Home-based transcranial direct current stimulation plus tracking training therapy in people with stroke: an open-label feasibility study.
Ann Van de Winckel, James R Carey, Teresa A Bisson and 3 others
PMID 30227864WHAT IT FOUND
Six people with chronic stroke safely completed home-based tDCS and finger tracking.
All participants could set up the equipment and recommended the program. However, the intervention did not improve motor or cognitive function, likely because the five short sessions were insufficient for efficacy.
Key findings
01All six participants completed the five treatment sessions without adverse events attributable to tDCS, and no scalp reddening was detected.
02Participants were able to independently don the head cap and adjust electrode placement after initial training, with no prompting needed in subsequent sessions.
03There were no meaningful changes in motor or cognitive function for the group, except for one participant who showed a decline attributed to natural spasticity variation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Very small sample size (n=6) limits generalizability and statistical power. Open-label design with no control group, so natural history or placebo effects cannot be ruled out. The intervention dose (five 20-minute sessions) was lower than previous studies showing efficacy (18-20 sessions of 45-60 minutes), making it impossible to determine if the lack of motor improvement was due to the treatment itself or insufficient intensity. Participants were cognitively high-functioning and had mild-to-moderate upper limb impairments, so findings do not apply to patients with severe hand dysfunction or cognitive deficits. A second investigator (observer) was always present in the room, which may have influenced participant compliance and safety, limiting the real-world applicability of fully unsupervised home use.
Declared interests
The authors declare no competing interests. The study was supported by the National Institutes of Health (NIH).
The easy way to misread this
Do not interpret the high usability and safety scores as evidence that this treatment improves motor function. The study was designed only to test feasibility and safety, and the intervention dose was too low to demonstrate efficacy.