Effects Of Transcranial Direct Current Stimulation Combined With Robot-assisted Therapy On Hand Motor Function Of Subacute Stroke Patients

Objective:Based on the "closed-loop" theory,this study aims to explore the effects of tDCS combined with robot-assisted therapy on subacute stroke patients with hand motor dysfunction,and provide the "closed loop" theory Clinical evidence.Methods:60 subacute stroke patients were randomly divided into CR group,RAT group and closed-loop group.The CR group only received 4 weeks of conventional rehabilitation;Basis on the CR group,the RAT group received 30 min/d,5 d/week,a total of 4 weeks of RAT training;Basis on the RAT group,subjects in the closed-loop group received 2m A/20 min bilateral tDCS intervention before RAT training,forming a "closed loop" training mode.The study used Fugl-Meyer assessment upper limb subscale(FMA-UL),Action Research Arm Test(ARAT),Box and Block test(BBT),modified Barthel index(MBI),grip strength and pinch strength before and after the intervention to evaluate the subjects’ hand motor function and activities of daily living.Results:Compared with before and after intervention,only MBI in CR group showed statistical difference(P = 0.048);FMA-UL(P = 0.024)and MBI(P = 0.048)in RAT group showed statistical difference;FMA-UL(P = 0.000),BBT(P = 0.00),MBI(P =0.024),grip strength(P = 0.002)and pinch strength(P = 0.004)in closed-loop group showed statistical difference before and after intervention.There was no significant difference between the groups before intervention.After the intervention,the FMA-UL(P = 0.010),BBT(P = 0.007),MBI(P = 0.001)and grip strength(P = 0.008)of the closed-loop group were significantly different from those of the CR group;the grip strength of the closed-loop group were significantly different from RAT group(P = 0.028);there were no significant differences in the RAT group compared with the CR group.Conclusion:Based on the "closed loop" theory,tDCS combined with RAT can promote the rehabilitation of hand motor dysfunction in subacute stroke patients,and can improve the patients’ activities of daily living.