Chu Fengming, Gao Ling, Zhou Jingjie, Jia Fan, Chen Jie, Tang Wei, Zhang Ming
The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, China.
The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, China.
PM R. 2025 Jul 2. doi: 10.1002/pmrj.13429.
Lower limb motor dysfunction is a common sequela of stroke. Further research is needed to identify effective rehabilitation methods to improve motor function.
To investigate the therapeutic effects of transcranial direct current stimulation (tDCS) and isokinetic strength training (IST), both individually and in combination, on two primary outcomes: lower limb motor function and lower limb muscle strength in individuals with chronic stroke. Additionally, it also explored the effects on balance, gait, and muscle tone as secondary outcomes.
Randomized controlled trial.
Inpatient department of university hospital.
A total of 56 individuals with chronic stroke (aged 35 to 77 years) were selected and randomly divided into four groups: control group (n = 14), tDCS group (n = 14), IST group (n = 13), and combined group (n = 15).
Two intervention techniques were employed: (1) 20 minutes of 2 mA tDCS, and (2) 20 minutes of IST. In addition, all participants received 80 minutes of standard rehabilitation therapy.
The primary outcomes were peak torque (PT) of knee flexion and extension and the Fugl-Meyer Assessment of Lower Extremity (FMA-LE) score. The secondary outcomes included the Berg Balance Scale, the 10-meter Walk Test, and the Modified Ashworth Scale scores. Data were collected at baseline and 4 weeks after the treatment.
After 4 weeks of treatment, the tDCS group showed a significant increase in knee extension PT and FMA-LE scores compared to baseline data by 3.59 (p = .009) and 2.07 (p = .009) respectively. In the IST group, knee flexion, extension PT, and FMA-LE scores were significantly higher than baseline data by 5.67 (p = .001), 7.18 (p < .001), and 3.00 (p = .007), respectively. The combined group showed significant increases in knee flexion, extension PT, and FMA-LE scores compared to baseline data by 10.13 (p < .001), 13.04 (p < .001), and 5.27 (p < .001). The combined group showed significantly superior treatment effects compared to the control group, tDCS group, and IST group.
Both tDCS and IST were effective in improving lower limb muscle strength and motor function in individuals with chronic stroke, but the combination of these two techniques was more effective.
下肢运动功能障碍是中风常见的后遗症。需要进一步研究以确定有效的康复方法来改善运动功能。
探讨经颅直流电刺激（tDCS）和等速力量训练（IST）单独及联合应用对慢性中风患者两个主要结局指标的治疗效果：下肢运动功能和下肢肌肉力量。此外，还探讨了对平衡、步态和肌张力等次要结局指标的影响。
随机对照试验。
大学医院住院部。
共选取56例慢性中风患者（年龄35至77岁），随机分为四组：对照组（n = 14）、tDCS组（n = 14）、IST组（n = 13）和联合组（n = 15）。
采用两种干预技术：（1）2毫安tDCS刺激20分钟，（2）IST训练20分钟。此外，所有参与者均接受80分钟的标准康复治疗。
主要结局指标为膝关节屈伸的峰值扭矩（PT）和下肢Fugl-Meyer评估量表（FMA-LE）评分。次要结局指标包括Berg平衡量表、10米步行试验和改良Ashworth量表评分。在基线和治疗4周后收集数据。
治疗4周后，与基线数据相比，tDCS组膝关节伸展PT和FMA-LE评分分别显著增加3.59（p = 0.009）和2.07（p = 0.009）。在IST组中，膝关节屈伸PT和FMA-LE评分分别比基线数据显著高出5.67（p = 0.001）、7.18（p < 0.001）和3.00（p = 0.007）。联合组与基线数据相比，膝关节屈伸PT和FMA-LE评分显著增加，分别为10.13（p < 0.001）、13.04（p < 0.001）和5.27（p < 0.001）。联合组的治疗效果显著优于对照组、tDCS组和IST组。
tDCS和IST均能有效改善慢性中风患者的下肢肌肉力量和运动功能，但两种技术联合应用效果更佳。
