Effect of Transcranial Direct Current Stimulation on Postural Stability and Lower Extremity Strength in Hemiplegic Stroke Patients
2
조회
0
다운로드
6
인용
0
참고문헌
키워드
초록
Objective To evaluate the effect of anodal transcranial direct current stimulation (tDCS) over the lesioned leg motor cortex, which can enhance the strength and coordination of the contralateral lower extremity and furthermore, enhance the postural stability of the hemiplegic subject.Methods Anodal or sham stimulation on the lesioned cortex of a lower extremity was delivered to 11 ambulatory hemiplegic patients. The stimulation intensity was 2 mA. All subjects took part in two 10-minute tDCS sessions consisting of anodal stimulation and sham stimulation. The interval period between real and sham stimulation was 48 hours. The order was counter-balanced among the subjects. Before and after each stimulation session, static postural stability was evaluated with eyes opened and closed. Also, the isometric strength of the hemiplegic side of the treated knee was measured before and after each stimulation session. Repeated measure ANOVA was used to determine the statistical significance of improvements in postural stability and strength.Results There was significant improvement for overall stability index with eyes opened and closed after anodal tDCS (p<0.05). Isometric strength of the lesioned quadriceps tended to increase after anodal tDCS (p<0.05). Postural stability and quadriceps strength were not changed after sham stimulation.Conclusion Anodal tDCS has potential value in hemiplegic stroke patients to improve balance and strengthen the affected lower extremity.
Abstract
Objective To evaluate the effect of anodal transcranial direct current stimulation (tDCS) over the lesioned leg motor cortex, which can enhance the strength and coordination of the contralateral lower extremity and furthermore, enhance the postural stability of the hemiplegic subject.Methods Anodal or sham stimulation on the lesioned cortex of a lower extremity was delivered to 11 ambulatory hemiplegic patients. The stimulation intensity was 2 mA. All subjects took part in two 10-minute tDCS sessions consisting of anodal stimulation and sham stimulation. The interval period between real and sham stimulation was 48 hours. The order was counter-balanced among the subjects. Before and after each stimulation session, static postural stability was evaluated with eyes opened and closed. Also, the isometric strength of the hemiplegic side of the treated knee was measured before and after each stimulation session. Repeated measure ANOVA was used to determine the statistical significance of improvements in postural stability and strength.Results There was significant improvement for overall stability index with eyes opened and closed after anodal tDCS (p<0.05). Isometric strength of the lesioned quadriceps tended to increase after anodal tDCS (p<0.05). Postural stability and quadriceps strength were not changed after sham stimulation.Conclusion Anodal tDCS has potential value in hemiplegic stroke patients to improve balance and strengthen the affected lower extremity.
참고문헌 (22)
- Kolominsky-Rabas PL., "Epidemiology of ischemic stroke subtypes according to TOAST criteria : incidence, recurrence, and long-term survival in ischemic stroke subtypes : a population-based study", Stroke, 32, pp.2735~2740 (2001)
- Hankey GJ., "Long-term disability after first-ever stroke and related prognostic factors in the Perth Community Stroke Study, 1989-1990", Stroke, 33, pp.1034~1040 (2002)
- Johansson BB., "Current trends in stroke rehabilitation : a review with focus on brain plasticity", Acta Neurol Scand, 123, pp.147~159 (2011)
- Geurts AC., "A review of standing balance recovery from stroke", Gait Posture, 22, pp.267~281 (2005)
- Rubenstein LZ., "The epidemiology of falls and syncope", Clin Geriatr Med, 18, pp.141~158 (2002)
- Tinetti ME., "The effect of falls and fall injuries on functioning in community-dwelling older persons", J Gerontol A Biol Sci Med Sci, 53, pp.M112~M119 (1998)
- Nitsche MA., "Treatment of depression with transcranial direct current stimulation(tDCS) : a review", Exp Neurol, 219, pp.14~19 (2009)
- Nitsche MA., "Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation", J Physiol, 527(Pt 3), pp.633~639 (2000)
- Hummel F., "Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke", Brain, 128(Pt 3), pp.490~499 (2005)
- 김덕용, "만성 뇌졸중 후 편마비 환자에서 2주간 경두개 전기 자극 후 상지 운동기능 향상", Annals of Rehabilitation Medicine, 33(1), pp.5~11 (2009), 대한재활의학회
- Jeffery DT., "Effects of transcranial direct current stimulation on the excitability of the leg motor cortex", Exp Brain Res, 182, pp.281~287 (2007)
- Tanaka S., "Enhancement of pinch force in the lower leg by anodal transcranial direct current stimulation", Exp Brain Res, 196, pp.459~465 (2009)
- Tanaka S., "Single session of transcranial direct current stimulation transiently increases knee extensor force in patients with hemiparetic stroke", Neurorehabil Neural Repair, 25, pp.565~569 (2011)
- Fertonani A., "Naming facilitation induced by transcranial direct current stimulation", Behav Brain Res, 208, pp.311~318 (2010)
- Kang EK., "Effect of a tDCS electrode montage on implicit motor sequence learning in healthy subjects", Exp Transl Stroke Med, 3, pp.4~ (2011)
- Madhavan S., "Non-invasive brain stimulation enhances fine motor control of the hemiparetic ankle : implications for rehabilitation", Exp Brain Res, 209, pp.9~17 (2011)
- Aydog E., "Dynamic postural balance in ankylosing spondylitis patients", Rheumatology(Oxford), 45, pp.445~448 (2006)
- 이호, "뇌졸중 환자에서 슬관절 근력 훈련이 보행, 균형 및 삶의 질에 미치는 효과", Annals of Rehabilitation Medicine, 31(6), pp.649~654 (2007), 대한재활의학회
- Tomas-Carus P., "Improvements of muscle strength predicted benefits in HRQOL and postural balance in women with fibromyalgia : an 8-month randomized controlled trial", Rheumatology(Oxford), 48, pp.1147~1151 (2009)
- Fregni F., "Transcranial direct current stimulation of the unaffected hemisphere in stroke patients", Neuroreport, 16, pp.1551~1555 (2005)
- Jorgensen HS., "Recovery of walking function in stroke patients : the Copenhagen Stroke Study", Arch Phys Med Rehabil, 76, pp.27~32 (1995)
- Kim CR., "Modulation of cortical activity after anodal transcranial direct current stimulation of the lower limb motor cortex : a functional MRI study", Brain Stimul, 5, pp.462~467 (2012)