Immediate effect of transcranial direct current stimulation combined with functional electrical stimulation on activity of the tibialis anterior muscle and balance of individuals with hemiparesis stemming from a stroke.
Aline Marina Alves Fruhauf, Fabiano Politti, Simone Dal Corso and 5 others
PMID 29643591WHAT IT FOUND
A single session of combined brain and muscle stimulation produced no immediate change in muscle activity or balance in stroke survivors.
Clinicians should not expect this combined protocol to yield instant functional gains.
Key findings
01The combination of anodal tDCS and active FES had no significant effect on electrical activity of the tibialis anterior muscle or static balance.
02No significant differences were found between pre-intervention and post-intervention evaluations of the stabilometric data.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study assessed only immediate effects after a single session, which may not reflect the outcomes of a multi-session treatment protocol. The participants had chronic stroke (median time since stroke 37 months) and varied in baseline severity, which may influence responsiveness to stimulation. The evaluation was performed after the stimulation ended, whereas some literature suggests tDCS effects may be more pronounced if the task is performed during stimulation.
Declared interests
The authors declared no conflicts of interest. The study was approved by a Human Research Ethics Committee and registered on ClinicalTrials.gov.
The easy way to misread this
Do not conclude that tDCS and FES are ineffective for stroke rehabilitation based on this study. It only tested the immediate effect of a single session. Previous research and the authors' own discussion suggest that multiple sessions or different timing of assessment might yield different results.