Médecine

Paramédical

Autres domaines


S'abonner

Effect of single-session dual-tDCS before physical therapy on lower-limb performance in sub-acute stroke patients: A randomized sham-controlled crossover study - 29/08/18

Doi : 10.1016/j.rehab.2018.04.005 
Wanalee Klomjai a, , Benchaporn Aneksan a, Anuchai Pheungphrarattanatrai a, Thanwarat Chantanachai a, Nattha Choowong a, Soontaree Bunleukhet a, Paradee Auvichayapat b, Yongchai Nilanon c, Vimonwan Hiengkaew a
a Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand 
b Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 
c Siriraj Stroke Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 

Corresponding author.

Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.

Connectez-vous pour en bénéficier!

Highlights

A single session of dual-tDCS applied before conventional physical therapy in sub-acute stroke patients immediately improved sit-to-stand performance. Such improvement was significantly greater than with conventional physical therapy alone.
A carry-over effect was found at approximately 1 week after the end of the intervention.
However, muscle strength as evaluated by knee extensor peak torque was unchanged in both limbs for both real and sham tDCS groups.

Le texte complet de cet article est disponible en PDF.

Abstract

Anodal stimulation increases cortical excitably, whereas cathodal stimulation decreases cortical excitability. Dual transcranial direct current stimulation (tDCS; anodal over the lesioned hemisphere, cathodal over the non-lesioned hemisphere) was found to enhance motor learning. The corresponding tDCS-induced changes were reported to reduce the inhibition exerted by the unaffected hemisphere on the affected hemisphere and restore the normal balance of the interhemispheric inhibition. Most studies were devoted to the possible modification of upper-limb motor function after tDCS; however, almost no study has demonstrated its effects on lower-limb function and gait, which are also commonly disordered in stroke patients with motor deficits. In this randomized sham-controlled crossover study, we included 19 patients with sub-acute stroke. Participants were randomly allocated to receive real or sham dual-tDCS followed by conventional physical therapy with an intervention interval of at least 1 week. Dual-tDCS was applied over the lower-limb M1 at 2-mA intensity for 20min. Lower-limb performance was assessed by the Timed Up and Go (TUG) and Five-Times-Sit-To-Stand (FTSTS) tests and muscle strength was assessed by peak knee torque of extension. We found a significant increase in time to perform the FTSST for the real group, with improvements significantly greater than for the sham group; the TUG score was significantly increased but not higher than for the sham group. An after-effect on FTSTS was found at approximately 1 week after the real intervention. Muscle strength was unchanged in both limbs for both real and sham groups. Our results suggest that a single session of dual-tDCS before conventional physical therapy could improve sit-to-stand performance, which appeared to be improved over conventional physical therapy alone. However, strength performance was not increased after the combination treatment.

Le texte complet de cet article est disponible en PDF.

Keywords : tDCS, Lower limb, Stroke, Physical therapy, Rehabilitation


Plan


© 2018  Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 61 - N° 5

P. 286-291 - septembre 2018 Retour au numéro
Article précédent Article précédent
  • Mobility and satisfaction with a microprocessor-controlled knee in moderately active amputees: A multi-centric randomized crossover trial
  • Céline Lansade, Eric Vicaut, Jean Paysant, Doménico Ménager, Marie-Christine Cristina, Frank Braatz, Stephan Domayer, Dominic Pérennou, Gérard Chiesa
| Article suivant Article suivant
  • Modulating the internal model of verticality by virtual reality and body-weight support walking: A pilot study
  • Anaïs Odin, Dominique Faletto-Passy, Franck Assaban, Dominic Pérennou

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

;

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.