Abstract | BACKGROUND: Several studies have investigated the effect of noninvasive brain stimulation (NIBS) on upper limb motor function in stroke, but the evidence so far is conflicting. OBJECTIVE: METHOD: Literature search was conducted for randomized controlled trials (RCTs) assessing the effect of " tDCS" or "rTMS" combined with other therapies on upper extremity motor recovery after stroke. The outcome measures were Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), and Barthel Index (BI). The mean difference (MD) and 95%CI were estimated for motor outcomes. Cochrane risk of bias tool was used to assess the quality of evidence. RESULT: Twenty-five RCTs involving 1102 participants were included in the review. Compared to sham stimulation, NIBS combined with other therapies has effectively improved FMA-UE (MD0.97 [95%CI, 0.09 to 1.86; p = .03]) and BI score (MD9.11 [95%CI, 2.27 to 15.95; p = .009]) in acute/sub- acute stroke ( MD1.73 [95%CI, 0.61 to 2.85; p = .003]) but unable to modify FMA-UE score in chronic stroke (MD-0.31 [95%CI, -1.77 to 1.15; p = .68]). Only inhibitory (MD3.04 [95%CI, 1.76 to 4.31; I2 = 82%, p < .001] protocol is associated with improved FMA-UE score. Twenty minutes of stimulation/session for ≥20 sessions was found to be effective in improving FMA-UE score (Stimulation time: ES0.45; p ≤ .001; Sessions: ES0.33; p ≤ .001). The NIBS did not produce any significant improvement in WMFT as compared to sham NIBS (MD0.91 [95% CI, -0.89 to 2.70; p = .32]). CONCLUSION:
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Authors | Ishtiaq Ahmed, Rustem Mustafaoglu, Nesrine Benkhalifa, Yakhoub Hassan Yakhoub |
Journal | Topics in stroke rehabilitation
(Top Stroke Rehabil)
Vol. 30
Issue 3
Pg. 213-234
(04 2023)
ISSN: 1945-5119 [Electronic] England |
PMID | 35112659
(Publication Type: Meta-Analysis, Systematic Review, Journal Article)
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Topics |
- Humans
- Stroke
(complications)
- Activities of Daily Living
- Stroke Rehabilitation
(methods)
- Recovery of Function
- Motor Disorders
(complications)
- Upper Extremity
- Physical Functional Performance
- Brain
- Randomized Controlled Trials as Topic
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