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Article type: Research Article
Authors: Viana, R.T.a | Laurentino, G.E.C.a | Souza, R.J.P.a | Fonseca, J.B.a | Silva Filho, E.M.a | Dias, S.N.a | Teixeira-Salmela, L.F.b | Monte-Silva, K.K.a; *
Affiliations: [a] Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil | [b] Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
Correspondence: [*] Address for correspondence: K. Monte-Silva, Department of Physical Therapy, Universidade Federal de Pernambuco, Avenue Professor Moraes Rego s/n, 50670-900 Recife, Pernambuco, Brazil. Tel.: +55 81 2126 7579; Fax: +55 81 2126 8491; E-mail: monte.silvakk@gmail.com
Abstract: Background:Upper limb (UL) impairment is the most common disabling deficit following a stroke. Previous studies have suggested that transcranial direct current stimulation (tDCS) enhances the effect of conventional therapies. Objective:This pilot double-blind randomized control trial aimed to determine whether or not tDCS, combined with Wii virtual reality therapy (VRT), would be superior to Wii therapy alone in improving upper limb function and quality of life in chronic stroke individuals. Methods:Twenty participants were randomly assigned either to an experimental group that received VRT and tDCS, or a control group that received VRT and sham tDCS. The therapy was delivered over 15 sessions with 13 minutes of active or sham anodal tDCS, and one hour of virtual reality therapy. The outcomes included were determined using the Fugl-Meyer scale, the Wolf motor function test, the modified Ashworth scale (MAS), grip strength, and the stroke specific quality of life scale (SSQOL). Minimal clinically important differences (MCID) were observed when assessing outcome data. Results:Both groups demonstrated gains in all evaluated areas, except for the SSQOL-UL domain. Differences between groups were only observed in wrist spasticity levels in the experimental group, where more than 50% of the participants achieved the MCID. Conclusions:These findings support that tDCS, combined with VRT therapy, should be investigated and clarified further.
Keywords: Virtual reality therapy, non-invasive brain stimulation, transcranial stimulation, rehabilitation, stroke, wii gaming system
DOI: 10.3233/NRE-141065
Journal: NeuroRehabilitation, vol. 34, no. 3, pp. 437-446, 2014
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