【論文摘要】Effect of Transcranial Direct Current Stimulation Combined With Neuromuscular Electrical Stimulation on Motor Recovery of Upper Extremity in Patients With Chronic Stroke: A Pilot Study

【論文摘要】經顱直流電剌激合併神經肌肉電剌激於慢性期中風病患上肢動作恢復的療效：一項先導性研究

魏雅瑩(Ya-Ying Wei) ； 許妙如(Miao-Ju Hsu) ； 吳珮楨(Pei-Chen Wu) ； 楊忠育(Chung-Yu Yang) ； 黃茂雄(Mao-Hsiung Huang) ； 林昭宏(Jau-Hong Lin)

《物理治療》 43卷2期 (2018/06) Pp. 165-166

https://doi.org/10.6215/FJPT.2018.75.P32

摘要

Background and Purpose: The feasibility and effect of bihemispheric-transcranial direct current stimulation (tDCS) combined with neuromuscular electrical stimulation (NMES) on upper extremity motor recovery in people with chronic stroke have not been investigated. The purpose of this preliminary study was to investigate the effect of the combination treatment strategy. Methods: We recruited ten chronic stroke patients from three outpatient clinics. Subjects were randomly allocated to the E1 group (bihemispheric tDCS + NMES, n = 3), E2 group (bihemispheric-tDCS + sham NMES, n = 3), and Control group (sham tDCS + sham NMES, n = 4). Subjects received a 30-minute intervention of tDCS applied concurrently with NMES at the wrist extensor muscle of paretic limb, 5 times per week, for 3 weeks. A constant direct current of 2 mA intensity was used for the tDCS, with the anodal and cathedral electrodes placed on the affected and nonaffected primary motor cortex, respectively. Upper-limb subscale of Fugl-Meyer assessment (UE-FMA), Action Research Arm Test (ARAT) and Modified Ashworth Scale (MAS) were assessed before and after the intervention. Results: Non-significant differences were found among groups for UE-FMA, ARAT and MAS. However, a trend was found that the motor recovery of upper extremity improved more in the E1 group than the other two groups (change in UE-FMA score: E1 group 38 ± 18 to 43 ± 17, E2 group 38 ± 25 to 40 ± 20, control group 37 ± 23 to 41 ± 22) after the 3-week intervention. Conclusion: Our preliminary findings suggest a combination stimulation strategy based on bihemispheric-tDCS and NMES had a positive effect on motor recovery of upper extremity for chronic stroke patients. Clinical Relevance: This preliminary finding may provide useful references for upper limbs motor recovery of stroke patients in physical therapy.