Effect of tDCS Concurrent With VR-Based Robotic Intervention on Hemiplegic Upper Limb Function After Subacute...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Upper limb hemiplegia recovery after stroke is challenging.
• Brain plasticity principles guide novel therapeutic approaches.
• Combining central and peripheral stimulation aims to enhance functional recovery.

Purpose of the Study:

• To evaluate the efficacy of transcranial direct current stimulation (tDCS) combined with virtual reality (VR)-based robotic intervention.
• To assess the impact on upper limb motor function and cortical excitability in subacute ischemic stroke patients.

Main Methods:

• A single-blinded, randomized controlled trial involving 40 subacute ischemic stroke patients.
• Patients were assigned to either an experimental group (tDCS + VR robotics) or a control group (sham tDCS + VR robotics).
• Interventions included 15 sessions over 3 weeks, with outcomes measured by FMA-UL, ARAT, MBI, and functional near-infrared spectroscopy (fNIRS).

Main Results:

• The experimental group showed significantly greater improvements in upper limb function (FMA-UL, ARAT) compared to the control group.
• fNIRS revealed increased activation in the ipsilesional primary motor cortex (M1) and contralesional prefrontal cortex (PFC) in the experimental group.
• While MBI scores improved in both groups, no significant difference was found between them.

Conclusions:

• tDCS combined with VR-based robotic intervention effectively enhances upper limb function and cortical activation (M1, PFC) in stroke patients.
• This combined therapy shows potential for improving motor recovery and brain plasticity.
• No significant advantage was observed in improving activities of daily living (ADL).