Combined therapy with contralateral controlled functional electrical stimulation and transcranial direct current stimulation for early post-stroke hand dysfunction.

OBJECTIVES

To explore the clinical efficacy of contralateral controlled functional electrical stimulation (CCFES) combined with transcranial direct current stimulation (tDCS) in the treatment of patients with early post-stroke hand dysfunction.

METHODS

Ninety patients with definitively diagnosed early post-stroke hand dysfunction were selected and divided into the control group (30 cases), experimental group 1 (EG1; 30 cases) and experimental group 2 (EG2; 30 cases) according to the random number table method. The control group received traditional therapy; experimental group 1 received tDCS in addition to standard care; experimental group 2 received both tDCS and CCFES in addition to standard treatments. Before and after treatment, all three groups were evaluated using the Fugl-Meyer assessment for upper extremity (FMA-UE), the functional test for the hemiplegic upper extremity-Hong Kong version (FTHUE-HK), the Modified Barthel Index (MBI), the Brunnstrom stages of hand, the Motor Assessment Scale (MAS) and surface electromyography (sEMG).

RESULTS

Before treatment, there were no significant differences in baseline characteristics among the three groups (P > 0.05). After treatment, significant improvements were observed in FMA-UE score, FTHUE-HK grading, MBI score, Brunnstrom hand staging, MAS score and sEMG compared with pre-treatment values (P < 0.05). Specifically, EG1 showed greater improvements than the control group (P < 0.05), whereas EG2 demonstrated better outcomes than both EG1 and the control group (P < 0.05).

CONCLUSIONS

Contralateral controlled functional electrical stimulation combined with tDCS substantially improves hand function in patients with early stage stroke, with better outcomes than tDCS therapy alone.