Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trial
BackgroundStroke survivors often exhibit low motivation for rehabilitation, hindering their ability to effectively complete rehabilitation training task effectively and participate in daily activities actively. Reward strategies have been identified as an effective method for boosting rehabilitation...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1200741/full |
| _version_ | 1797803798653042688 |
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| author | Ping Zhou Ping Zhou Wenxi Li Jingwang Zhao Siyun Chen Yufeng Chen Xia Shen Dongsheng Xu Dongsheng Xu Dongsheng Xu |
| author_facet | Ping Zhou Ping Zhou Wenxi Li Jingwang Zhao Siyun Chen Yufeng Chen Xia Shen Dongsheng Xu Dongsheng Xu Dongsheng Xu |
| author_sort | Ping Zhou |
| collection | DOAJ |
| description | BackgroundStroke survivors often exhibit low motivation for rehabilitation, hindering their ability to effectively complete rehabilitation training task effectively and participate in daily activities actively. Reward strategies have been identified as an effective method for boosting rehabilitation motivation, but their long-term efficacy remains uncertain. Transcranial direct current stimulation (tDCS) has been recognized as a technique that facilitates plastic changes and functional reorganization of cortical areas. Particularly, tDCS can improve the functional connectivity between brain regions associated with goal-directed behavior when applied to the left dorsolateral prefrontal cortex (dlPFC). Combing reward strategies with tDCS (RStDCS) has been shown to motivate healthy individuals to exert more effort in task performance. However, research exploring the combined and sustained effects of these strategies on rehabilitation motivation in stroke survivors is lacking.Methods and designEighty-seven stroke survivors with low motivation and upper extremity dysfunction will be randomized to receive either conventional treatment, RS treatment, or RStDCS treatment. The RStDCS group will receive reward strategies combined with anodal tDCS stimulation of the left dlPFC. The RS group will receive reward strategies combined with sham stimulation. The conventional group will receive conventional treatment combined with sham stimulation. tDCS stimulation is performed over 3 weeks of hospitalization, 20 min/time, five times a week. Reward strategies refers to personalized active exercise programs for patients during hospitalization and at home. Patients can voluntarily choose tasks for active exercise and self-report to the therapist so as to punch a card for points and exchange gifts. The conventional group will receive home rehabilitation instructions prior to discharge. Rehabilitation motivation, measured using RMS. RMS, FMA, FIM, and ICF activity and social engagement scale will be compared at baseline, 3 weeks, 6 weeks, and 3 months post-enrollment to evaluate patients’ multifaceted health condition based on the ICF framework.DiscussionThis study integrates knowledge from social cognitive science, economic behavioral science, and other relevant fields. We utilize straightforward and feasible reward strategies, combined with neuromodulation technology, to jointly improve patients’ rehabilitation motivation. Behavioral observations and various assessment tools will be used to monitor patients’ rehabilitation motivation and multifaceted health condition according to the ICF framework. The aim is to provide a preliminary exploration path for professionals to develop comprehensive strategies for improving patient rehabilitation motivation and facilitating a complete “hospital—home—society” rehabilitation process.Clinical trial registrationhttps://www.chictr.org.cn/showproj.aspx?proj=182589, ChiCTR2300069068 |
| first_indexed | 2024-03-13T05:26:29Z |
| format | Article |
| id | doaj.art-73fcf3f475594edfa75a197aefb0430f |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-13T05:26:29Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-73fcf3f475594edfa75a197aefb0430f2023-06-15T05:45:55ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-06-011410.3389/fneur.2023.12007411200741Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trialPing Zhou0Ping Zhou1Wenxi Li2Jingwang Zhao3Siyun Chen4Yufeng Chen5Xia Shen6Dongsheng Xu7Dongsheng Xu8Dongsheng Xu9Rehabilitation Medicine Research Center, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University School of Medicine, Shanghai, ChinaDepartment of Rehabilitation Medicine, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaRehabilitation Medicine Research Center, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University School of Medicine, Shanghai, ChinaDepartment of Rehabilitation Medicine, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaBackgroundStroke survivors often exhibit low motivation for rehabilitation, hindering their ability to effectively complete rehabilitation training task effectively and participate in daily activities actively. Reward strategies have been identified as an effective method for boosting rehabilitation motivation, but their long-term efficacy remains uncertain. Transcranial direct current stimulation (tDCS) has been recognized as a technique that facilitates plastic changes and functional reorganization of cortical areas. Particularly, tDCS can improve the functional connectivity between brain regions associated with goal-directed behavior when applied to the left dorsolateral prefrontal cortex (dlPFC). Combing reward strategies with tDCS (RStDCS) has been shown to motivate healthy individuals to exert more effort in task performance. However, research exploring the combined and sustained effects of these strategies on rehabilitation motivation in stroke survivors is lacking.Methods and designEighty-seven stroke survivors with low motivation and upper extremity dysfunction will be randomized to receive either conventional treatment, RS treatment, or RStDCS treatment. The RStDCS group will receive reward strategies combined with anodal tDCS stimulation of the left dlPFC. The RS group will receive reward strategies combined with sham stimulation. The conventional group will receive conventional treatment combined with sham stimulation. tDCS stimulation is performed over 3 weeks of hospitalization, 20 min/time, five times a week. Reward strategies refers to personalized active exercise programs for patients during hospitalization and at home. Patients can voluntarily choose tasks for active exercise and self-report to the therapist so as to punch a card for points and exchange gifts. The conventional group will receive home rehabilitation instructions prior to discharge. Rehabilitation motivation, measured using RMS. RMS, FMA, FIM, and ICF activity and social engagement scale will be compared at baseline, 3 weeks, 6 weeks, and 3 months post-enrollment to evaluate patients’ multifaceted health condition based on the ICF framework.DiscussionThis study integrates knowledge from social cognitive science, economic behavioral science, and other relevant fields. We utilize straightforward and feasible reward strategies, combined with neuromodulation technology, to jointly improve patients’ rehabilitation motivation. Behavioral observations and various assessment tools will be used to monitor patients’ rehabilitation motivation and multifaceted health condition according to the ICF framework. The aim is to provide a preliminary exploration path for professionals to develop comprehensive strategies for improving patient rehabilitation motivation and facilitating a complete “hospital—home—society” rehabilitation process.Clinical trial registrationhttps://www.chictr.org.cn/showproj.aspx?proj=182589, ChiCTR2300069068https://www.frontiersin.org/articles/10.3389/fneur.2023.1200741/fullstrokerehabilitation medicinesocial cognitionpatient-centered careelectric stimulation therapy |
| spellingShingle | Ping Zhou Ping Zhou Wenxi Li Jingwang Zhao Siyun Chen Yufeng Chen Xia Shen Dongsheng Xu Dongsheng Xu Dongsheng Xu Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trial Frontiers in Neurology stroke rehabilitation medicine social cognition patient-centered care electric stimulation therapy |
| title | Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trial |
| title_full | Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trial |
| title_fullStr | Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trial |
| title_full_unstemmed | Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trial |
| title_short | Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trial |
| title_sort | modulated effectiveness of rehabilitation motivation by reward strategies combined with tdcs in stroke study protocol for a randomized controlled trial |
| topic | stroke rehabilitation medicine social cognition patient-centered care electric stimulation therapy |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1200741/full |
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