Transcranial direct current stimulation for upper extremity motor dysfunction in poststroke patients: A systematic review and meta-analysis.

IF 2.6 3区医学 Q1 REHABILITATION

Clinical Rehabilitation Pub Date : 2024-06-01 Epub Date: 2024-03-01 DOI:10.1177/02692155241235336

Xian Tang, Nan Zhang, Zhiyuan Shen, Xin Guo, Jun Xing, Shujuan Tian, Yuan Xing

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引用次数: 0

Abstract

Objective: To evaluate the efficacy and safety of transcranial direct current stimulation in poststroke patients with upper extremity motor dysfunction using a systematic review and meta-analysis.

Data sources: We searched the Web of Science, Cochrane Library, EMBASE, and PubMed for randomized controlled trials investigating the effects of both active and sham stimulation up until January 27, 2024.

Review methods: Efficacy, including the upper extremity Fugl-Meyer Assessment, Action Research Arm Test, Barthel Index, and safety, were assessed. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool and the Physiotherapy Evidence Database Scale. Meta-analysis was performed using the RevMan 5.4 software.

Results: Forty-four studies with 1555 participants were included. Transcranial direct current stimulation proved effective in improving upper extremity motor function (standardized mean difference = 0.22, 95% confidence interval: 0.12-0.32, P < 0.001) and Barthel Index (mean difference = 4.65, 95% confidence interval: 2.82-6.49, P < 0.001). Subgroup analysis revealed the highest transcranial direct current stimulation efficacy in patients with subacute stroke. Both anodal and cathodal stimulation were effective against upper extremity motor dysfunction. C3/C4 was the most effective stimulus target. Optimal stimulation parameters included stimulus current densities <0.057 mA/cm² for 20-30 min and <30 sessions. Adverse effects and dropouts during follow-up showed that transcranial direct current stimulation is safe and feasible.

Conclusions: Our findings suggest that both anodal and cathodal stimulation were significantly effective in subacute stroke patients, particularly when preceding other treatments and when C3/C4 is targeted.

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经颅直流电刺激治疗脑卒中后患者的上肢运动功能障碍：系统回顾和荟萃分析。

目的通过系统综述和荟萃分析评估经颅直流电刺激对上肢运动功能障碍的卒中后患者的疗效和安全性：我们在 Web of Science、Cochrane Library、EMBASE 和 PubMed 中检索了截至 2024 年 1 月 27 日调查主动和假刺激效果的随机对照试验：综述方法：对疗效（包括上肢 Fugl-Meyer 评估、行动研究臂测试、Barthel 指数）和安全性进行了评估。采用 Cochrane Risk of Bias 2 工具和物理治疗证据数据库量表评估偏倚风险。使用 RevMan 5.4 软件进行了 Meta 分析：结果：共纳入 44 项研究，1555 名参与者。经颅直流电刺激可有效改善上肢运动功能（标准化平均差 = 0.22，95% 置信区间：0.12-0.32，P P 2，20-30 分钟），结论：经颅直流电刺激可有效改善上肢运动功能（标准化平均差 = 0.22，95% 置信区间：0.12-0.32，P P 2，20-30 分钟）：我们的研究结果表明，阳极和阴极刺激对亚急性中风患者均有显著疗效，尤其是在其他治疗之前和针对 C3/C4 时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Rehabilitation 医学-康复医学

CiteScore

5.60

自引率

6.70%

发文量

117

审稿时长

4-8 weeks

期刊介绍： Clinical Rehabilitation covering the whole field of disability and rehabilitation, this peer-reviewed journal publishes research and discussion articles and acts as a forum for the international dissemination and exchange of information amongst the large number of professionals involved in rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE)