Effects of the combination therapy of transcranial direct current stimulation with robotic therapy for hemiplegic arms in chronic strokes

目的：探讨经颅直流电刺激(Tdcs)与机器人手臂训练(AT)联合治疗慢性脑卒中患者上肢功能障碍时，阴阳极tdcs对患侧的影响与阴阳极tdcs对健侧的影响是否存在差异。方法：随机对照试验设计。18例慢性卒中患者接受了两种不同的治疗方法：AT联合阳极型TDC和阴极型TDC。每次干预时间为5天。结果被确定为上肢运动性瘫痪、痉挛和日常生活能力的变化。结果：与阴阳极刺激相比，右侧大脑半球病变患者的远端痉挛状态在阴极刺激下明显改善。结论：TDCs的极性联合治疗对右脑损害患者有不同程度的疗效。

Objective : Under the combined therapy using transcranial direct current stimulation(tDCS) with robot-assisted arm training(AT) for impairment of the upper limb in chronic stroke patients, to clarify whether differences exist in the effect of anodal tDCS on the affected hemisphere and cathodal tDCS on the unaffected hemisphere. Methodfs : A RCT design. 18 chronic stroke patients underwent two different treatments : AT combined with anodal tDCS, and cathodal tDCS. Each intervention was administered on 5 days. Outcomes were identified as changes in motor paresis, spasticity and ADL for the upper limb. Results : Distal spasticity was significantly improved with cathodal stimulation compared to anodal stimulation in patients with right hemispheric lesions. Conclusions : This combined therapy demonstrated that polarity of tDCS had different effects for patients with damage to the right hemisphere.