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

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, m...

Full description

Saved in:
Bibliographic Details
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
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c366t-c830845a8f9a0a416d01de40514131288848582b07cc7b87fcc8f584952c68d13
cites cdi_FETCH-LOGICAL-c366t-c830845a8f9a0a416d01de40514131288848582b07cc7b87fcc8f584952c68d13
container_end_page 648
container_issue 7
container_start_page 635
container_title Topics in stroke rehabilitation
container_volume 30
creator Massaferri, Renato
Montenegro, Rafael
de Freitas Fonseca, Guilherme
Bernardes, Wendell
Cunha, Felipe A.
Farinatti, Paulo
description 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 
doi_str_mv 10.1080/10749357.2023.2165260
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1080_10749357_2023_2165260</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2761973613</sourcerecordid><originalsourceid>FETCH-LOGICAL-c366t-c830845a8f9a0a416d01de40514131288848582b07cc7b87fcc8f584952c68d13</originalsourceid><addsrcrecordid>eNp9kctu1DAUhi1ERS_wCCAv2WTwiePEYQUaKCC1YgGsLccXanDsYDtUw4vwung003bHyv_iO_51zofQcyAbIJy8AjJ0I2XDpiUt3bTQs7Ynj9AZjB1rGMD4uObKNHvoFJ3n_IMQYDDyJ-iU9j2hbOzO0N_r1Rc3Ry09Xm522akaSpIuuPAdqzhPLhiNb125weXd9gt285Lib5MfaOtKMDnv4SUGE0rGLuDFxMUbLG0xCeeS4k_zGkus4zp500zeBY2TDDrO7k8tUDFUxvsaS3LSP0UnVvpsnh3fC_Tt8v3X7cfm6vOHT9u3V42qO5RGcUp4xyS3oySyg14T0KYjDDqg0HLOO854O5FBqWHig1WKW8a7kbWq5xroBXp5-Ldu9Ws1uYjZZWW8l8HENYt26GEcaA-0ouyAqhRzTsaKJblZpp0AIvZOxJ0TsXcijk7q3ItjxTrNRt9P3UmowJsD4IKNaZa3MXktitz5mGy9kXJZ0P93_APtCp3a</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2761973613</pqid></control><display><type>article</type><title>Multimodal physical training combined with tDCS improves physical fitness components in people after stroke: a double-blind randomized controlled trial</title><source>Taylor and Francis:Jisc Collections:Taylor and Francis Read and Publish Agreement 2024-2025:Medical Collection (Reading list)</source><creator>Massaferri, Renato ; Montenegro, Rafael ; de Freitas Fonseca, Guilherme ; Bernardes, Wendell ; Cunha, Felipe A. ; Farinatti, Paulo</creator><creatorcontrib>Massaferri, Renato ; Montenegro, Rafael ; de Freitas Fonseca, Guilherme ; Bernardes, Wendell ; Cunha, Felipe A. ; Farinatti, Paulo</creatorcontrib><description>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 &lt; 0.05) for FM-total (29.6% vs. 15.9%; effect size [ES] = 0.78), FM-LL (35.9% vs. 9.0%; ES = 1.23), 10MWT (10.6% vs. 3.8%; ES = 0.67), W max (75.0% vs. 4.3%; ES = 1.68), W-GET (91.6% vs. 12.4%; ES = 1.62), PT-EXT (25.6% vs. −6.5%; ES = 1.94) and PT-FLEX (26.3% vs. 9.8%; ES = 0.65) of the paretic limb, and DS-EXT (−13.7% vs. 2.5; ES = 1.43). Bi-hemispheric cortical tDCS optimized the effects of MPT performed with moderate volume and intensity upon muscle strength, motor function, and cardiorespiratory performance in stroke hemiparetic survivors. (Registration number RBR-22rh3p).</description><identifier>ISSN: 1074-9357</identifier><identifier>EISSN: 1945-5119</identifier><identifier>DOI: 10.1080/10749357.2023.2165260</identifier><identifier>PMID: 36603594</identifier><language>eng</language><publisher>England: Taylor &amp; Francis</publisher><subject>brain stimulation ; Cerebrovascular accident ; Double-Blind Method ; exercise ; Exercise Therapy ; functional capacity ; health ; Humans ; neuromodulation ; Physical Fitness ; Stroke ; Stroke Rehabilitation ; Transcranial Direct Current Stimulation</subject><ispartof>Topics in stroke rehabilitation, 2023-10, Vol.30 (7), p.635-648</ispartof><rights>2023 Taylor &amp; Francis Group, LLC 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c366t-c830845a8f9a0a416d01de40514131288848582b07cc7b87fcc8f584952c68d13</citedby><cites>FETCH-LOGICAL-c366t-c830845a8f9a0a416d01de40514131288848582b07cc7b87fcc8f584952c68d13</cites><orcidid>0000-0002-8912-5656 ; 0000-0003-2463-1280</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36603594$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Massaferri, Renato</creatorcontrib><creatorcontrib>Montenegro, Rafael</creatorcontrib><creatorcontrib>de Freitas Fonseca, Guilherme</creatorcontrib><creatorcontrib>Bernardes, Wendell</creatorcontrib><creatorcontrib>Cunha, Felipe A.</creatorcontrib><creatorcontrib>Farinatti, Paulo</creatorcontrib><title>Multimodal physical training combined with tDCS improves physical fitness components in people after stroke: a double-blind randomized controlled trial</title><title>Topics in stroke rehabilitation</title><addtitle>Top Stroke Rehabil</addtitle><description>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 &lt; 0.05) for FM-total (29.6% vs. 15.9%; effect size [ES] = 0.78), FM-LL (35.9% vs. 9.0%; ES = 1.23), 10MWT (10.6% vs. 3.8%; ES = 0.67), W max (75.0% vs. 4.3%; ES = 1.68), W-GET (91.6% vs. 12.4%; ES = 1.62), PT-EXT (25.6% vs. −6.5%; ES = 1.94) and PT-FLEX (26.3% vs. 9.8%; ES = 0.65) of the paretic limb, and DS-EXT (−13.7% vs. 2.5; ES = 1.43). Bi-hemispheric cortical tDCS optimized the effects of MPT performed with moderate volume and intensity upon muscle strength, motor function, and cardiorespiratory performance in stroke hemiparetic survivors. (Registration number RBR-22rh3p).</description><subject>brain stimulation</subject><subject>Cerebrovascular accident</subject><subject>Double-Blind Method</subject><subject>exercise</subject><subject>Exercise Therapy</subject><subject>functional capacity</subject><subject>health</subject><subject>Humans</subject><subject>neuromodulation</subject><subject>Physical Fitness</subject><subject>Stroke</subject><subject>Stroke Rehabilitation</subject><subject>Transcranial Direct Current Stimulation</subject><issn>1074-9357</issn><issn>1945-5119</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kctu1DAUhi1ERS_wCCAv2WTwiePEYQUaKCC1YgGsLccXanDsYDtUw4vwung003bHyv_iO_51zofQcyAbIJy8AjJ0I2XDpiUt3bTQs7Ynj9AZjB1rGMD4uObKNHvoFJ3n_IMQYDDyJ-iU9j2hbOzO0N_r1Rc3Ry09Xm522akaSpIuuPAdqzhPLhiNb125weXd9gt285Lib5MfaOtKMDnv4SUGE0rGLuDFxMUbLG0xCeeS4k_zGkus4zp500zeBY2TDDrO7k8tUDFUxvsaS3LSP0UnVvpsnh3fC_Tt8v3X7cfm6vOHT9u3V42qO5RGcUp4xyS3oySyg14T0KYjDDqg0HLOO854O5FBqWHig1WKW8a7kbWq5xroBXp5-Ldu9Ws1uYjZZWW8l8HENYt26GEcaA-0ouyAqhRzTsaKJblZpp0AIvZOxJ0TsXcijk7q3ItjxTrNRt9P3UmowJsD4IKNaZa3MXktitz5mGy9kXJZ0P93_APtCp3a</recordid><startdate>20231003</startdate><enddate>20231003</enddate><creator>Massaferri, Renato</creator><creator>Montenegro, Rafael</creator><creator>de Freitas Fonseca, Guilherme</creator><creator>Bernardes, Wendell</creator><creator>Cunha, Felipe A.</creator><creator>Farinatti, Paulo</creator><general>Taylor &amp; Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8912-5656</orcidid><orcidid>https://orcid.org/0000-0003-2463-1280</orcidid></search><sort><creationdate>20231003</creationdate><title>Multimodal physical training combined with tDCS improves physical fitness components in people after stroke: a double-blind randomized controlled trial</title><author>Massaferri, Renato ; Montenegro, Rafael ; de Freitas Fonseca, Guilherme ; Bernardes, Wendell ; Cunha, Felipe A. ; Farinatti, Paulo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-c830845a8f9a0a416d01de40514131288848582b07cc7b87fcc8f584952c68d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>brain stimulation</topic><topic>Cerebrovascular accident</topic><topic>Double-Blind Method</topic><topic>exercise</topic><topic>Exercise Therapy</topic><topic>functional capacity</topic><topic>health</topic><topic>Humans</topic><topic>neuromodulation</topic><topic>Physical Fitness</topic><topic>Stroke</topic><topic>Stroke Rehabilitation</topic><topic>Transcranial Direct Current Stimulation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Massaferri, Renato</creatorcontrib><creatorcontrib>Montenegro, Rafael</creatorcontrib><creatorcontrib>de Freitas Fonseca, Guilherme</creatorcontrib><creatorcontrib>Bernardes, Wendell</creatorcontrib><creatorcontrib>Cunha, Felipe A.</creatorcontrib><creatorcontrib>Farinatti, Paulo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Topics in stroke rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Massaferri, Renato</au><au>Montenegro, Rafael</au><au>de Freitas Fonseca, Guilherme</au><au>Bernardes, Wendell</au><au>Cunha, Felipe A.</au><au>Farinatti, Paulo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multimodal physical training combined with tDCS improves physical fitness components in people after stroke: a double-blind randomized controlled trial</atitle><jtitle>Topics in stroke rehabilitation</jtitle><addtitle>Top Stroke Rehabil</addtitle><date>2023-10-03</date><risdate>2023</risdate><volume>30</volume><issue>7</issue><spage>635</spage><epage>648</epage><pages>635-648</pages><issn>1074-9357</issn><eissn>1945-5119</eissn><abstract>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 &lt; 0.05) for FM-total (29.6% vs. 15.9%; effect size [ES] = 0.78), FM-LL (35.9% vs. 9.0%; ES = 1.23), 10MWT (10.6% vs. 3.8%; ES = 0.67), W max (75.0% vs. 4.3%; ES = 1.68), W-GET (91.6% vs. 12.4%; ES = 1.62), PT-EXT (25.6% vs. −6.5%; ES = 1.94) and PT-FLEX (26.3% vs. 9.8%; ES = 0.65) of the paretic limb, and DS-EXT (−13.7% vs. 2.5; ES = 1.43). Bi-hemispheric cortical tDCS optimized the effects of MPT performed with moderate volume and intensity upon muscle strength, motor function, and cardiorespiratory performance in stroke hemiparetic survivors. (Registration number RBR-22rh3p).</abstract><cop>England</cop><pub>Taylor &amp; Francis</pub><pmid>36603594</pmid><doi>10.1080/10749357.2023.2165260</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-8912-5656</orcidid><orcidid>https://orcid.org/0000-0003-2463-1280</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 1074-9357
ispartof Topics in stroke rehabilitation, 2023-10, Vol.30 (7), p.635-648
issn 1074-9357
1945-5119
language eng
recordid cdi_crossref_primary_10_1080_10749357_2023_2165260
source Taylor and Francis:Jisc Collections:Taylor and Francis Read and Publish Agreement 2024-2025:Medical Collection (Reading list)
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
title Multimodal physical training combined with tDCS improves physical fitness components in people after stroke: a double-blind randomized controlled trial
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-09T20%3A16%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Multimodal%20physical%20training%20combined%20with%20tDCS%20improves%20physical%20fitness%20components%20in%20people%20after%20stroke:%20a%20double-blind%20randomized%20controlled%20trial&rft.jtitle=Topics%20in%20stroke%20rehabilitation&rft.au=Massaferri,%20Renato&rft.date=2023-10-03&rft.volume=30&rft.issue=7&rft.spage=635&rft.epage=648&rft.pages=635-648&rft.issn=1074-9357&rft.eissn=1945-5119&rft_id=info:doi/10.1080/10749357.2023.2165260&rft_dat=%3Cproquest_cross%3E2761973613%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c366t-c830845a8f9a0a416d01de40514131288848582b07cc7b87fcc8f584952c68d13%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2761973613&rft_id=info:pmid/36603594&rfr_iscdi=true