Transcranial Direct Current Stimulation combined with treadmill training in the subacute phase following stroke: case series

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Background
Stroke is a common cause of gait impairment and regaining a normal gait is a major target in stroke rehabilitation. To facilitate motor recovery after stroke, a variety of experimental approaches have been tested. Recent developments include non-invasive brain stimulation techniques such as transcranial Direct Current Stimulation (tDCS). In neurophysiologic studies an imbalance of interhemispheric interactions has been demonstrated which is believed to interfere with the recovery process. This imbalance can be ameliorated by upregulation of the excitability in the lesioned hemisphere applying anodal tDCS.

Aims: to evaluate the feasibility of anodal tDCS with body weight support treadmill training (BWSTT) in the subacute stroke patients.

Methods
Four subjects (Table 1.) participated in BWSTT coupled with anodal tDCS thrice per week for 4 weeks. Subjects were included within 14 days from stroke onset. Anodal tDCS was delivered to excite the cortical leg motor area using 35 cm2 saline soaked electrodes. During BWSTT a 2 mA current was applied for 20 minutes. Evaluations conducted at baseline and after the intervention included 10-meters walking test (10 MWT), isokinetic muscle strength of knee extensors and three-dimensional gait analysis.

Results
All 4 subjects demonstrated improved gait velocity determined by the 10MWT (Fig. 1). Changes in peak torque of paretic knee extensors werer non-significant (Fig. 2). Gait analysis performed at 3 subjects revealed better temporal and spatial symmetry (Fig.3). No major side effects were reported.

Conclusions
This case series supports the feasibility of anodal tDCS combined with body weight support treadmill training and demonstrates that this type of intervention carries potential for strategy to improve gait recovery in early phase of rehabilitation. Data represents preliminary results of an ongoing study which will include additional subjects in order to establish factors correlated with favorable outcome.
Original languageEnglish
Publication year9 Apr 2014
Publication statusPublished - 9 Apr 2014
Event8th World Congress for NeuroRehabilitation - Istanbul, Turkey
Duration: 8 Apr 201413 Apr 2014

Conference

Conference8th World Congress for NeuroRehabilitation
CountryTurkey
CityIstanbul
Period08/04/201413/04/2014

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