[article] 
inAnnals of physical and rehabilitation medicine > Vol. 61, n°5 (Septembre 2018) . - p. 286-291

Titre :	Effect of single-session dual-tDCS before physical therapy on lower-limb performance in sub-acute stroke patients: A randomized sham-controlled crossover study
Type de document :	texte imprimé
Auteurs :	Wanalee Klomjai ; Benchaporn Aneksan ; Anuchai Pheungphrarattanatrai ; Thanwarat Chantanachai ; Nattha Choowong ; Soontaree Bunleukhet ; Paradee Auvichayapat ; Yongchai Nilanon ; Vimonwan Heingkaew
Année de publication :	2018
Article en page(s) :	p. 286-291
Note générale :	Doi : 10.1016/j.rehab.2018.04.005
Langues :	Anglais (eng)
Mots-clés :	tDCS  Lower limb  Stroke  Physical therapy  Rehabilitation
Résumé :	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.
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[article] Effect of single-session dual-tDCS before physical therapy on lower-limb performance in sub-acute stroke patients: A randomized sham-controlled crossover study [texte imprimé] / Wanalee Klomjai ; Benchaporn Aneksan ; Anuchai Pheungphrarattanatrai ; Thanwarat Chantanachai ; Nattha Choowong ; Soontaree Bunleukhet ; Paradee Auvichayapat ; Yongchai Nilanon ; Vimonwan Heingkaew . - 2018 . - p. 286-291.
Doi : 10.1016/j.rehab.2018.04.005
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 61, n°5 (Septembre 2018) . - p. 286-291

Mots-clés :	tDCS  Lower limb  Stroke  Physical therapy  Rehabilitation
Résumé :	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.
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