TY - JOUR

T1 - Combined transcranial direct current stimulation and home-based occupational therapy for upper limb motor impairment following intracerebral hemorrhage

T2 - a double-blind randomized controlled trial

AU - Mortensen, Jesper

AU - Figlewski, Krystian

AU - Andersen, Henning

PY - 2016

Y1 - 2016

N2 - PURPOSE: To investigate the combined effect of transcranial direct current stimulation (tDCS) and home-based occupational therapy on activities of daily living (ADL) and grip strength, in patients with upper limb motor impairment following intracerebral hemorrhage (ICH).METHODS: A double-blind randomized controlled trial with one-week follow-up. Patients received five consecutive days of occupational therapy at home, combined with either anodal (n = 8) or sham (n = 7) tDCS. The primary outcome was ADL performance, which was assessed with the Jebsen-Taylor test (JTT).RESULTS: Both groups improved JTT over time (p < 0.01). The anodal group improved grip strength compared with the sham group from baseline to post-assessment (p = 0.025). However, this difference was attenuated at one-week follow-up. There was a non-significant tendency for greater improvement in JTT in the anodal group compared with the sham group, from baseline to post-assessment (p = 0.158).CONCLUSIONS: Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is a promising add-on intervention regarding training of upper limb motor impairment. It is well tolerated by patients and can easily be applied for home-based training. Larger studies with long-term follow-up are needed to further explore possible effects of tDCS in patients with ICH.IMPLICATIONS FOR REHABILITATION: Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is well tolerated by patients and can easily be applied for home-based rehabilitation.

AB - PURPOSE: To investigate the combined effect of transcranial direct current stimulation (tDCS) and home-based occupational therapy on activities of daily living (ADL) and grip strength, in patients with upper limb motor impairment following intracerebral hemorrhage (ICH).METHODS: A double-blind randomized controlled trial with one-week follow-up. Patients received five consecutive days of occupational therapy at home, combined with either anodal (n = 8) or sham (n = 7) tDCS. The primary outcome was ADL performance, which was assessed with the Jebsen-Taylor test (JTT).RESULTS: Both groups improved JTT over time (p < 0.01). The anodal group improved grip strength compared with the sham group from baseline to post-assessment (p = 0.025). However, this difference was attenuated at one-week follow-up. There was a non-significant tendency for greater improvement in JTT in the anodal group compared with the sham group, from baseline to post-assessment (p = 0.158).CONCLUSIONS: Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is a promising add-on intervention regarding training of upper limb motor impairment. It is well tolerated by patients and can easily be applied for home-based training. Larger studies with long-term follow-up are needed to further explore possible effects of tDCS in patients with ICH.IMPLICATIONS FOR REHABILITATION: Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is well tolerated by patients and can easily be applied for home-based rehabilitation.

KW - Activities of Daily Living

KW - Adult

KW - Aged

KW - Combined Modality Therapy

KW - Denmark

KW - Double-Blind Method

KW - Female

KW - Home Care Services

KW - Humans

KW - Male

KW - Middle Aged

KW - Motor Disorders

KW - Occupational Therapy

KW - Recovery of Function

KW - Stroke

KW - Transcranial Direct Current Stimulation

KW - Treatment Outcome

KW - Upper Extremity

KW - Journal Article

KW - Randomized Controlled Trial

KW - Research Support, Non-U.S. Gov't

U2 - 10.3109/09638288.2015.1055379

DO - 10.3109/09638288.2015.1055379

M3 - Journal article

C2 - 26079636

VL - 38

SP - 637

EP - 643

JO - Disability and Rehabilitation

JF - Disability and Rehabilitation

SN - 0963-8288

IS - 7

ER -