【論文摘要】Effect of Transcranial Direct Current Stimulation for Ambulation in Patients With Stroke: A Meta-Analysis

【論文摘要】經顱直流電刺激對於中風病人步態功能之影響：後設分析

田慧勳(Hui-Hsun Tien) ； 陳怡伶(Yi-Lin Chen) ； 吳苡甄(Yi-Chen Wu) ； 劉文瑜(Wen-Yu Liu) ； 連恒裕(Hen-Yu Lien)

《物理治療》 44卷2期 (2019/06) Pp. 133-133

https://doi.org/10.6215/FJPT.201906.P33

摘要

Background and Purpose: Transcranial direct current stimulation (tDCS) has been used extensively to enhance motor performances following stroke. However, most systematic reviews and meta-analyses investigated the effects of tDCS on motor performances of upper extremity. To explore the effects of tDCS on walking ability after stroke, a meta-analysis had revealed some of its beneficial effects on limited measures of mobility and muscle strength of lower extremity. However, the evidence suffers from limited sample size accumulated prior to April 2017 with post-scores only analyses. Therefore, the aims of this meta-analysis were to use the change scores (post-pre) to analyze the effect of tDCS on ambulation in stroke which included randomized controlled trials (RCTs) with larger sample size published recently. Methods: Clinical studies investigated the effects of tDCS for ambulation in stroke were allocated through a systematic search. PubMed, MEDLINE, Physiotherapy Evidence Database (PEDro), Scopus and Cochrane databases were searched for studies published up to August 2018. PEDro scale was used to assess the methodological quality of research. The effect size of individual study was calculated by standardized mean difference (SMD) for all outcome analyses. All analyses were conducted using Comprehensive Meta-Analysis (Biostat Inc. Version 3). Results: 14 studies with 266 patients were qualified for analysis. The overall PEDro score (6.8) indicated good research quality of the included studies. Results showed significant effect of tDCS on Tinetti test (p = 0.029), Rivermead Mobility Index (p = 0.008), Timed Up and Go test (p = 0.034) and Functional Ambulation Category (p = 0.008). Conclusion: The result provided an evidence to support the effect of tDCS on improving functional mobility and walking ability. Future study should differentiate the effects of different stimulation protocols such as uni-hemispheric and dual-hemispheric tDCS. Clinical Relevance: This study provided the most updated clinical evidence of tDCS on mobility and ability of ambulation in patients with stroke.