Transcranial direct current stimulation combined with isokinetic strength training to improve lower limb motor function in chronic stroke survivors: A randomized controlled study.

Abstract

Lower limb motor dysfunction is a common sequela of stroke. Further research is needed to identify effective rehabilitation methods to improve motor function. To investigate the therapeutic effects of transcranial direct current stimulation (tDCS) and isokinetic strength training (IST), both individually and in combination, on two primary outcomes: lower limb motor function and lower limb muscle strength in individuals with chronic stroke. Additionally, it also explored the effects on balance, gait, and muscle tone as secondary outcomes. Randomized controlled trial. Inpatient department of university hospital. A total of 56 individuals with chronic stroke (aged 35 to 77 years) were selected and randomly divided into four groups: control group (n = 14), tDCS group (n = 14), IST group (n = 13), and combined group (n = 15). Two intervention techniques were employed: (1) 20 minutes of 2 mA tDCS, and (2) 20 minutes of IST. In addition, all participants received 80 minutes of standard rehabilitation therapy. The primary outcomes were peak torque (PT) of knee flexion and extension and the Fugl-Meyer Assessment of Lower Extremity (FMA-LE) score. The secondary outcomes included the Berg Balance Scale, the 10-meter Walk Test, and the Modified Ashworth Scale scores. Data were collected at baseline and 4 weeks after the treatment. After 4 weeks of treatment, the tDCS group showed a significant increase in knee extension PT and FMA-LE scores compared to baseline data by 3.59 (p = .009) and 2.07 (p = .009) respectively. In the IST group, knee flexion, extension PT, and FMA-LE scores were significantly higher than baseline data by 5.67 (p = .001), 7.18 (p < .001), and 3.00 (p = .007), respectively. The combined group showed significant increases in knee flexion, extension PT, and FMA-LE scores compared to baseline data by 10.13 (p < .001), 13.04 (p < .001), and 5.27 (p < .001). The combined group showed significantly superior treatment effects compared to the control group, tDCS group, and IST group. Both tDCS and IST were effective in improving lower limb muscle strength and motor function in individuals with chronic stroke, but the combination of these two techniques was more effective.