Combined Transcranial Direct Current Stimulation with Occupational Therapy Improves Activities of Daily Living in Traumatic Brain Injuries: A Pilot Randomized Clinical Trial

Abstract

Introduction: Traumatic brain injury (TBI) is one of the leading causes of long-term disability worldwide. Occupational therapy interventions in these patients are mainly focused on improving patients’ ability to perform daily occupations. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique whose potential for motor and cognitive recovery of patients with TBI has been investigated; however, its effect on functional outcomes following TBI is unknown. This study aims to determine the effectiveness of tDCS combined with routine occupational therapy on the activities of daily living in patients with TBI. Materials and Methods: This was a single-blind, randomized clinical trial. A total of 24 patients with TBI were recruited using the convenience sampling method and were randomly assigned to the experimental (n=12) and control groups (n=12). Both groups underwent routine occupational therapy for 10 sessions (3 days per week), and the experimental group received tDCS (20 min) in addition to routine occupational therapy. Activities of daily living were assessed using the functional independence measure (FIM) at the baseline and the day after the end of the intervention. Results: After a 10-session intervention, both groups experienced significant improvements in the cognitive subscale and the FIM total score (P<0.001). Additionally, the findings showed that these improvements were significantly higher in the experimental group (P<0.001). Conclusion: According to the findings, although routine occupational therapy can effectively improve the ability of patients with TBI to perform daily living activities, adding tDCS as a complementary intervention can accelerate recovery in these patients.