Vlotinou Penelope, Tsiptsios Dimitrios, Karatzetzou Stella, Kalogirou Georgios, Stefas Eleftherios, Aggelousis Nikolaos, Vadikolias Konstantinos
Neurology Department, Democritus University of Thrace, Alexandroupolis, Greece.
Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece.
Maedica (Bucur). 2022 Mar;17(1):169-176. doi: 10.26574/maedica.2022.17.1.169.
Stroke represents a major cause of upper limb motor impairment among stroke survivors, resulting in functional disability and affecting negatively their quality of life. Thus, it is imperative that stroke rehabilitation be efficient. Up to the present, several intervention methods have been proposed in an attempt to improve recovery potential poststroke, transcranial direct current stimulation (tDCS) and mirror therapy (MT) being among them. The aim of this review is to investigate the utility of tDCS administration in conjunction with MT on chronic stroke population. A literature research of two databases (MEDLINE and Scopus) was conducted in order to identify all relevant studies published between January 1st 2010 and September 30th 2021 that focused on the efficacy of the combined application of tDCS and MT on upper limb rehabilitation among chronic stroke patients. Three studies fulfilled the selection criteria and were included in the present review. Transcranial direct current stimulation application along with MT exhibited statistically significant increases in Box and block test, grip strength, Action research arm test score and Nottingham extended activities of daily living score within the experimental group compared to controls. The timing-dependent interaction effects seem to be of key importance, as sequentially delivered tDCS prior to MT is considered to be more advantageous and time-efficient compared to the concurrent application of tDCS and MT. Application of tDCS in parallel with MT represents a promising neurorehabilitation tool for post-stroke patients regarding upper limb motor performance, movement efficiency and daily function. Future studies are needed in order to clarify whether sequential or concurrent tDCS and MT application is more beneficial.
中风是中风幸存者上肢运动功能障碍的主要原因，会导致功能残疾并对他们的生活质量产生负面影响。因此，中风康复必须高效。到目前为止，已经提出了几种干预方法，试图提高中风后的恢复潜力，经颅直流电刺激（tDCS）和镜像疗法（MT）都在其中。本综述的目的是研究tDCS与MT联合应用于慢性中风患者群体的效用。为了识别2010年1月1日至2021年9月30日期间发表的所有相关研究，对两个数据库（MEDLINE和Scopus）进行了文献检索，这些研究聚焦于tDCS和MT联合应用对慢性中风患者上肢康复的疗效。三项研究符合选择标准并被纳入本综述。与对照组相比，实验组中经颅直流电刺激与镜像疗法联合应用在箱块测试、握力、动作研究手臂测试评分和诺丁汉扩展日常生活活动评分方面均有统计学显著提高。时间依赖性相互作用效应似乎至关重要，因为与tDCS和MT同时应用相比，在MT之前依次给予tDCS被认为更具优势且更省时。与MT并行应用tDCS对于中风后患者的上肢运动表现、运动效率和日常功能而言是一种有前景的神经康复工具。需要进一步的研究来阐明依次应用还是同时应用tDCS和MT更有益。
