學院 |
醫學院 |
系所 |
職能治療學系 |
題名 |
Timing-dependent effects of transcranial direct current stimulation with mirror therapy on daily function and motor control in chronic stroke: a randomized controlled pilot study |
作者 |
Liao, W-W., Chiang, W-C., Lin, K-C., Wu, C-Y.*, Liu, C-T., Hsieh, Y-W., Lin, Y-C., & Chen, C-L. |
期刊名稱 |
Journal of NeuroEngineering and Rehabilitation(SCIE 期刊) |
發表日期 |
2020 |
著作性質 |
原著 |
語文 |
英文 |
關鍵字 |
Timing-dependent effect, Transcranial
direct current stimulation, Mirror therapy, Stroke, Activities of daily living, Upper extremity kinematics |
摘要 |
Background: The timing of transcranial direct current stimulation (tDCS) with
neurorehabilitation interventions may affect its modulatory effects. Motor
function has been reported to be modulated by the timing of tDCS; however, whether the timing of tDCS would also
affect restoration of daily function and upper extremity motor control with neurorehabilitation in stroke patients
remains largely unexplored. Mirror therapy (MT) is a potentially effective neurorehabilitation approach for
improving paretic arm function in stroke patients. This study aimed to
determine whether the timing of tDCS with MT would
influence treatment effects on daily function, motor function and motor control in individuals with chronic
stroke. Methods: This study was a double-blinded randomized controlled trial.
Twenty-eight individuals with chronic stroke received one of the following
three interventions: (1) sequentially combined tDCS with MT (SEQ), (2) concurrently combined tDCS with MT (CON),
and (3) sham tDCS with MT (SHAM). Participants received interventions for 90 min/day, 5 days/week
for 4 weeks. Daily function was assessed using the Nottingham Extended Activities of Daily Living Scale. Upper
extremity motor function was assessed using the Fugl-Meyer Assessment Scale. Upper extremity motor control was
evaluated using movement kinematic assessments. Results: There were significant differences in daily function between the
three groups. The SEQ group had greater improvement in daily function than the
CON and SHAM groups. Kinematic analyses showed that movement time of the paretic hand significantly reduced
in the SEQ group after interventions. All three groups had significant improvement in motor function from pre-intervention to post-intervention. Conclusion: The timing of tDCS with MT may influence restoration of daily
function and movement efficiency of the paretic hand in chronic stroke
patients. Sequentially applying tDCS prior to MT seems to be advantageous for enhancing daily function and hand
movement control, and may be considered as a potentially useful strategy in future clinical application |