一项双盲随机对照试验，探究阳极经颅直流电刺激和单侧机器人疗法对亚急性和慢性中风患者上肢功能障碍的影响。

A double-blinded randomised controlled trial exploring the effect of anodal transcranial direct current stimulation and uni-lateral robot therapy for the impaired upper limb in sub-acute and chronic stroke.

作者信息

Triccas L Tedesco, Burridge J H, Hughes A, Verheyden G, Desikan M, Rothwell J

机构信息

Faculty of Health Sciences, University of Southampton, Southampton, UK.

KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.

出版信息

NeuroRehabilitation. 2015;37(2):181-91. doi: 10.3233/NRE-151251.

DOI:10.3233/NRE-151251

PMID:26484510

Abstract

BACKGROUND

Neurorehabilitation technologies such as robot therapy (RT) and transcranial Direct Current Stimulation (tDCS) can promote upper limb (UL) motor recovery after stroke.

OBJECTIVE

To explore the effect of anodal tDCS with uni-lateral and three-dimensional RT for the impaired UL in people with sub-acute and chronic stroke.

METHODS

A pilot randomised controlled trial was conducted. Stroke participants had 18 one-hour sessions of RT (ArmeoSpring) over eight weeks during which they received 20 minutes of either real tDCS or sham tDCS during each session. The primary outcome measure was the Fugl-Meyer assessment (FMA) for UL impairments and secondary were: UL function, activities and stroke impact collected at baseline, post-intervention and three-month follow-up.

RESULTS

22 participants (12 sub-acute and 10 chronic) completed the trial. No significant difference was found in FMA between the real and sham tDCS groups at post-intervention and follow-up (p = 0.123). A significant 'time' x 'stage of stroke' was found for FMA (p = 0.016). A higher percentage improvement was noted in UL function, activities and stroke impact in people with sub-acute compared to chronic stroke.

CONCLUSIONS

Adding tDCS did not result in an additional effect on UL impairment in stroke. RT may be of more benefit in the sub-acute than chronic phase.

摘要

背景

机器人疗法（RT）和经颅直流电刺激（tDCS）等神经康复技术可促进中风后上肢（UL）运动功能恢复。

目的

探讨阳极tDCS联合单侧三维RT对亚急性和慢性中风患者受损上肢的影响。

方法

进行一项初步随机对照试验。中风参与者在八周内进行18次每次一小时的RT（ArmeoSpring）治疗，在此期间，他们在每次治疗中接受20分钟的真正tDCS或假tDCS。主要结局指标是上肢损伤的Fugl-Meyer评估（FMA），次要指标包括：在基线、干预后和三个月随访时收集的上肢功能、活动能力及中风影响。

结果

22名参与者（12名亚急性和10名慢性）完成了试验。在干预后和随访时，真正tDCS组和假tDCS组在FMA上未发现显著差异（p = 0.123）。发现FMA存在显著的“时间”×“中风阶段”交互作用（p = 0.016）。与慢性中风患者相比，亚急性中风患者在上肢功能、活动能力及中风影响方面的改善百分比更高。