Effects of Dual Transcranial Direct Current Stimulation and Modified Constraint-Induced Movement Therapy to Improve Upper-Limb Function after Stroke: A Double-Blinded, Pilot Randomized Controlled Trial.

BACKGROUND: Dual transcranial direct current stimulation (dual tDCS) can be combined with stroke rehabilitation interventions to promote excitatory changes in the cerebral cortex. OBJECTIVE: To investigate how the combined intervention of dual tDCS and modified constraint-induced movement therapy (mCIMT) using both anodal and cathodal stimulation affects on the recovery of upper limb function in chronic stroke patients. METHODS: This study was a double-blind randomized controlled trial. A total of 30 patients were randomly assigned to the experimental group (dual tDCS and mCIMT) or control group (sham dual tDCS and mCIMT). The experimental and control group performed mCIMT immediately after applying dual tDCS for 20 min, but the control group also performed mCIMT after applying sham tDCS for 20 min in a state where no current flows. The total intervention period was performed 5 times a week for 4 weeks. The outcome was assessed using Fugle-Meyer Assessment (FMA) Motor Activity Log (MAL) Accelerometer. RESULTS: There was a significant improvement in AOU of MAL and usage of unaffected side in the experimental group compared to the control group, and the experimental group showed more than a small effect difference compared to the control group in the effect size of all evaluations. CONCLUSIONS: This study has clinical significance in that it presents the possibility of convergence intervention that considers the therapeutic efficiency in clinical practice.