Efficacy observation of combined transcutaneous vagus nerve stimulation and transcranial direct current stimulation on gait in 169 subacute stroke patients.

The study enrolled only subacute stroke patients, first stroke 14 to 45 days after onset, with lower limb Brunnstrom stage 3 or higher, so it does not show what happens in acute, chronic, more severely affected or less able patients. Participants were recruited from one hospital, and the authors describe the sample as relatively small and confined to subacute stroke, limiting generalisability to broader stroke populations. The supplied text lists several outcomes but does not state which one was primary, so the combined group's superiority is not anchored to one specified endpoint. Assessments were made before treatment and four weeks after treatment only, so there is no evidence about longer-term walking, balance or daily function. The authors state there is no standardized protocol for taVNS and tDCS stimulation parameters, and they did not determine optimal intensity, duration or location. 169 of 180 patients completed the study, and the text does not say how many were analysed in each group beyond the table counts.

Do not conclude that taVNS and tDCS alone improve gait without rehabilitation. All groups received standard rehabilitation, and the combined group received both stimulations before rehabilitation, so the benefit cannot be separated from the rehabilitation programme.