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      Combined transcranial direct current stimulation and robot-assisted gait training in patients with chronic stroke: a preliminary comparison.

      Clinical Rehabilitation
      Aged, Electric Stimulation Therapy, methods, Female, Gait Disorders, Neurologic, etiology, rehabilitation, Humans, Italy, Male, Middle Aged, Outpatient Clinics, Hospital, Pilot Projects, Robotics, Stroke, complications, Transcranial Magnetic Stimulation, Walking, physiology

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          Abstract

          To evaluate whether robot-assisted gait training combined with transcranial direct current stimulation is more effective than robot-assisted gait training alone or conventional walking rehabilitation for improving walking ability in stroke patients. Pilot randomized clinical trial. Rehabilitation unit of a university hospital. Thirty patients with chronic stroke. All patients received ten 50-minute treatment sessions, five days a week, for two consecutive weeks. Group 1 (n = 10) underwent a robot-assisted gait training combined with transcranial direct current stimulation; group 2 (n = 10) underwent a robot-assisted gait training combined with sham transcranial direct current stimulation; group 3 (n = 10) performed overground walking exercises. Patients were evaluated before, immediately after and two weeks post treatment. six-minute walking test, 10-m walking test. No differences were found between groups 1 and 2 for all primary outcome measures at the after treatment and follow-up evaluations. A statistically significant improvement was found after treatment in performance on the six-minute walking test and the 10-m walking test in favour of group 1 (six-minute walking test: 205.20 ± 61.16 m; 10-m walking test: 16.20 ± 7.65 s) and group 2 (six-minute walking test: 182.5 ± 69.30 m; 10-m walking test: 17.71 ± 8.20 s) compared with group 3 (six-minute walking test: 116.30 ± 75.40 m; 10-m walking test: 26.30 ± 14.10 s). All improvements were maintained at the follow-up evaluation. In the present pilot study transcranial direct current stimulation had no additional effect on robot-assisted gait training in patients with chronic stroke. Larger studies are required to confirm these preliminary findings.

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