Combined therapy with contralateral controlled functional electrical stimulation and transcranial direct current stimulation for early post-stroke hand dysfunction.

Objectives: To explore the clinical efficacy of contralateral controlled functional electrical stimulation (CCFES) combined with transcranial direct current stimulation (tDCS) in the treatment of patients with early post-stroke hand dysfunction.

Methods: Ninety patients with definitively diagnosed early post-stroke hand dysfunction were selected and divided into the control group (30 cases), experimental group 1 (EG1; 30 cases) and experimental group 2 (EG2; 30 cases) according to the random number table method. The control group received traditional therapy; experimental group 1 received tDCS in addition to standard care; experimental group 2 received both tDCS and CCFES in addition to standard treatments. Before and after treatment, all three groups were evaluated using the Fugl-Meyer assessment for upper extremity (FMA-UE), the functional test for the hemiplegic upper extremity-Hong Kong version (FTHUE-HK), the Modified Barthel Index (MBI), the Brunnstrom stages of hand, the Motor Assessment Scale (MAS) and surface electromyography (sEMG).

Results: Before treatment, there were no significant differences in baseline characteristics among the three groups (P > 0.05). After treatment, significant improvements were observed in FMA-UE score, FTHUE-HK grading, MBI score, Brunnstrom hand staging, MAS score and sEMG compared with pre-treatment values (P < 0.05). Specifically, EG1 showed greater improvements than the control group (P < 0.05), whereas EG2 demonstrated better outcomes than both EG1 and the control group (P < 0.05).

Conclusions: Contralateral controlled functional electrical stimulation combined with tDCS substantially improves hand function in patients with early stage stroke, with better outcomes than tDCS therapy alone.