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Combination transcranial direct current stimulation and virtual reality therapy for upper extremity training in patients with subacute stroke.
Arch Phys Med Rehabil. 2014 Mar; 95(3):431-8.AP

Abstract

OBJECTIVE

To investigate the effects of combination cathodal transcranial direct current stimulation (tDCS) and virtual reality (VR) therapy for upper extremity (UE) training in patients with subacute stroke.

DESIGN

Pilot randomized controlled trial. Patients were randomly assigned to 1 of 3 groups: group A received cathodal tDCS, group B received VR, and group C received combination therapy (cathodal tDCS was simultaneously applied during VR therapy).

SETTING

University hospital.

PARTICIPANTS

Patients (N=59) with impaired unilateral UE motor function after stroke.

INTERVENTION

Fifteen sessions of treatment over a 3-week period.

MAIN OUTCOME MEASURES

The Modified Ashworth Scale, manual muscle test (MMT), Manual Function Test (MFT), Fugl-Meyer Scale (FMS), and Box and Block Test were used to assess UE function. To evaluate activities of daily living, the Korean-Modified Barthel Index (K-MBI) was used. All outcomes were measured before and immediately after treatment.

RESULTS

After treatment, all groups demonstrated significant improvements in MMT, MFT, FMS, and K-MBI scores. The change in MFT and FMS scores was different between the 3 groups. Post hoc analysis revealed that the improvement of MFT and FMS scores in group C was significantly higher than those of the other 2 groups.

CONCLUSIONS

In the present pilot study, the combination of brain stimulation using tDCS and peripheral arm training using VR could facilitate a stronger beneficial effect on UE impairment than using each intervention alone. This combination therapy might be a helpful method to enhance recovery of the paretic UE in patients with stroke.

Authors+Show Affiliations

Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan Ulsan Regional Cardiocerebrovascular Center, Dong-A University Hospital, Busan, Republic of Korea.Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: mhchun@amc.seoul.kr.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24239790

Citation

Lee, Sook Joung, and Min Ho Chun. "Combination Transcranial Direct Current Stimulation and Virtual Reality Therapy for Upper Extremity Training in Patients With Subacute Stroke." Archives of Physical Medicine and Rehabilitation, vol. 95, no. 3, 2014, pp. 431-8.
Lee SJ, Chun MH. Combination transcranial direct current stimulation and virtual reality therapy for upper extremity training in patients with subacute stroke. Arch Phys Med Rehabil. 2014;95(3):431-8.
Lee, S. J., & Chun, M. H. (2014). Combination transcranial direct current stimulation and virtual reality therapy for upper extremity training in patients with subacute stroke. Archives of Physical Medicine and Rehabilitation, 95(3), 431-8. https://doi.org/10.1016/j.apmr.2013.10.027
Lee SJ, Chun MH. Combination Transcranial Direct Current Stimulation and Virtual Reality Therapy for Upper Extremity Training in Patients With Subacute Stroke. Arch Phys Med Rehabil. 2014;95(3):431-8. PubMed PMID: 24239790.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combination transcranial direct current stimulation and virtual reality therapy for upper extremity training in patients with subacute stroke. AU - Lee,Sook Joung, AU - Chun,Min Ho, Y1 - 2013/11/14/ PY - 2013/08/16/received PY - 2013/10/22/revised PY - 2013/10/28/accepted PY - 2013/11/19/entrez PY - 2013/11/19/pubmed PY - 2014/4/22/medline KW - Combined modality therapy KW - Rehabilitation KW - Stroke KW - Virtual reality exposure therapy SP - 431 EP - 8 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 95 IS - 3 N2 - OBJECTIVE: To investigate the effects of combination cathodal transcranial direct current stimulation (tDCS) and virtual reality (VR) therapy for upper extremity (UE) training in patients with subacute stroke. DESIGN: Pilot randomized controlled trial. Patients were randomly assigned to 1 of 3 groups: group A received cathodal tDCS, group B received VR, and group C received combination therapy (cathodal tDCS was simultaneously applied during VR therapy). SETTING: University hospital. PARTICIPANTS: Patients (N=59) with impaired unilateral UE motor function after stroke. INTERVENTION: Fifteen sessions of treatment over a 3-week period. MAIN OUTCOME MEASURES: The Modified Ashworth Scale, manual muscle test (MMT), Manual Function Test (MFT), Fugl-Meyer Scale (FMS), and Box and Block Test were used to assess UE function. To evaluate activities of daily living, the Korean-Modified Barthel Index (K-MBI) was used. All outcomes were measured before and immediately after treatment. RESULTS: After treatment, all groups demonstrated significant improvements in MMT, MFT, FMS, and K-MBI scores. The change in MFT and FMS scores was different between the 3 groups. Post hoc analysis revealed that the improvement of MFT and FMS scores in group C was significantly higher than those of the other 2 groups. CONCLUSIONS: In the present pilot study, the combination of brain stimulation using tDCS and peripheral arm training using VR could facilitate a stronger beneficial effect on UE impairment than using each intervention alone. This combination therapy might be a helpful method to enhance recovery of the paretic UE in patients with stroke. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/24239790/Combination_transcranial_direct_current_stimulation_and_virtual_reality_therapy_for_upper_extremity_training_in_patients_with_subacute_stroke_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(13)01130-1 DB - PRIME DP - Unbound Medicine ER -