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01-07-2021 | Stroke | Original Article

Breaking the ice to improve motor outcomes in patients with chronic stroke: a retrospective clinical study on neuromodulation plus robotics

Authors: Antonino Naro, Luana Billeri, Alfredo Manuli, Tina Balletta, Antonino Cannavò, Simona Portaro, Paola Lauria, Fabrizio Ciappina, Rocco Salvatore Calabrò

Published in: Neurological Sciences | Issue 7/2021

Abstract

Background

Stroke is one of the main causes of impairment affecting daily activities and quality of life. There is a growing effort to potentiate the recovery of functional gait and to enable stroke patients to walk independently.

Aim

To estimate the effects of dual-site transcranial direct current stimulation (dstDCS) on gait recovery in chronic stroke patients provided with robot-aided gait training (RAGT).

Methods

Thirty-seven patients were included in this retrospective clinical study. Nine patients were provided with dstDCS during the first 10 min of RAGT by using Lokomat®Pro (on-RAGT), 15 patients immediately after RAGT (post-RAGT), and 13 patients immediately before RAGT (pre-RAGT).

Results

Each group improved over time concerning disability burden and lower limb strength. on-RAGT and post-RAGT experienced better improvement in balance (p < 0.001) and, moderately, gait endurance (p = 0.04) as compared to pre-RAGT. Furthermore, all treatments decreased the facilitation of the unaffected hemisphere (p < 0.001) and the inhibition of the affected hemisphere (p < 0.001). The duration of such aftereffects was found to be greater for post-RAGT.

Discussion and conclusion

This is the first trial with dstDCS coupled with RAGT in chronic stroke patients with gait impairment. When timely coupled with RAGT, dstDCS may be considered an effective tool for the recovery of lower limb function in patients with first unilateral stroke in the chronic phase. Moreover, our data suggest the ductility of dstDCS concerning RAGT timing, thus making this intervention suitable in a neurorehabilitation setting and well adaptable to patients’ needs.

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Title: Breaking the ice to improve motor outcomes in patients with chronic stroke: a retrospective clinical study on neuromodulation plus robotics
Authors: Antonino Naro
Luana Billeri
Alfredo Manuli
Tina Balletta
Antonino Cannavò
Simona Portaro
Paola Lauria
Fabrizio Ciappina
Rocco Salvatore Calabrò
Publication date: 01-07-2021
Publisher: Springer International Publishing
Keywords: Stroke
Motor Evoked Potential
Motor Evoked Potential
Published in: Neurological Sciences / Issue 7/2021
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-020-04875-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Breaking the ice to improve motor outcomes in patients with chronic stroke: a retrospective clinical study on neuromodulation plus robotics

Abstract

Background

Aim

Methods

Results

Discussion and conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aim

Methods

Results

Discussion and conclusion

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