Effect of Short Period Simultaneous Stimulation of Transcranial Direct Current Stimulation (tDCS) on Occupational Therapy to Motor Function of Upper Extremity in Stroke Subject

Adrian Utomo, I Lukitra Wardhani, I Putu Alit Pawana

= http://dx.doi.org/10.20473/spmrj.v2i2.20623
Abstract views = 356 times | downloads = 484 times



Objective: Stroke could cause upper extremity motor function disturbances that may affect to quality of life. The affected brain has an ability to get recovery by neuroplasticity process. Transcranial direct current stimulation (tDCS) is a non-invasive modality that could induce brain neuroplasticity
Goal: To determine the effect of tDCS stimulation on recovery of upper extremity motor function in subacute ischaemic stroke patient.
Methods: 22 stroke patients included in inclusion criteria, divided into 2 groups, control group and intervention group. Control group had occupational therapy for 5 days consecutively and intervention group had occupational therapy and tDCS stimulation simultaneously for 5 days consecutively. Upper extremity motor function was evaluated with Fugl-Meyer Assessment (FMA) before and after the treatment.
Results: Significant improvement of FMA score on control group (p=0,018) and intervention group (p=0,000). Comparison of the result after the treatment revealed that the intervention group showed more significant improvement in FMA score than the control group (p=0,000).
Conclusion: Application of tDCS stimulation on occupational therapy simultaneously showed improvement of upper extremity motor function in subacute ischaemic stroke patient better than only occupational therapy.
Key Words: Transcranial direct current stimulation, occupational therapy, Fugl-Meyer Assessment, upper extremity motor function, subacute ischemic stroke.


Transcranial direct current stimulation, occupational therapy, Fugl-Meyer Assessment, upper extremity motor function, subacute ischemic stroke

Full Text:



Zorowits RD, Baerga E, Cuccurullo SJ. 2015. Stroke. In: Physical Medicine and Rehabilitation Board Review. 2nd ed. New York: Demos medical;.2015 pp. 1- 27.

Jauch EC, Saver JL, Adams HP, Bruno A, Connors JJ, Demaerschalk BM. et al. Guidelines for the early management of patients with acute ischemic stroke. Newyork: American Heart Association; 2013.

Kementerian Kesehatan RI. Riset Kesehatan Dasar 2013. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI; 2013.

Sciusco A, Ditrenta G, Rahim A. Mirror therapy in the motor recovery of upper extremity. Eur Med Phys. 2008:44.

Busser Y, Lisa G, Steenbackers K, Waarlo S. Uncovering the mechanism of transcranial direct current stimulation- induced neuroplasticity after stroke. Research proposal for the Honours programme at the Radboud University’s Faculty of Science. 2016; 1-15.

Brita F, Janine R, Keri M, Heidi MS, Yuanyuan J, Cohen LG, et al. Direct current stimulation promotes BDNF-dependent synaptic plasticity: Potential implications for motor learning. Leonardo. 2011;66(2):198–204. ISSN 10974199.doi: 10.1016/j.neuron.2010.03.035.

Lefaucheur JP, Antal A, Ayache SS, Benninger DH, Brunelin J, Cogiamanian F, et al. Evidence- based guidelines on the therapeutic use of transcranial direct current stimulation. Clinical neurophysiology journal [internet]. 2017. Available from: http://dx.doi.org/10.1016/j.clinph.2016.10.0 87 1388-2457/_2016

Stagg CJ, Nitsche MA. Physiological basis of transcranial direct current stimulation. The Neuroscientist. 2011;17(1):37-53.

Andrade SM, Batista LM, Nogueira LL, Oliveira RF, Carvalho AG, Lima SS, et al. Constraint-induced movement therapy combined with transcranial direct current stimulation over premotor cortex improves motor function in severe stroke: a pilot randomized controlled trial. Hindawi Rehabilitation Research and Practice. 2017; 9. Available from: https://doi.org/10.1155/2017/6842549

Wardhani NR, Martini S. Hubungan antara karakteristk pasien stroke dan dukungan keluarga dengan kepatuhan menjalani rehabilitasi. Jurnal Berkala Epidemiologi. 2015;3.

Rahayu EO. Perbedaan risiko stroke berdasarkan faktor risiko biologi pada usia produktif. Jurnal Berkala Epidemiologi. 2016;4.

Pin-Barre C, Laurin J. Physical exercise as a diagnostic, rehabilitation, and preventive tool: influence on neuroplasticity and motor recovery after stroke. Neural plasticity. 2015;15:608581.

Ploughman M, Windle V, MacLellan CL, White N, Doré JJ, Corbett D. Brain-derived neurotrophic factor contributes to recovery of skilled reaching after focal ischemia in rats. Stroke. 2009;40(4): 1490-5.

Mandal AK, Mokashi SP. Effect of ocupational therapy task oriented approach on recovery of upper-extremity motor function and activities of daily living in stroke patients. The Indian journal of Occupational Therapy. 2009;61(2).

Car JH, Shepherd RB. Investigation of a new motor assesment scale for stroke patient. J. Phys. Ther (Am). 1985.

Jannette B, Dite W. Additional task related practice improves mobility and upper limb function early after Stroke: A randomized controlled trail. Aus. J. of Physiotherapy. 2004;50:219-24.

Butler AJ, Shuster M, O’Hara E, Hurley K, Middlebrooks D, Guilkey K. A meta-analysis of the efficacy of anodal transcranial direct current stimulation for upper limb motor recovery in stroke survivors. Journal of Hand Therapy. 2012;-:p:26

Ilic NV, Raspopovic ED, Nedeljkovic U. Effects of anodal tDCS and occupational therapy on fine motor skill deficits in patient with chronic stroke. Restorativ Neurology and Neuroscience. 2016. Available from: DOI:10.3233/RNN-160668

Rozisky JR, Antunes LC, Brietzke AP, de Sousa AC, Caumo W. Transcranial direct current stimulation and neuroplasticity in: Rogers L. Transcranial Direct Current Stimulation (tDCS): Emerging Uses, Safety And Neurobiological Effects Nova Pub Inc. 2015. p63-75. Available from: https://www.researchgate.net/publication/30 54394


  • There are currently no refbacks.

Creative Commons License
SPMRJ by  Unair is licensed under a Creative Commons Attribution 4.0 International License.



View SPMRJ Stats