It is believed that unihemispheric concurrent dual-site transcranial direct current stimulation (tDCSUHCDS) of the primary motor cortex (M1) and the dorsolateral prefrontal cortex (DLPFC) causes an increase in motor cortex excitability. However, the clinical effect of this type of stimulation on patients with neurological conditions is not yet known. The aim of the present study was to assess the effect of anodal-tDCSUHCDS (a-tDCSUHCDS) on upper limb motor function in subacute stroke patients. Fifteen patients participated in this sham-controlled crossover study. The main outcome measures were the reaction time (RT) to visual stimuli, completion time of a nine-pin pegboard (9-PPB), and the scores from the Fugl–Meyer assessment (FMA) for the upper limb of the involved side before and after three brain stimulation conditions. For a-tDCSUHCDS, the anodal electrodes were placed on the M1 and the DLPFC, while for a-tDCS, the anodal electrode was placed on the M1. For the sham stimulation, the tDCS was turned off after 30 s. For brain stimulation, the selected current was 1 mA for 20 min. After a-tDCSUHCDS, there was a significant reduction in the RT and completion time of the 9-PPB compared with the times after a-tDCS and the sham stimulation: p = 0.013 and p = 0.022, respectively). However, there was no significant difference in the FMA scores after the three types of stimulations (p = 0.085). Compared with a-tDCS, a-tDCSUHCDS temporarily improved the RT and dexterity of the involved hand in subacute stroke patients.Clinical Trial Registration: Iranian Registry of Clinical Trials (IRCT), identifier IRCT2015012520787N1.
Purpose: The first step to manage motor impairment of upper limb in patients with subacute stroke is having an accurate assessment tool. The Fugl-Meyer assessment of upper extremity and 9-hole pegboard test are used to evaluate motor function and hand dexterity in stroke survivals. The present study aimed to investigate the test-retest reliability and minimal detectable change (MDC) in these two tests.
Methods:A total of 15 patients with subacute stroke (54-76 years old) participated in this study. They were selected non-randomly from rehabilitation clinics and hospitals of Tehran, Iran, based on inclusive and exclusive criteria. Intraclass correlation coefficient (ICC), standard error measurement (SEM), and MDC were used for investigating intraday and interday reliability for 1 hour and 3 days.Results: Intraday reliabilities of Fugl-Meyer and 9-hole pegboard were excellent with ICC of 0.98 and 0.98, also MDC of 1.96 and 8.59, respectively. The interday reliabilities of these tests were also excellent with ICC of 0.99 and 0.96, as well as MDC of 1.52 and 12.69, respectively. The absolute reliability (SEM) was less than 10% of maximum acquired scores indicating acceptable errors of measurement.
Conclusion:Results show that the Fugl-Meyer assessment and 9-hole pegboard test have excellent test-retest reliability. Therefore these tests can be used for appropriate treatment planning and clinical decision making in patients with subacute stroke.
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