https://orcid.org/0000-0001-8643-4720
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Abstract
Introduction
Recovery of upper limb motor function remains a major challenge to stroke rehabilitation experts and stroke survivors alike. Stimulation of the motor cortex by noninvasive brain stimulators and therapy focused on repetitive functional activities can increase upper limb functioning after stroke. Hence, this study was designed to determine therapeutic efficacy of transcranial direct current stimulation (tDCS) and repetitive functional task-oriented programme (RFTOP) for upper limb functional rehabilitation in stroke survivors.
Materials and Methods
A single-blind randomized control trial involving 78 individuals with sub-acute and chronic stroke. They were randomized into three groups: Group 1: Anodal tDCS + RFTOP; Group 2: Cathodal tDCS + RFTOP; Group 3: RFTOP only. Participants had two sessions of therapy in a week for six weeks. Upper limb function was assessed using Fugl-Meyer Assessment Upper Extremity (FMA-UE) and Box and Block Test (BBT). Significance was set at p < 0.05.
Results
Baseline comparison of the groups showed no significant difference (FMA-UE: p = 0.237; BBT: p = 0.183). All groups showed statistical significant difference between baseline and post intervention in scores of FMA-UE (p ≤ 0.001) and BBT (p < 0.001). Mean difference comparison showed statistical significant difference among groups for FMA-UE hand domain (p = 0.009) and BBT (p = <0.001). Post hoc analysis showed the difference among the groups was between anodal against cathodal and anodal against control.
Conclusion
tDCS and RFTOP were efficacious for upper limb functional rehabilitation in stroke survivors. Anodal tDCS showed better clinical improvement compared to Cathodal tDCS.
Acknowledgements
The authors would like to thank the following participating centers and research assistants for their contributions to the success of this research.
Participating centers: Lagos University Teaching Hospital (LUTH) Idi-Araba; Lagos State University Teaching Hospital (LASUTH) Ikeja; General Hospital Gbagada; General Hospital, Isolo and General Hospital Marina.
Research assistants: Mr. Daniel Ayeni and Miss. Sola Sholarin. They assisted in patient assessment at baseline and post-intervention in the manner described in the methods.
Author contributions
All authors participated in the study design, data collection, data analysis, data interpretation and manuscript drafting. All authors read and approved the manuscript.
Author’s participation
CA ADEAGBO, OA OLAWALE and CAO GBIRI: Conceptualization, literature search, Data collection, Data analysis, and manuscript writing.
Disclosure statement
The authors declare that there is no conflict of interest. The authors declare that the results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. Preliminary results of this study were presented at the 16th Annual Conference.
Additional information
Notes on contributors
Caleb Adewumi Adeagbo
Caleb Adewumi Adeagbo (MSc. Physiotherapy) studied Physiotherapy at the College of Medicine of the University of Lagos and graduated with Distinction, his Master Degree was from School of Postgraduate Studies, University of Lagos and also graduated with Distinction. Presently he is a Ph.D. student of the School of Postgraduate Studies, University of Lagos. His affiliation is Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine of the University of Lagos. Research interest: Neurological rehabilitation (stroke rehabilitation and prevention).
Olajide Ayinla Olawale
Olajide Ayinla Olawale (Ph.D., FNSP) received foundation training in Physiotherapy at the University of Lagos and graduated with a B.Sc. (Hons). He proceeded to the University of Ibadan and obtained M.Ed. degree in Exercise Physiology. He obtained a Ph.D. in Physiology with Stroke as focus of Research (University of Lagos). His affiliation is Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine of the University of Lagos. Research interest: Neurological rehabilitation and physiotherapy education.
Caleb Ademola Omuwa Gbiri
Caleb Ademola Omuwa Gbiri (Ph.D., FWSO) is a Neurophysiotherapist and Ethical Philosopher. He holds a Bachelor degree in Physiotherapy and Masters and Doctoral Degrees in Neurophysiotherapy (University of Ibadan). He is a Post-Doctoral Fellowship holder in Philosophy and Ethics of Mental Health (University of Pretoria). His affiliation is Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine of the University of Lagos. Research interest: Neurological rehabilitation and mental health.