Deans' stroke musings: Effects of Transcranial Direct Current Stimulation (tDCS) Combined with Wrist Robot-assisted Rehabilitation on Motor Recovery in Subacute Stroke Patients: A Randomized Controlled Trial

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, June 13, 2019

Effects of Transcranial Direct Current Stimulation (tDCS) Combined with Wrist Robot-assisted Rehabilitation on Motor Recovery in Subacute Stroke Patients: A Randomized Controlled Trial

There seems to be no objective diagnosis of damage so this will never be repeatable and usable in creating a stroke rehab protocol.

The Fugl-Meyer upper extremity scale has no objective distinction for changes in ability and thus would be useless as a measurement tool.

The Modified Ashworth Scale is way too subjective to be of any use in knowing if improvements are occurring.

Effects of Transcranial Direct Current Stimulation (tDCS) Combined with Wrist Robot-assisted Rehabilitation on Motor Recovery in Subacute Stroke Patients: A Randomized Controlled Trial

Mazzoleni S, Tran VD, Dario P, Posteraro F.

Abstract

Both transcranial direct current stimulation (tDCS) and wrist robot-assisted training have demonstrated to be promising approaches for stroke rehabilitation. However, the effects of the combination of the two treatments in subacute stroke patients are not yet clear. To investigate the effectiveness of combining tDCS and wrist robot-assisted rehabilitation in subacute stroke patients in comparison with the wrist robotic training only, a single-blind, randomized, sham-controlled trial was performed with 40 subacute stroke patients (25 ± 7 days from stroke onset time). Patients were randomly assigned to experimental group (EG, n = 20) where patients receive real tDCS (2mA, 20 minutes, the anodal electrode on the primary motor cortex -M1 -area of the affected hemisphere(C3/C4 in the 10-20 EEG system and the cathodal electrode on the contralateral orbit bone) or control group (CG, n = 20) where patients receive sham tDCS (5 seconds) during wrist robotic rehabilitation training. The effects of the treatment were evaluated by means of the upper extremity, shoulder-elbow and wrist subsections of the Fugl-Meyer Assessment Scale, Modified Ashworth Scale, Motricity Index and Box & Block test together with kinematic parameters. One out of 20 patients in the CG did not complete the treatment. All the clinical outcome measures except the Modified Ashworth Scale showed a significant increase after the treatment in both groups. However, no significant difference in the average changes after treatment between groups was observed. The movement velocity and smoothness showed significant increases after the training, even though no significant difference between groups was observed. The combination of wrist robot-assisted training and tDCS did not show additional effects in comparison with wrist robot-assisted training only in subacute stroke patients. The negative results found in this study are specific for the specific intervention. The timing of delivering the tDCS and the robot-assisted therapy has to be deeply investigated to enhance the effectiveness of the training.