Efficacy of transcranial direct current stimulation and over-ground walking task on functional mobility and quality of life of stroke survivors

C. Adeagbo, Caleb Ao Gbiri, O. Olawale
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Abstract

Introduction: High proportion of stroke survivors have impaired functional mobility and decrease in overall quality of life (QoL). Transcranial direct current stimulation (tDCS) (non-invasive brain stimulation) and over-ground walking task (OGWT) (functional task-oriented training) have been suggested to improve functional mobility and QoL of stroke survivors. Hence, this study determined the efficacy of tDCS (anodal and cathodal) with OGWT on functional mobility and QoL of stroke survivors. Materials and methods: Seventy eight (78) stroke survivors were randomised into three groups: anodal group (anodal tDCS with OGWT); cathodal group (cathodal tDCS with OGWT) and control group (OGWT only). Participants had two sessions of intervention per week for six weeks. Functional mobility was assessed using 10 meter walk test (10MWT) measuring steps, time and velocity while QoL was measured using Stroke Specific QoL (SSQoL) scale. Significance level was set at p < 0.05. Results: Participants (46 males) were aged 56.78 ± 10.24 years. The groups were matched for functional mobility and QoL at baseline and only work/productivity domain of SSQoL showed statistically significant difference (p = 0.028). Each group showed statistically significant improvement between baseline and post-intervention scores of items in functional mobility (p ≤ 0.001) and total SSQoL (p ≤ 0.001). Anodal group showed better statistically significant improvement in step (p = 0.008), time (p = 0.024), velocity (p = 0.001) and total SSQoL (p = 0.016) among the groups when the mean differences were compared. Conclusion: tDCS with OGWT is efficacious in improving functional mobility and QoL of stroke survivors. Specifically anodal tDCS with OGWT showed better clinical improvement in step, time, velocity and QoL in stroke survivors.
经颅直流电刺激和地上行走任务对脑卒中幸存者功能活动能力和生活质量的影响
高比例的脑卒中幸存者功能活动能力受损,总体生活质量下降。经颅直流电刺激(tDCS)(无创脑刺激)和地面行走任务(OGWT)(功能任务导向训练)被认为可以改善脑卒中幸存者的功能活动能力和生活质量。因此,本研究确定了tDCS(阳极和阴极)联合OGWT对脑卒中幸存者功能活动能力和生活质量的影响。材料和方法:78例脑卒中幸存者随机分为三组:阳极组(阳极tDCS + OGWT);阴极组(阴极tDCS + OGWT)和对照组(仅OGWT)。参与者每周进行两次干预,持续六周。功能活动能力采用10米步行测验(10MWT)测量步数、时间和速度,生活质量采用脑卒中特异性生活质量(SSQoL)量表。p < 0.05为显著性水平。结果:男性46例,年龄56.78±10.24岁。两组在基线时的功能活动性和生活质量匹配,只有工作/生产力领域的生活质量差异有统计学意义(p = 0.028)。两组功能活动能力单项评分和SSQoL总分比较,均有显著改善(p≤0.001)。阳极组在步长(p = 0.008)、时间(p = 0.024)、速度(p = 0.001)和总SSQoL (p = 0.016)方面均有显著改善,差异有统计学意义。结论:tDCS联合OGWT可有效改善脑卒中幸存者的功能活动能力和生活质量。特别是在脑卒中幸存者中,阳极tDCS联合OGWT在步长、时间、速度和生活质量方面表现出更好的临床改善。
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