Home-based transcranial direct current stimulation plus tracking training therapy in people with stroke: an open-label feasibility study

Ann Van de Winckel, James R Carey, Teresa A Bisson, Elsa C Hauschildt, Christopher D Streib, William K Durfee, Ann Van de Winckel, James R Carey, Teresa A Bisson, Elsa C Hauschildt, Christopher D Streib, William K Durfee

Abstract

Background: Transcranial direct current stimulation (tDCS) is an effective neuromodulation adjunct to repetitive motor training in promoting motor recovery post-stroke. Finger tracking training is motor training whereby people with stroke use the impaired index finger to trace waveform-shaped lines on a monitor. Our aims were to assess the feasibility and safety of a telerehabilitation program consisting of tDCS and finger tracking training through questionnaires on ease of use, adverse symptoms, and quantitative assessments of motor function and cognition. We believe this telerehabilitation program will be safe and feasible, and may reduce patient and clinic costs.

Methods: Six participants with hemiplegia post-stroke [mean (SD) age was 61 (10) years; 3 women; mean (SD) time post-stroke was 5.5 (6.5) years] received five 20-min tDCS sessions and finger tracking training provided through telecommunication. Safety measurements included the Digit Span Forward Test for memory, a survey of symptoms, and the Box and Block test for motor function. We assessed feasibility by adherence to treatment and by a questionnaire on ease of equipment use. We reported descriptive statistics on all outcome measures.

Results: Participants completed all treatment sessions with no adverse events. Also, 83.33% of participants found the set-up easy, and all were comfortable with the devices. There was 100% adherence to the sessions and all recommended telerehabilitation.

Conclusions: tDCS with finger tracking training delivered through telerehabilitation was safe, feasible, and has the potential to be a cost-effective home-based therapy for post-stroke motor rehabilitation.

Trial registration: NCT02460809 (ClinicalTrials.gov).

Keywords: Neurological rehabilitation; Physical therapy; Stroke; Telerehabilitation; Transcranial direct current stimulation.

Conflict of interest statement

Ethics approval and consent to participate

The internal review board (IRB) of the University of Minnesota approved the study (IRB number 1503 M65941). All participants signed a consent form.

Consent for publication

The participant has signed consent for publication of the picture.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Participant with right hemiparesis receiving transcranial direct current magnetic stimulation (tDCS) in their home simultaneous while performing the finger movement tracking task on the tracking computer (left). The tDCS computer (right) shows the supervising investigator, located off-site, who communicated with the participant through the video conferencing application, controlled the tDCS stimulator through web-based software, and controlled the tracking protocols. (Permission was obtained from the participant for the publication of this picture)
Fig. 2
Fig. 2
Research design and participants’ study timeline

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