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Transcranial direct current stimulation and repetitive functional task-oriented programme for upper limb functional rehabilitation in stroke survivors
Adeagbo CA, Olawale OA, Gbiri CAO
Physical Therapy Reviews 2021;26(6):420-427
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Recovery of upper limb motor function remains a major challenge to stroke rehabilitation experts and stroke survivors alike. Stimulation of the motor cortex by noninvasive brain stimulators and therapy focused on repetitive functional activities can increase upper limb functioning after stroke. Hence, this study was designed to determine therapeutic efficacy of transcranial direct current stimulation (tDCS) and repetitive functional task-oriented programme (RFTOP) for upper limb functional rehabilitation in stroke survivors. A single-blind randomized control trial involving 78 individuals with sub-acute and chronic stroke. They were randomized into three groups: group 1: anodal tDCS plus RFTOP; group 2: cathodal tDCS plus RFTOP; group 3: RFTOP only. Participants had two sessions of therapy in a week for six weeks. Upper limb function was assessed using Fugl-Meyer Assessment Upper Extremity (FMA-UE) and Box and Block Test (BBT). Significance was set at p < 0.05. Baseline comparison of the groups showed no significant difference (FMA-UE: p = 0.237; BBT: p = 0.183). All groups showed statistical significant difference between baseline and post intervention in scores of FMA-UE (p <= 0.001) and BBT (p < 0.001). Mean difference comparison showed statistical significant difference among groups for FMA-UE hand domain (p = 0.009) and BBT (p =< 0.001). Post hoc analysis showed the difference among the groups was between anodal against cathodal and anodal against control. tDCS and RFTOP were efficacious for upper limb functional rehabilitation in stroke survivors. Anodal tDCS showed better clinical improvement compared to cathodal tDCS.

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