Award Date

5-17-2019

Degree Type

Dissertation

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

Advisor 1

Jing Nong Liang

First Committee Member

Merrill Landers

Second Committee Member

Daniel Young

Number of Pages

33

Abstract

Background and Purpose: Individuals who have experienced a pyramidal cerebrovascular accident (pCVA) often exhibit impairments to volitional control of corresponding motor tasks. Promising effects in motor response, post-application of transcranial direct current stimulation (tDCS), have been reported in studies on individuals with the ability to achieve independent gait for 20 minutes. These studies mainly examined the effects of combined tDCS with locomotor training on lower extremity function among higher functioning individuals post-stroke. The purpose of this study was to determine the effect of tDCS among individuals post-stroke who may not have independent ambulatory capabilities, focusing on motor response and less demanding outcomes. The results of this study will extend knowledge on tDCS effects among lower functioning individuals post-CVA. Methods: Four individuals with chronic stroke (2.38 ± 0.63 years) randomly received either cathodal stimulation or a sham treatment to their non-lesioned hemisphere. Transcranial magnetic stimulation (TMS) was used in order identify the tibialis anterior hotspot in the motor cortex of their lesioned hemisphere such that we were able to assess and reassess the effects of tDCS at the same hotspot location. Fourteen days later, subjects attended a second session where they received the intervention that they did not receive in the first session (either sham or cathodal tDCS). Lower extremity (LE) function was evaluated by comparing pre and post intervention Timed Up and Go (TUG) scores, as well as Step Length, Stride Length, Stride Width, Stance Time, Swing Time, Gait Velocity, Ambulation Time, and Cadence. Motor response was evaluated by comparing pre and post intervention Motor Evoked Potential (MEP) values. Results: There was a statistically significant change in the MEP value measured before and after cathodal tDCS compared to sham (p = 0.037 < 0.05). There was no statistically significant difference when comparing tDCS to sham interventions for: resting motor threshold maximum stimulator output (rMT MSO%), TUG, Step Length, Stride Length, Stride Width, Stance Time, Swing Time, Gait Velocity, Ambulation Time, and Cadence. Discussion: For those who are living post-stroke, the application of cathodal tDCS may provide a relative increase in cortical excitability of the ipsilesional hemisphere. Future tDCS research should incorporate functional interventions to see if they can promote lasting effects.

Keywords

Physical therapy; Transcranial Direct Current Stimulation; Stroke

Disciplines

Medicine and Health Sciences | Physical Therapy | Rehabilitation and Therapy

File Format

pdf

File Size

1.435 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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