Effects of Transcranial Direct Current Stimulation on
Motor Activity of Lower Limb Muscles in Chronic Stroke†
Sirinuch Utarapichat MD1, Wasuwat Kitisomprayoonkul MD2
Affiliation :
1 Division of Orthopedic Surgery and Rehabilitation Medicine, Veteran General Hospital, Bangkok, Thailand
2 Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Background : Anodal transcranial direct current stimulation [tDCS] enhances cortical excitability and increases lower limb force
in healthy volunteer and stroke patients. Effects of tDCS on motor activity of lower limb muscle and gait performance in chronic
stroke patients was not explored.
Objective : To study the effects of tDCS on motor activity of lower limb muscles and gait performance in chronic stroke patients.
Materials and Methods : Ten chronic stroke patients participated in a single-blind, crossover, and sham-controlled pilot study. Each
patient participated in two stimulation conditions applied to the lower limb motor cortex area of affected hemisphere, i.e., anodal
stimulation (2 mA, 10 minutes) and sham stimulation (2 mA, 30 seconds). The sequence of stimulation was randomly assigned.
Wash-out period between stimulation is at least 48 hours. Root mean square [RMS] amplitude and median frequency [MF] of the
vastus medialis oblique [VMO] and tibialis anterior [TA] muscles of the paretic limb and the Timed Up & Go test [TUG] were
measured before and immediately after stimulation.
Results : The average RMS amplitude of the VMO muscle of the paretic limb increased by 13.6% and 7.7% after anodal tDCS and
sham stimulation, consecutively. The average RMS amplitude of the TA muscle decreased by 2.3% and increased by 9.1% after tDCS
and sham stimulation. The average MF of the VMO muscle of the paretic limb decreased by 1.9% and 2.9% after anodal tDCS and
sham stimulation, consecutively. The average MF of the TA muscle decreased by 2.4% and increased by 2.9% after tDCS and sham
stimulation. The TUG was decreased by 1.2% and increased by 1.7% after tDCS and sham stimulation, consecutively. RMS, MF, and
TUG were not statistically different between tDCS and sham stimulation (ANCOVA test, p>0.05).
Conclusion : Single session of anodal tDCS at ipsilesional hemisphere could not enhance motor activity of lower limb muscles in
chronic stroke patients.
Keywords : Transcranial direct current stimulation, Stroke, Rehabilitation, Motor cortex
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