Multimodal physical training combined with tDCS improves physical fitness components in people after stroke: a double-blind randomized controlled trial

• Published in: Topics in stroke rehabilitation 2023-10, Vol.30 (7), p.635-648
• Main Authors: Massaferri, Renato, Montenegro, Rafael, de Freitas Fonseca, Guilherme, Bernardes, Wendell, Cunha, Felipe A., Farinatti, Paulo
• Format: Article
• Language: English
• Subjects: brain stimulation; Cerebrovascular accident; Double-Blind Method; exercise; Exercise Therapy; functional capacity; health; Humans; neuromodulation; Physical Fitness; Stroke; Stroke Rehabilitation; Transcranial Direct Current Stimulation
• ISSN: 1074-9357; 1945-5119
• DOI: 10.1080/10749357.2023.2165260

Transcranial direct current stimulation (tDCS) seems to be a potential tool to optimize the long-term effects of multimodal physical training (MPT) on fitness components in post-stroke patients. We investigated the effects of cortical tDCS combined with MPT on motor function reflected by strength, motor performance, and cardiorespiratory capacity in chronic stroke patients. This double-blind randomized controlled trial included 18 volunteers (55 ± 10 y, 72 ± 13 kg), who underwent MPT preceded by either sham stimulation (SHAM) or 2 mA bi-hemispheric tDCS. MPT consisted of 24 sessions of 60-70 min performed 2 d/wk within 12-16 weeks, with individualized intensity. Outcomes were Fugl-Meyer scores for lower limbs (FM-LL), and total (FM-Total); speed in the 10-m walk test (10MWT); oxygen uptake and work output at maximal effort (VO 2max and W max ), and gas exchange threshold (VO 2 -GET and W-GET); peak torque of isokinetic knee extension (PT-EXT) and flexion (PT-FLEX) of paretic and non-paretic limbs; bilateral strength deficit during knee extension (DS-EXT) and flexion (DS-FLEX). Pre- vs. post-intervention improvements were detected in tDCS vs. SHAM (p