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Effect of single-session dual-tDCS before physical therapy on lower-limb performance in sub-acute stroke patients: A randomized sham-controlled crossover study / Wanalee Klomjai in Annals of physical and rehabilitation medicine, Vol. 61, n°5 (Septembre 2018)
[article]
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. Permalink : ./index.php?lvl=notice_display&id=80617
in Annals of physical and rehabilitation medicine > Vol. 61, n°5 (Septembre 2018) . - p. 286-291[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. Permalink : ./index.php?lvl=notice_display&id=80617 Exemplaires (1)
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Exclu du prêtNon-invasive brain stimulation (NIBS) and motor recovery after stroke / M. SIMONETTA-MOREAU in Annals of physical and rehabilitation medicine, Vol. 57, n°8 (Novembre 2014)
[article]
Titre : Non-invasive brain stimulation (NIBS) and motor recovery after stroke Titre original : Neuromodulation corticale non invasive (NIBS) et récupération motrice post-AVC Type de document : texte imprimé Auteurs : M. SIMONETTA-MOREAU, Auteur Année de publication : 2014 Article en page(s) : p.530-542 Langues : Français (fre) Mots-clés : Stroke Motor recovery rTMS TBS tDCS PAS Brain plasticity AVC Récupération motrice Plasticité cérébrale Résumé : Recovery of motor function after stroke occurs largely on the basis of a sustained capacity of the adult brain for plastic changes. This brain plasticity has been validated by functional imaging and electrophysiological studies. Various concepts of how to enhance beneficial plasticity and in turn improve functional recovery are emerging based on the concept of functional interhemispheric balance between the two motor cortices. Besides conventional rehabilitation interventions and the most recent neuropharmacological approaches, non-invasive brain stimulation (NIBS) has recently been proposed as an add-on method to promote motor function recovery after stroke. Several methods can be used based either on transcranial magnetic stimulation (repetitive mode: rTMS, TBS) via a coil, or small electric current via larges electrodes placed on the scalp, (transcranial direct current stimulation tDCS). Depending on the different electrophysiological parameters of stimulation used, NIBS can induce a transient modulation of the excitability of the stimulated motor cortex (facilitation or inhibition) via a probable LTP-LTD-like mechanism. Several small studies have shown feasible and positive treatment effects for most of these strategies and their potential clinical relevance to help restoring the disruption of interhemispheric imbalance after stroke. Results of these studies are encouraging but many questions remain unsolved: what are the optimal stimulation parameters? What is the best NIBS intervention? Which cortex, injured or intact, should be stimulated? What is the best window of intervention? Is there a special subgroup of stroke patients who could strongly benefit from these interventions? Finally is it possible to boost NIBS treatment effect by motor training of the paretic hand or by additional neuropharmacological interventions? There is clearly a need for large-scale, controlled, multicenter trials to answer these questions before proposing their routine use in the management of stroke patients.
Le cerveau d’un patient victime d’un accident vasculaire cérébral (AVC) a les capacités de reconfigurer son activité dans les suites de l’infarctus. Cette plasticité cérébrale spontanée, substrat de la récupération fonctionnelle, a fait l’objet de nombreux travaux de recherche en imagerie fonctionnelle et en électrophysiologie aboutissant au concept de balance interhémisphérique et au développement de techniques de neuromodulation corticale, visant à faciliter les processus naturels de plasticité corticale. Ces méthodes non invasives utilisent soit, l’application sur le scalp à travers un coil d’un courant magnétique en mode répétitif, (stimulation magnétique transcrânienne répétitive rTMS, TBS), soit l’application d’un courant électrique continu de faible intensité à travers deux larges électrodes placées sur le scalp, (stimulation électrique directe transcrânienne, tDCS). Elles permettent d’induire une modulation de l’excitabilité du cortex moteur sous-jacent transitoire et focale, (facilitation ou inhibition en fonction des paramètres de stimulation), par un mécanisme de type LTP/LTD. Ces méthodes visent principalement à restaurer l’équilibre de la balance interhémisphérique entre le cortex moteur du côté lésé et du côté sain. Plusieurs études ont souligné leur intérêt potentiel dans la récupération motrice post-AVC en montrant des améliorations sensibles des performances motrices de la main parétique comparativement à des stimulations placebo, ainsi que leur bonne tolérance. Cependant, de nombreuses questions demeurent encore en suspens avant de pouvoir les utiliser en routine, concernant les paramètres de stimulation optimaux, les cibles potentielles, le choix des techniques, la meilleure période de leur application (phase aiguë, chronique), les critères de sélection des patients susceptibles d’en bénéficier et finalement leur place par rapport aux techniques conventionnelles de rééducation et les approches neuropharmacologiques.Permalink : ./index.php?lvl=notice_display&id=34537
in Annals of physical and rehabilitation medicine > Vol. 57, n°8 (Novembre 2014) . - p.530-542[article] Non-invasive brain stimulation (NIBS) and motor recovery after stroke = Neuromodulation corticale non invasive (NIBS) et récupération motrice post-AVC [texte imprimé] / M. SIMONETTA-MOREAU, Auteur . - 2014 . - p.530-542.
Langues : Français (fre)
in Annals of physical and rehabilitation medicine > Vol. 57, n°8 (Novembre 2014) . - p.530-542
Mots-clés : Stroke Motor recovery rTMS TBS tDCS PAS Brain plasticity AVC Récupération motrice Plasticité cérébrale Résumé : Recovery of motor function after stroke occurs largely on the basis of a sustained capacity of the adult brain for plastic changes. This brain plasticity has been validated by functional imaging and electrophysiological studies. Various concepts of how to enhance beneficial plasticity and in turn improve functional recovery are emerging based on the concept of functional interhemispheric balance between the two motor cortices. Besides conventional rehabilitation interventions and the most recent neuropharmacological approaches, non-invasive brain stimulation (NIBS) has recently been proposed as an add-on method to promote motor function recovery after stroke. Several methods can be used based either on transcranial magnetic stimulation (repetitive mode: rTMS, TBS) via a coil, or small electric current via larges electrodes placed on the scalp, (transcranial direct current stimulation tDCS). Depending on the different electrophysiological parameters of stimulation used, NIBS can induce a transient modulation of the excitability of the stimulated motor cortex (facilitation or inhibition) via a probable LTP-LTD-like mechanism. Several small studies have shown feasible and positive treatment effects for most of these strategies and their potential clinical relevance to help restoring the disruption of interhemispheric imbalance after stroke. Results of these studies are encouraging but many questions remain unsolved: what are the optimal stimulation parameters? What is the best NIBS intervention? Which cortex, injured or intact, should be stimulated? What is the best window of intervention? Is there a special subgroup of stroke patients who could strongly benefit from these interventions? Finally is it possible to boost NIBS treatment effect by motor training of the paretic hand or by additional neuropharmacological interventions? There is clearly a need for large-scale, controlled, multicenter trials to answer these questions before proposing their routine use in the management of stroke patients.
Le cerveau d’un patient victime d’un accident vasculaire cérébral (AVC) a les capacités de reconfigurer son activité dans les suites de l’infarctus. Cette plasticité cérébrale spontanée, substrat de la récupération fonctionnelle, a fait l’objet de nombreux travaux de recherche en imagerie fonctionnelle et en électrophysiologie aboutissant au concept de balance interhémisphérique et au développement de techniques de neuromodulation corticale, visant à faciliter les processus naturels de plasticité corticale. Ces méthodes non invasives utilisent soit, l’application sur le scalp à travers un coil d’un courant magnétique en mode répétitif, (stimulation magnétique transcrânienne répétitive rTMS, TBS), soit l’application d’un courant électrique continu de faible intensité à travers deux larges électrodes placées sur le scalp, (stimulation électrique directe transcrânienne, tDCS). Elles permettent d’induire une modulation de l’excitabilité du cortex moteur sous-jacent transitoire et focale, (facilitation ou inhibition en fonction des paramètres de stimulation), par un mécanisme de type LTP/LTD. Ces méthodes visent principalement à restaurer l’équilibre de la balance interhémisphérique entre le cortex moteur du côté lésé et du côté sain. Plusieurs études ont souligné leur intérêt potentiel dans la récupération motrice post-AVC en montrant des améliorations sensibles des performances motrices de la main parétique comparativement à des stimulations placebo, ainsi que leur bonne tolérance. Cependant, de nombreuses questions demeurent encore en suspens avant de pouvoir les utiliser en routine, concernant les paramètres de stimulation optimaux, les cibles potentielles, le choix des techniques, la meilleure période de leur application (phase aiguë, chronique), les critères de sélection des patients susceptibles d’en bénéficier et finalement leur place par rapport aux techniques conventionnelles de rééducation et les approches neuropharmacologiques.Permalink : ./index.php?lvl=notice_display&id=34537 Exemplaires (1)
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Exclu du prêtTranscranial direct current stimulation in post-stroke aphasia rehabilitation: A systematic review / Elisa Biou in Annals of physical and rehabilitation medicine, Vol. 62, n°2 (Mars 2019)
[article]
Titre : Transcranial direct current stimulation in post-stroke aphasia rehabilitation: A systematic review Type de document : texte imprimé Auteurs : Elisa Biou ; Hélène Cassoudesalle ; Mélanie Cogné ; Igor Sibon ; Isabelle De Gabory ; Patrick Dehail ; Jérôme Aupy ; Bertrand Glize Année de publication : 2019 Article en page(s) : p. 104-121 Note générale : https://doi.org/10.1016/j.rehab.2019.01.003 Langues : Anglais (eng) Mots-clés : Aphasia TDCS Rehabilitation Speech therapy Résumé : Abstract
Background
Transcranial direct current stimulation (tDCS) is a non-invasive tool that induces neuromodulation in the brain. Several studies have shown the effectiveness of tDCS in improving language recovery in post-stroke aphasia. However, this innovative technique is not currently used in routine speech and language therapy (SLT) practice.
Objective
This systematic review aimed to summarise the role of tDCS in aphasia rehabilitation.
Methods
We searched MEDLINE via PubMed and Scopus on October 5, 2018 for English articles published from 1996 to 2018. Eligible studies involved post-stroke aphasia rehabilitation with tDCS combined or not with SLT.
Results
We retained 5 meta-analyses and 48 studies. Among the 48 studies, 39 were randomised controlled trials (558 patients), 2 prospective studies (56 patients), and 5 case studies (5 patients). Two articles were sub-analyses of a randomised clinical trial. Methods used in these studies were heterogeneous. Only 6 studies did not find a significant effect of tDCS on language performance. As compared with earlier meta-analyses, the 2 latest found significant effects.
Conclusion
Evidence from published peer reviewed literature is effective for post-stroke aphasia rehabilitation at the chronic stages. tDCS devices are easy to use, safe and inexpensive. They can be used in routine clinical practice by speech therapists for aphasia rehabilitation. However, further studies should investigate the effectiveness in the subacute post-stroke phase and determine the effect of the lesion for precisely identifying the targeted brain areas. We discuss crucial challenges for future studies.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065719300107 Permalink : ./index.php?lvl=notice_display&id=84105
in Annals of physical and rehabilitation medicine > Vol. 62, n°2 (Mars 2019) . - p. 104-121[article] Transcranial direct current stimulation in post-stroke aphasia rehabilitation: A systematic review [texte imprimé] / Elisa Biou ; Hélène Cassoudesalle ; Mélanie Cogné ; Igor Sibon ; Isabelle De Gabory ; Patrick Dehail ; Jérôme Aupy ; Bertrand Glize . - 2019 . - p. 104-121.
https://doi.org/10.1016/j.rehab.2019.01.003
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°2 (Mars 2019) . - p. 104-121
Mots-clés : Aphasia TDCS Rehabilitation Speech therapy Résumé : Abstract
Background
Transcranial direct current stimulation (tDCS) is a non-invasive tool that induces neuromodulation in the brain. Several studies have shown the effectiveness of tDCS in improving language recovery in post-stroke aphasia. However, this innovative technique is not currently used in routine speech and language therapy (SLT) practice.
Objective
This systematic review aimed to summarise the role of tDCS in aphasia rehabilitation.
Methods
We searched MEDLINE via PubMed and Scopus on October 5, 2018 for English articles published from 1996 to 2018. Eligible studies involved post-stroke aphasia rehabilitation with tDCS combined or not with SLT.
Results
We retained 5 meta-analyses and 48 studies. Among the 48 studies, 39 were randomised controlled trials (558 patients), 2 prospective studies (56 patients), and 5 case studies (5 patients). Two articles were sub-analyses of a randomised clinical trial. Methods used in these studies were heterogeneous. Only 6 studies did not find a significant effect of tDCS on language performance. As compared with earlier meta-analyses, the 2 latest found significant effects.
Conclusion
Evidence from published peer reviewed literature is effective for post-stroke aphasia rehabilitation at the chronic stages. tDCS devices are easy to use, safe and inexpensive. They can be used in routine clinical practice by speech therapists for aphasia rehabilitation. However, further studies should investigate the effectiveness in the subacute post-stroke phase and determine the effect of the lesion for precisely identifying the targeted brain areas. We discuss crucial challenges for future studies.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065719300107 Permalink : ./index.php?lvl=notice_display&id=84105 Exemplaires (1)
Cote Support Localisation Section Disponibilité Revue Revue Centre de Documentation HELHa Campus Montignies Armoires à volets Document exclu du prêt - à consulter sur place
Exclu du prêt