tDCS synchronous robotic training on lower-limb with post-stroke hemiplegia: a comparative study between synchronous...

This study was aimed to compare the effects of tDCS synchronized with robotic training(RT)and tDCS sequential followed by RT on lower-limb with post-stroke hemiplegia, thus to inform clinical decision-making between these delivery schedules.

64 patients who met the inclusion and exclusion criteria were allocated into a synchronous group and a sequential group. The synchronous group underwent tDCS synchronous RT, while the sequential group received RT after tDCS ended. Both group received 40 minutes for treatment, five times a week, for a continuous two weeks. Gait Watch three-dimensional gait analysis system was used for both groups before and after treatment. Additionally, the Fugl-Meyer assessment for lower extremities (FMA-LE), functional ambulation category (FAC), and the modified Barthel index(MBI)were used to assess the motor function of lower extremities, walking function, and activities of daily living (ADL) in both groups.

Finally, 60 cases finished the study (30 for each group). Before treatment, there was no difference in baseline data between groups (p > 0.05). After treatment, there was no difference in FMA-LE between group (F = 1.751, p = 0.191). The incidence of 95% CI of the hip flexion, knee flexion, FAC, step difference and MBI in synchronous group were more superior than those in the sequential group (all p < 0.001).

Synchronous tDCS-RT produced superior gait and functional benefits compared with sequential delivery, but did not differentially improve lower-limb motor impairment as measured by the FMA-LE on lower-limb with post-stroke hemiplegia.