Doctor of Physical Therapy (DPT)
Jing Nong Liang
First Committee Member
Second Committee Member
Number of Pages
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.
Physical therapy; Transcranial Direct Current Stimulation; Stroke
Medicine and Health Sciences | Physical Therapy | Rehabilitation and Therapy
University of Nevada, Las Vegas
Drobitch, Neil; Henry, Kylie; Lyons, Sage; and Schomig, James, "Modulation of Corticospinal Excitability Using Cathodal Transcranial Direct Current Stimulation to Improve Walking in Individuals with Chronic Post Stroke Hemiparesis" (2019). UNLV Theses, Dissertations, Professional Papers, and Capstones. 3759.
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