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A randomized sham-controlled trial on the effects of dual-tDCS “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol

BACKGROUND: Dual-transcranial direct current stimulation (tDCS) has been used to rebalance the cortical excitability of both hemispheres following unilateral-stroke. Our previous study showed a positive effect from a single-session of dual-tDCS applied before physical therapy (PT) on lower limb perf...

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Autores principales: Klomjai, Wanalee, Aneksan, Benchaporn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013129/
https://www.ncbi.nlm.nih.gov/pubmed/35428346
http://dx.doi.org/10.1186/s13102-022-00463-9
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author Klomjai, Wanalee
Aneksan, Benchaporn
author_facet Klomjai, Wanalee
Aneksan, Benchaporn
author_sort Klomjai, Wanalee
collection PubMed
description BACKGROUND: Dual-transcranial direct current stimulation (tDCS) has been used to rebalance the cortical excitability of both hemispheres following unilateral-stroke. Our previous study showed a positive effect from a single-session of dual-tDCS applied before physical therapy (PT) on lower limb performance. However, it is still undetermined if other timings of brain stimulation (i.e., during motor practice) induce better effects. The objective of this study was to examine the effect of a single-session of dual-tDCS “during” PT on lower limb performance in sub-acute stroke and then compare the results with our previous data using a “before” stimulation paradigm. METHOD: For the current “during” protocol, 19 participants were participated in a randomized sham-controlled crossover trial. Dual-tDCS over the M1 of both cortices (2 mA) was applied during the first 20 min of PT. The Timed Up and Go and Five-Times-Sit-To-Stand tests were assessed at pre- and post-intervention and 1-week follow-up. Then, data from the current study were compared with those of the previous “before” study performed in a different group of 19 subjects. Both studies were compared by the difference of mean changes from the baseline. RESULTS: Dual-tDCS “during” PT and the sham group did not significantly improve lower limb performance. By comparing with the previous data, performance in the “before” group was significantly greater than in the “during” and sham groups at post-intervention, while at follow-up the “before” group had better improvement than sham, but not greater than the “during” group. CONCLUSION: A single-session of dual-tDCS during PT induced no additional advantage on lower limb performance. The “before” group seemed to induce better acute effects; however, the benefits of the after-effects on motor learning for both stimulation protocols were probably not different. Trial registration Current randomized controlled trials was prospectively registered at the clinicaltrials.gov, registration number: NCT04051671. The date of registration was 09/08/2019.
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spelling pubmed-90131292022-04-17 A randomized sham-controlled trial on the effects of dual-tDCS “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol Klomjai, Wanalee Aneksan, Benchaporn BMC Sports Sci Med Rehabil Research BACKGROUND: Dual-transcranial direct current stimulation (tDCS) has been used to rebalance the cortical excitability of both hemispheres following unilateral-stroke. Our previous study showed a positive effect from a single-session of dual-tDCS applied before physical therapy (PT) on lower limb performance. However, it is still undetermined if other timings of brain stimulation (i.e., during motor practice) induce better effects. The objective of this study was to examine the effect of a single-session of dual-tDCS “during” PT on lower limb performance in sub-acute stroke and then compare the results with our previous data using a “before” stimulation paradigm. METHOD: For the current “during” protocol, 19 participants were participated in a randomized sham-controlled crossover trial. Dual-tDCS over the M1 of both cortices (2 mA) was applied during the first 20 min of PT. The Timed Up and Go and Five-Times-Sit-To-Stand tests were assessed at pre- and post-intervention and 1-week follow-up. Then, data from the current study were compared with those of the previous “before” study performed in a different group of 19 subjects. Both studies were compared by the difference of mean changes from the baseline. RESULTS: Dual-tDCS “during” PT and the sham group did not significantly improve lower limb performance. By comparing with the previous data, performance in the “before” group was significantly greater than in the “during” and sham groups at post-intervention, while at follow-up the “before” group had better improvement than sham, but not greater than the “during” group. CONCLUSION: A single-session of dual-tDCS during PT induced no additional advantage on lower limb performance. The “before” group seemed to induce better acute effects; however, the benefits of the after-effects on motor learning for both stimulation protocols were probably not different. Trial registration Current randomized controlled trials was prospectively registered at the clinicaltrials.gov, registration number: NCT04051671. The date of registration was 09/08/2019. BioMed Central 2022-04-15 /pmc/articles/PMC9013129/ /pubmed/35428346 http://dx.doi.org/10.1186/s13102-022-00463-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Klomjai, Wanalee
Aneksan, Benchaporn
A randomized sham-controlled trial on the effects of dual-tDCS “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol
title A randomized sham-controlled trial on the effects of dual-tDCS “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol
title_full A randomized sham-controlled trial on the effects of dual-tDCS “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol
title_fullStr A randomized sham-controlled trial on the effects of dual-tDCS “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol
title_full_unstemmed A randomized sham-controlled trial on the effects of dual-tDCS “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol
title_short A randomized sham-controlled trial on the effects of dual-tDCS “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol
title_sort randomized sham-controlled trial on the effects of dual-tdcs “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013129/
https://www.ncbi.nlm.nih.gov/pubmed/35428346
http://dx.doi.org/10.1186/s13102-022-00463-9
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