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

目的：在经颅直流电刺激（tDCS）与机器人辅助手臂训练（AT）联合治疗慢性脑卒中上肢损伤的情况下，探讨正极tDCS对患半球和正极tDCS对未患半球的影响是否存在差异。方法：随机对照试验设计。18例慢性脑卒中患者接受了两种不同的治疗：AT联合阳极tDCS和阴极tDCS。每次干预持续5天。结果确定为上肢运动轻瘫、痉挛和ADL的变化。结果：与阳极刺激相比，阴极刺激能显著改善右半球病变患者的远端痉挛。结论：这种联合治疗表明，tDCS极性对右半球损伤患者有不同的影响。

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.