tDCS and Upper Extremity Function in Stroke

Not Applicable

Recruiting

Interventions: Device: Transcranial direct current stimulation
Device: Sham transcranial direct current stimulation

Brief Summary: Research on the effects of Anodal transcranial Direct Current Stimulation (tDCS) on hand dexterity and quality of life in stroke patients is limited. While the highlighted article focuses on Parkinson's disease, it underscores anodal tDCS potential to modulate brain activity and promote neural plasticity, suggesting potential relevance to stroke rehabilitation

Detailed Description: tDCS seems like a hopeful way to help stroke patients improve their upper limb function, but there are still some problems and questions that need to be answered. Previous studies have investigated the impact of (tDCS) on upper limb recovery among stroke patients. However, evidence is scarce on the effect of tDCS on hand dexterity and quality of life in stroke patients. Furthermore, these studies have not adequately explored how the severity of stroke influences the efficacy of tDCS on upper limb motor recovery. Additionally, there is a lack of research examining the cumulative effects of tDCS on both upper limb motor recovery and hand dexterity, as well as QoL, particularly concerning stroke severity.

Recruitment & Eligibility

Inclusion Criteria

Stroke for more than 6 months.
Age 40-80 years
Both gender
National Institutes of Health Stroke Scale (NIHSS) for severity level (Mild (1-4), Moderate (5-15), Moderate to Severe (16-20), Severe (21-42)

Exclusion Criteria

Any patient with Upper limb amputation on the effected side, contracture, burn injury that leads to joint limitation and functional limitation.
Known cases of Multiple Sclerosis and Parkinson and any Musculoskeletal disorder and Cardiopulmonary disorder.
Any patient with Metallic implants
Individuals with a history of seizures or epilepsy
Individuals with Skin allergies on the scalp

Arm && Interventions

Group	Intervention	Description
Sham tDCS Group	Transcranial direct current stimulation	sham tDCS, task-oriented training (i.e. placing cones on another cone, inserting needles into a box
Active tDCS	Sham transcranial direct current stimulation	The dosage of anodal tDCS will be 20 minutes with an intensity of 2mA. It's administered before exercise therapy sessions over a period of 8 weeks and 3 times a week
Active tDCS	Transcranial direct current stimulation	The dosage of anodal tDCS will be 20 minutes with an intensity of 2mA. It's administered before exercise therapy sessions over a period of 8 weeks and 3 times a week
Sham tDCS Group	Sham transcranial direct current stimulation	sham tDCS, task-oriented training (i.e. placing cones on another cone, inserting needles into a box

Primary Outcome Measures

Name	Time	Method
Action Research Arm Test	8 week	The Action Research Arm Test (ARAT) is a clinical assessment tool used to evaluate upper limb function and recovery in individuals who have experienced a stroke or other neurological conditions affecting arm movement. The ARAT consists of a series of 19 items/tasks that assess different aspects of upper limb function, including reaching, grasping, gripping, and manipulating objects of various sizes and shapes. The tasks are scored based on the individual's ability to complete them successfully and the quality of movement exhibited during the task. Scores range from 0 to 3. (0=Unable to perform, 1= Partially performs the task, 2= Completes the task with some difficulty and 3= Completes the task without difficulty)
FMA-Upper Extremity	8 week	The Fugl-Meyer Assessment for Upper Extremity (FMA-UE) is a clinical tool for evaluating motor recovery in stroke and neurological conditions affecting the upper limbs and with a sensitivity of 77%, a specificity of 89%. It assesses motor function through tasks like reaching and grasping, scored on a 3-point scale. Higher scores indicate better function, with a maximum score of 66. Clinicians use it to track progress, plan treatment, and assess outcomes in rehabilitation settings

Secondary Outcome Measures

Name	Time	Method
Stroke Specific Quality of Life	8 week	The of Stroke Specific Quality of Life (SS-QOL) questionnaire is a tool used to assess the quality of life in individuals who have experienced a stroke. The SS-QOL reveals a sensitivity of 70.0% and a specificity of 75.8%. It measures various domains including physical function, mobility, social participation, emotional well-being, and cognition. The SS-QOL helps clinicians and researchers understand the impact of stroke on a person's overall quality of life and modify interventions accordingly

Locations (1): Pakistan Railway General Hospital
🇵🇰
Rawalpindi, Punjab, Pakistan