Effect of Transcranial Direct Current Stimulation Combined with Rehabilitation on Arm and Hand Function in Stroke Patients: A Systematic Review and Meta-Analysis

• Published in: Healthcare (Basel) Vol. 9; no. 12; p. 1705
• Main Authors: Lee, Joo-Hyun, Jeun, Yu-Jin, Park, Hae Yean, Jung, Young-Jin
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 08-12-2021; MDPI
• Subjects: Activities of daily living; arm and hand function; Bias; Brain research; Clinical trials; Intervention; Meta-analysis; Occupational therapy; Physical therapy; Rehabilitation; Stroke; Systematic Review; transcranial direct current stimulation; Validity; Virtual reality; arm and hand function; meta-analysis; rehabilitation; systematic review; stroke; transcranial direct current stimulation
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare9121705

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that may enhance motor recovery after stroke. We performed a systematic review and meta-analysis to assess the efficacy of tDCS combined with rehabilitation on arm and hand function after stroke. Electronic databases were searched from their inception to September 2021. We performed a systematic review of selected randomized controlled trials, and methodological qualities were measured using the PEDro (Physiotherapy Evidence Database) scale. We calculated the standardized mean difference for effect size using the Comprehensive Meta-Analysis 3.0 software. We selected 28 studies for the systematic review and 20 studies for the meta-analysis. The overall effect size was 0.480 (95% CI [0.307; 0.653],
< 0.05), indicating a moderate effect size of tDCS combined with rehabilitation for upper extremity function in stroke survivors. The tDCS with occupational therapy/physical therapy (0.696; 95% CI [0.390; 1.003],
< 0.05) or virtual reality therapy (0.510; 95% CI [0.111; 0.909],
< 0.05) was also significantly more effective than other treatments. This meta-analysis of 20 randomized controlled trials provides further evidence that tDCS combined with rehabilitation, especially occupational therapy/physical therapy and virtual reality therapy, may benefit upper extremity function of the paretic upper limb in stroke patients.