-based occupational therapy on activities of daily living (ADL) and grip strength, in patients with upper limb motor impairment following intracerebral hemorrhage (ICH). METHODS: A double-blind randomized controlled trial with one-week follow-up. Patients received five consecutive days of occupational therapy at home, combined with either anodal (n = 8) or sham (n = 7) tDCS. The primary outcome was ADL performance, which was assessed with the Jebsen-Taylor test (JTT). RESULTS: Both groups improved JTT over time (p < 0.01). The anodal group improved grip strength compared with the sham group from baseline to post-assessment (p = 0.025). However, this difference was attenuated at one-week follow-up. There was a non-significant tendency for greater improvement in JTT in the anodal group compared with the sham group, from baseline to post-assessment (p = 0.158). CONCLUSIONS: Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is a promising add-on intervention regarding training of upper limb motor impairment. It is well tolerated by patients and can easily be applied for home-based training. Larger studies with long-term follow-up are needed to further explore possible effects of tDCS in patients with ICH. IMPLICATIONS FOR REHABILITATION: Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is well tolerated by patients and can easily be applied for home-based rehabilitation.
Authors: A Antal; I Alekseichuk; M Bikson; J Brockmöller; A R Brunoni; R Chen; L G Cohen; G Dowthwaite; J Ellrich; A Flöel; F Fregni; M S George; R Hamilton; J Haueisen; C S Herrmann; F C Hummel; J P Lefaucheur; D Liebetanz; C K Loo; C D McCaig; C Miniussi; P C Miranda; V Moliadze; M A Nitsche; R Nowak; F Padberg; A Pascual-Leone; W Poppendieck; A Priori; S Rossi; P M Rossini; J Rothwell; M A Rueger; G Ruffini; K Schellhorn; H R Siebner; Y Ugawa; A Wexler; U Ziemann; M Hallett; W Paulus Journal: Clin Neurophysiol Date: 2017-06-19 Impact factor: 3.708
Authors: Marom Bikson; Pnina Grossman; Chris Thomas; Adantchede Louis Zannou; Jimmy Jiang; Tatheer Adnan; Antonios P Mourdoukoutas; Greg Kronberg; Dennis Truong; Paulo Boggio; André R Brunoni; Leigh Charvet; Felipe Fregni; Brita Fritsch; Bernadette Gillick; Roy H Hamilton; Benjamin M Hampstead; Ryan Jankord; Adam Kirton; Helena Knotkova; David Liebetanz; Anli Liu; Colleen Loo; Michael A Nitsche; Janine Reis; Jessica D Richardson; Alexander Rotenberg; Peter E Turkeltaub; Adam J Woods Journal: Brain Stimul Date: 2016-06-15 Impact factor: 8.955
Authors: Begonya Otal; Anirban Dutta; Águida Foerster; Oscar Ripolles; Amy Kuceyeski; Pedro C Miranda; Dylan J Edwards; Tihomir V Ilić; Michael A Nitsche; Giulio Ruffini Journal: Front Neurol Date: 2016-02-24 Impact factor: 4.003
Authors: Ann Van de Winckel; James R Carey; Teresa A Bisson; Elsa C Hauschildt; Christopher D Streib; William K Durfee Journal: J Neuroeng Rehabil Date: 2018-09-18 Impact factor: 4.262