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||Elsner, B., Kwakkel, G., Kugler, J., & Mehrholz, J. (2017). Transcranial direct current stimulation (tDCS) for improving capacity in activities and arm function after stroke: a network meta-analysis of randomised controlled trials. Journal of NeuroEngineering and Rehabilitation, 14(95).
||Brain, electrical stimulation, functional limitations, health promotion, limbs, literature reviews, motor skills, safety, stroke
||This systematic review with a network meta-analysis provides an overview of the evidence network regarding the efficacy and safety of transcranial direct current stimulation (tDCS) and the effectiveness of the different stimulation types. tDCS is an emerging approach for improving capacity in activities of daily living (ADL) and upper-limb function after stroke. Several databases were searched up to July 5, 2016 for randomized trials that compared any kind of active tDCS (anodal, cathodal, or dual tDCS) versus control for improving ADL capacity and arm function after stroke, and examined its safety. Results showed 12 randomized controlled trials with 284 participants examined the effect of tDCS on the primary outcome, ADL capacity. Researchers found evidence of a significant moderate effect in favor of cathodal tDCS, whereas no significant effects were found for the other active tDCS (i.e., dual tDCS, anodal tDCS, and sham tDCS) or control interventions. Sixteen studies with 302 participants examined upper-limb motor function as measured with Upper Extremity Fugl-Meyer Motor scores. The study found no evidence of an effect of cathodal tDCS, dual tDCS, anodal tDCS, sham tDCS, or physical rehabilitation interventions. Finally, analysis of 26 trials with 754 participants found no statistically significant differences between sham tDCS, physical rehabilitation interventions, cathodal tDCS, methylphenidate, dual tDCS, and anodal tDCS, regarding the safety of tDCS or its control interventions as revealed by the number of dropouts and adverse events. Overall, findings suggest that cathodal tDCS is the most promising treatment option to improve ADL capacity in people with stroke.
|Full-Text Availability Options:||https://www.ncbi.nlm.nih.gov/pubmed/28903772|