Constraint-Induced Movement Therapy Combined With Anodal Transcranial Direct Current Stimulation and Peripheral...

Although previous studies have shown a certain effect for affected upper extremity motor function for constraint-induced movement therapy (CIMT) with transcranial direct current stimulation (tDCS), there is insufficient evidence to make treatment recommendations. Here, we aimed to determine whether the addition of anodal-tDCS and peripheral neuromuscular electrical stimulation (PNES) to CIMT is superior to CIMT alone for improving upper extremity function in patients with chronic stroke.

This retrospective study included patients with chronic hemiparesis following a stroke who underwent CIMT at a college hospital between 2012 and 2018. The participants had either received CIMT alone (five-hour training sessions per day for 10 consecutive weekdays) or CIMT combined with anodal-tDCS and PNES.

A total of 25 patients met all eligibility criteria, and 19 and 6 patients were included in the CIMT alone and CIMT combined with anodal-tDCS and PNES groups, respectively. Both groups showed significant improvement in all outcomes following CIMT (p < 0.05). The Fugl-Meyer assessment showed a significant difference between the groups in the CIMT combined with anodal-tDCS and PNES group (p = 0.047).

Preconditioning interventions, including tDCS and PNES, may be good methods for further enhancing the effectiveness of CIMT.