A Meta-Analysis on Dual Protocols for Chronic Stroke Motor Recovery: Robotic Training and tDCS
Two popular chronic stroke rehabilitation protocols are robotic-assisted movements and transcranial direct current stimulation (tDCS). Separately, both protocols have produced encouraging motor recovery improvements. An intriguing question remains: what happens to motor recovery when both protocols...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Applied Sciences |
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| Online Access: | https://www.mdpi.com/2076-3417/13/3/1992 |
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| author | Rye-Kyeong Kim Nyeonju Kang Zeel Desai James H. Cauraugh |
| author_facet | Rye-Kyeong Kim Nyeonju Kang Zeel Desai James H. Cauraugh |
| author_sort | Rye-Kyeong Kim |
| collection | DOAJ |
| description | Two popular chronic stroke rehabilitation protocols are robotic-assisted movements and transcranial direct current stimulation (tDCS). Separately, both protocols have produced encouraging motor recovery improvements. An intriguing question remains: what happens to motor recovery when both protocols are administered together? Do the two protocols together produce additive dual effects? This systematic review and meta-analysis investigated the dual effect of combining robotic training and tDCS. We investigated the potential effects of tDCS protocols in addition to robotic-training programs on motor recovery of the upper and lower extremities post-stroke. A systematic literature search identified 20 qualified studies that used robotic training combined with tDCS protocols for upper limb (i.e., 15 studies) and lower limb (i.e., 5 studies) post-stroke rehabilitation. Individuals in the subacute and chronic stages of recovery were investigated. The 20 included studies compared additive effects of the combined protocols with robotic training sham control groups. Further, we estimated short-term and long-term treatment effects of the combined protocols. The random-effects model meta-analyses failed to find any significant short-term and long-term motor improvements in the upper extremities after the combined treatments. However, robotic-assisted movements combined with tDCS protocols revealed significant moderate transient and sustained improvements in functions of the lower limbs post-stroke. These meta-analytic findings suggest clinical implications concerning coupled top-down and bottom-up training protocols (i.e., robotic training and tDCS combined), which will allow us to make progress toward post-stroke motor recovery. |
| first_indexed | 2024-03-11T09:51:31Z |
| format | Article |
| id | doaj.art-e27aabca030c4788a7d5f1351a9d4930 |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-11T09:51:31Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-e27aabca030c4788a7d5f1351a9d49302023-11-16T16:13:14ZengMDPI AGApplied Sciences2076-34172023-02-01133199210.3390/app13031992A Meta-Analysis on Dual Protocols for Chronic Stroke Motor Recovery: Robotic Training and tDCSRye-Kyeong Kim0Nyeonju Kang1Zeel Desai2James H. Cauraugh3Division of Sport Science, Health Promotion Center, Sport Science Institute, Incheon National University, Incheon 22012, Republic of KoreaDivision of Sport Science, Health Promotion Center, Sport Science Institute, Incheon National University, Incheon 22012, Republic of KoreaDepartment of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USADepartment of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USATwo popular chronic stroke rehabilitation protocols are robotic-assisted movements and transcranial direct current stimulation (tDCS). Separately, both protocols have produced encouraging motor recovery improvements. An intriguing question remains: what happens to motor recovery when both protocols are administered together? Do the two protocols together produce additive dual effects? This systematic review and meta-analysis investigated the dual effect of combining robotic training and tDCS. We investigated the potential effects of tDCS protocols in addition to robotic-training programs on motor recovery of the upper and lower extremities post-stroke. A systematic literature search identified 20 qualified studies that used robotic training combined with tDCS protocols for upper limb (i.e., 15 studies) and lower limb (i.e., 5 studies) post-stroke rehabilitation. Individuals in the subacute and chronic stages of recovery were investigated. The 20 included studies compared additive effects of the combined protocols with robotic training sham control groups. Further, we estimated short-term and long-term treatment effects of the combined protocols. The random-effects model meta-analyses failed to find any significant short-term and long-term motor improvements in the upper extremities after the combined treatments. However, robotic-assisted movements combined with tDCS protocols revealed significant moderate transient and sustained improvements in functions of the lower limbs post-stroke. These meta-analytic findings suggest clinical implications concerning coupled top-down and bottom-up training protocols (i.e., robotic training and tDCS combined), which will allow us to make progress toward post-stroke motor recovery.https://www.mdpi.com/2076-3417/13/3/1992strokerobotictranscranial direct current stimulationrehabilitationmeta-analysis |
| spellingShingle | Rye-Kyeong Kim Nyeonju Kang Zeel Desai James H. Cauraugh A Meta-Analysis on Dual Protocols for Chronic Stroke Motor Recovery: Robotic Training and tDCS Applied Sciences stroke robotic transcranial direct current stimulation rehabilitation meta-analysis |
| title | A Meta-Analysis on Dual Protocols for Chronic Stroke Motor Recovery: Robotic Training and tDCS |
| title_full | A Meta-Analysis on Dual Protocols for Chronic Stroke Motor Recovery: Robotic Training and tDCS |
| title_fullStr | A Meta-Analysis on Dual Protocols for Chronic Stroke Motor Recovery: Robotic Training and tDCS |
| title_full_unstemmed | A Meta-Analysis on Dual Protocols for Chronic Stroke Motor Recovery: Robotic Training and tDCS |
| title_short | A Meta-Analysis on Dual Protocols for Chronic Stroke Motor Recovery: Robotic Training and tDCS |
| title_sort | meta analysis on dual protocols for chronic stroke motor recovery robotic training and tdcs |
| topic | stroke robotic transcranial direct current stimulation rehabilitation meta-analysis |
| url | https://www.mdpi.com/2076-3417/13/3/1992 |
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