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【論文摘要】Effects of Transcranial Direct Current Stimulation Combined With Neuromuscular Electrical Stimulation on Motor Recovery of Upper Extremity in Patients With Chronic Stroke

【論文摘要】經顱直流電刺激合併神經肌肉電刺激於慢性中風病患上肢動作恢復的療效

摘要


Background and Purpose: Previous studies have shown transcranial direct current stimulation (tDCS) and neuromuscular electrical stimulation (NMES) have been effective for promoting motor recovery of stroke patients. However, the effects of tDCS combined with NMES on upper extremity (UE) motor recovery in patients with stroke have not been investigated. The purpose of this study was to investigate the effects of the combination treatment strategy. Methods: A randomized, double-blinded and sham-stimulation study was conducted. Twenty-three participants with chronic stroke (onset > 6 months) were assigned into one of three groups (tDCS combined with NMES, tDCS combined with sham NMES, or sham tDCS combined with sham NMES) by block randomization. In addition to conventional rehabilitation, all subjects received an additional protocol with a total of 15 sessions for 3 weeks (5 times per week, 30 min daily). The UE subscale of Fugl-Meyer Assessment (UE-FMA) and Action Research Arm Test (ARAT) as primary outcome measures were assessed at beginning of the intervention, 3-week post-treatment, and one-month follow-up. Results: Most of the participants had mild to moderate disability in activity of daily living. No significant differences in the primary outcome measures at post-treatment and one-month follow-up were found among the tDCS combined with NMES group (n = 8), tDCS combined with sham NMES group (n = 8), and the sham tDCS combined with sham NMES group (n = 7). However, significant score changes in UE-FMA (from baseline to post-treatment, p = 0.02) and ARAT (from baseline to post-treatment, p = 0.04) were found for the tDCS combined with NMES group. Conclusion: This preliminary study reveals that the tDCS combined with NMES appears to be beneficial to UE motor recovery after stroke, but is not superior to the tDCS alone.

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