Trial Outcomes & Findings for Robotic Therapy and Transcranial Direct Current Stimulation in Patients With Stroke (NCT NCT02416791)

NCT ID: NCT02416791

Last Updated: 2020-10-20

Results Overview

Change in Motor function subscale was assessed. Scores range from 0 to 66. Lower scores indicate greater severity.

Recruitment status

TERMINATED

Study phase

NA

Target enrollment

9 participants

Primary outcome timeframe

6 weeks from baseline

Results posted on

2020-10-20

Participant Flow

Participant milestones

Participant milestones
Measure
Active tDCS + Robotic Therapy + Physical Therapy
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
6 Weeks
STARTED
3
3
3
6 Weeks
COMPLETED
3
3
3
6 Weeks
NOT COMPLETED
0
0
0
6 Months
STARTED
3
3
3
6 Months
COMPLETED
3
3
2
6 Months
NOT COMPLETED
0
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Active tDCS + Robotic Therapy + Physical Therapy
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
6 Months
Lost to Follow-up
0
0
1

Baseline Characteristics

Robotic Therapy and Transcranial Direct Current Stimulation in Patients With Stroke

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Total
n=9 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Categorical
Between 18 and 65 years
2 Participants
n=5 Participants
3 Participants
n=7 Participants
2 Participants
n=5 Participants
7 Participants
n=4 Participants
Age, Categorical
>=65 years
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
Age, Continuous
55.3 years
STANDARD_DEVIATION 15.2 • n=5 Participants
53.33 years
STANDARD_DEVIATION 4.02 • n=7 Participants
54.0 years
STANDARD_DEVIATION 8.52 • n=5 Participants
54.22 years
STANDARD_DEVIATION 10.97 • n=4 Participants
Sex: Female, Male
Female
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
Sex: Female, Male
Male
2 Participants
n=5 Participants
3 Participants
n=7 Participants
2 Participants
n=5 Participants
7 Participants
n=4 Participants
Race/Ethnicity, Customized
Ethnicity · Back
2 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
7 Participants
n=4 Participants
Race/Ethnicity, Customized
Ethnicity · White
1 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
2 Participants
n=4 Participants
Race/Ethnicity, Customized
Ethnicity · Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Time since stroke
49.3 days
STANDARD_DEVIATION 11.1 • n=5 Participants
40.0 days
STANDARD_DEVIATION 16.75 • n=7 Participants
36.66 days
STANDARD_DEVIATION 11.11 • n=5 Participants
41.56 days
STANDARD_DEVIATION 15.21 • n=4 Participants
Manual dominance
Right
3 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
8 Participants
n=4 Participants
Manual dominance
Left
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Hemisphere lesioned
Right hemisphere
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
Hemisphere lesioned
Left hemisphere
3 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
7 Participants
n=4 Participants
Upper Extremity Fugl Meyer Assessment
19.3 units on a scale
STANDARD_DEVIATION 9.8 • n=5 Participants
17.7 units on a scale
STANDARD_DEVIATION 4.2 • n=7 Participants
21.7 units on a scale
STANDARD_DEVIATION 7.8 • n=5 Participants
18.89 units on a scale
STANDARD_DEVIATION 6.27 • n=4 Participants
Mini Mental State Exam
20 units on a scale
n=5 Participants
27 units on a scale
n=7 Participants
25 units on a scale
n=5 Participants
25 units on a scale
n=4 Participants
National Institutes of Health Stroke Scale
6 units on a scale
n=5 Participants
6 units on a scale
n=7 Participants
3 units on a scale
n=5 Participants
4 units on a scale
n=4 Participants
Modified Rankin Scale
3 units on a scale
n=5 Participants
3 units on a scale
n=7 Participants
3 units on a scale
n=5 Participants
3 units on a scale
n=4 Participants
Hospital Anxiety and Depression Scale
8 units on a scale
n=5 Participants
6 units on a scale
n=7 Participants
8 units on a scale
n=5 Participants
8 units on a scale
n=4 Participants

PRIMARY outcome

Timeframe: 6 weeks from baseline

Change in Motor function subscale was assessed. Scores range from 0 to 66. Lower scores indicate greater severity.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Change in Upper Extremity Fugl Meyer Assessment
10.6 score on a scale
Standard Deviation 7.3
12.3 score on a scale
Standard Deviation 11.4
22.3 score on a scale
Standard Deviation 12.4

PRIMARY outcome

Timeframe: Post treatment (6 weeks from baseline).

Population: RT: robotic therapy; OT: occupational therapy; PT: physical therapy Sham tDCS +RT + PT: 3 participants;each participant was supposed to participate in 18 sessions = 54 sessions in total; there was seven absences and the total number of sessions was 47 for the three patients.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=53 Number of sessions
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=47 Number of sessions
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=53 Number of sessions
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Percentage of Sessions With Adverse Events
Dysesthesia reported during PT
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Pain reported during tDCS
0 percentage of sessions
0 percentage of sessions
1.9 percentage of sessions
Percentage of Sessions With Adverse Events
Fatigue reported during tDCS
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Tingling reported during tDCS
100 percentage of sessions
27.7 percentage of sessions
37.7 percentage of sessions
Percentage of Sessions With Adverse Events
Burning reported during tDCS
0 percentage of sessions
2.1 percentage of sessions
5.7 percentage of sessions
Percentage of Sessions With Adverse Events
Hot reported during tDCS
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Pinching reported during tDCS
9.4 percentage of sessions
31.9 percentage of sessions
30.2 percentage of sessions
Percentage of Sessions With Adverse Events
Metallic taste reported during tDCS
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Itching reported during tDCS
5.6 percentage of sessions
2.1 percentage of sessions
5.7 percentage of sessions
Percentage of Sessions With Adverse Events
Pain reported during RT or OT
5.7 percentage of sessions
24.3 percentage of sessions
7.5 percentage of sessions
Percentage of Sessions With Adverse Events
Fatigue reported during RT or OT
18.9 percentage of sessions
14 percentage of sessions
17 percentage of sessions
Percentage of Sessions With Adverse Events
Dizziness reported during RT or OT
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Syncope reported during RT or OT
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Seizure reported during RT or OT
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Sleepiness reported during RT or OT
9.4 percentage of sessions
6.4 percentage of sessions
5.7 percentage of sessions
Percentage of Sessions With Adverse Events
Dysesthesia reported during RT or OT
1.8 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Pain reported during PT
11.3 percentage of sessions
23.4 percentage of sessions
24.5 percentage of sessions
Percentage of Sessions With Adverse Events
Fatigue reported during PT
3.8 percentage of sessions
17 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Dizziness reported during PT
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Syncope reported during FT
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Seizure reported during PT
0 percentage of sessions
0 percentage of sessions
0 percentage of sessions
Percentage of Sessions With Adverse Events
Sleepiness reported during PT
1.8 percentage of sessions
6.4 percentage of sessions
5.7 percentage of sessions

SECONDARY outcome

Timeframe: 6 weeks from baseline

Scores range from 0 to 6. Higher scores indicate greater severity.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Change in Modified Rankin Scale
0 score on a scale
Interval 0.0 to 0.0
0 score on a scale
Interval 0.0 to -1.0
-1 score on a scale
Interval -1.0 to -1.0

SECONDARY outcome

Timeframe: 6 weeks from baseline

Scores range from 0 to 42. Higher scores indicate greater severity.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Change in National Institutes of Health Stroke Scale
-3 score on a scale
Interval -5.0 to 0.0
-1 score on a scale
Interval -2.0 to -1.0
-2 score on a scale
Interval -3.0 to 0.0

SECONDARY outcome

Timeframe: 6 weeks from baseline

Scores in each domain of the Stroke Impact Scale range from 0 to 100, with higher scores indicating a better quality of life. The change was calculated as the value at the later time point minus the value at the earlier time point; so that, positive numbers represent increases and negative numbers represent decreases.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Change in Stroke Impact Scale
Strength
14.6 score on a scale
Standard Deviation 7.7
16.7 score on a scale
Standard Deviation 7.8
10.4 score on a scale
Standard Deviation 7.7
Change in Stroke Impact Scale
Memory
11.9 score on a scale
Standard Deviation 4.4
14.3 score on a scale
Standard Deviation 10.4
-1.2 score on a scale
Standard Deviation 3.6
Change in Stroke Impact Scale
Emotions
9.2 score on a scale
Standard Deviation 13.6
5.5 score on a scale
Standard Deviation 3.1
3.7 score on a scale
Standard Deviation 1.5
Change in Stroke Impact Scale
Comunication
2.3 score on a scale
Standard Deviation 6.7
6.0 score on a scale
Standard Deviation 1.7
3.6 score on a scale
Standard Deviation 4.4
Change in Stroke Impact Scale
Activities of daily living
14.1 score on a scale
Standard Deviation 22.4
25.8 score on a scale
Standard Deviation 10.0
20.0 score on a scale
Standard Deviation 7.8
Change in Stroke Impact Scale
Mobility
24.1 score on a scale
Standard Deviation 30.4
15.8 score on a scale
Standard Deviation 1.0
20.4 score on a scale
Standard Deviation 2.5
Change in Stroke Impact Scale
HandFunction
15.0 score on a scale
Standard Deviation 12.2
36.7 score on a scale
Standard Deviation 0.3
46.6 score on a scale
Standard Deviation 17.8
Change in Stroke Impact Scale
Participation
10.4 score on a scale
Standard Deviation 34.7
15.6 score on a scale
Standard Deviation 6.6
-6.2 score on a scale
Standard Deviation 6.2

SECONDARY outcome

Timeframe: 6 weeks

Scores range from 0 to 4, with 5 choices. A score of 1 indicates no resistance, and 4 indicates rigidity.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Number of Participants Who Presented Score on Modified Ashworth Scale >2
0 participants
0 participants
0 participants

SECONDARY outcome

Timeframe: 6 weeks from baseline

Each domain contains taks scored on 0 to 5 ordinal scale. Lower scores indicate greater severity.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Change in Motor Activity Log
Amount of Movement
0.6 score on a scale
Standard Deviation 0.4
0.4 score on a scale
Standard Deviation 0.4
0.6 score on a scale
Standard Deviation 0.2
Change in Motor Activity Log
Quality of Movement
0.6 score on a scale
Standard Deviation 0.4
0.5 score on a scale
Standard Deviation 0.6
0.8 score on a scale
Standard Deviation 0.5

SECONDARY outcome

Timeframe: 6 months follow-up

Motor function subscale was assessed. Scores range from 0 to 66. Lower scores indicate greater severity.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=2 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Upper Extremity Fugl Meyer Assessment
42 score on a scale
Standard Deviation 13
34 score on a scale
Standard Deviation 14.9
44.5 score on a scale
Standard Deviation 15.5

SECONDARY outcome

Timeframe: 6 months follow-up

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=2 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Number of Participants With Adverse Events
headache
0 participants
0 participants
0 participants
Number of Participants With Adverse Events
pain on shoulder mobilization
1 participants
2 participants
1 participants
Number of Participants With Adverse Events
dizziness
0 participants
0 participants
0 participants
Number of Participants With Adverse Events
syncope
0 participants
0 participants
0 participants
Number of Participants With Adverse Events
seizures
0 participants
0 participants
0 participants
Number of Participants With Adverse Events
dysesthesia
0 participants
0 participants
0 participants
Number of Participants With Adverse Events
psychiatric disorder
0 participants
0 participants
0 participants
Number of Participants With Adverse Events
sleep
0 participants
1 participants
0 participants

SECONDARY outcome

Timeframe: 6 weeks from baseline

Fatigue Severity Scale is a 9 -item questionnaire. Each item scores on a 7-point scale. The total score range from 9 to 63 points. Higher scores indicate greater fatigue.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Change in Fatigue Severity Scale
1.7 score on a scale
Standard Deviation 11.4
-1.7 score on a scale
Standard Deviation 16.3
-30.7 score on a scale
Standard Deviation 13.7

SECONDARY outcome

Timeframe: 6 weeks from baseline

The global Pittsburgh Sleep Quality Index score is calculated by totaling the seven component scores, providing an overall score ranging from 0 to 21. Lower scores denote a healthier sleep quality.

Outcome measures

Outcome measures
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 Participants
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Change in Pittsburgh Sleep Quality Index
-1.0 score on a scale
Standard Deviation 1.0
-2.3 score on a scale
Standard Deviation 2.5
0.3 score on a scale
Standard Deviation 3.1

Adverse Events

Active tDCS + Robotic Therapy + Physical Therapy

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Sham tDCS + Robotic Therapy + Physical Therapy

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Sham tDCS + Physical Therapy + Occupational Therapy

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Active tDCS + Robotic Therapy + Physical Therapy
n=3 participants at risk
Active tDCS (transcranial direct current stimulation) will be applied prior to the robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Active tDCS: Active tDCS will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA). Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Robotic Therapy + Physical Therapy
n=3 participants at risk
Sham tDCS (transcranial direct current stimulation) will be applied prior to robotic training. After robot training, the patient will receive physical therapy for 40 minutes. Number of treatment sessions: 18 (3 times a week, for 6 weeks). Robotic Therapy: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb. Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes.
Sham tDCS + Physical Therapy + Occupational Therapy
n=3 participants at risk
Sham tDCS (transcranial direct current stimulation) will be applied prior to conventional therapy (40 minutes of physical therapy and 40 minutes of occupational therapy) Number of treatment sessions: 18 (3 times a week, for 6 weeks). Sham tDCS: In sham tDCS, no current will be delivered through the tDCS device. Physical Therapy: Physical therapy will be administered for 40 minutes. Occupational Therapy: Occupational therapy will be administered for 40 minutes.
Skin and subcutaneous tissue disorders
Tingling
100.0%
3/3 • Number of events 53 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
100.0%
3/3 • Number of events 13 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
66.7%
2/3 • Number of events 20 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
Skin and subcutaneous tissue disorders
Pinching
33.3%
1/3 • Number of events 5 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
100.0%
3/3 • Number of events 15 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
66.7%
2/3 • Number of events 16 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
Musculoskeletal and connective tissue disorders
Fatigue
66.7%
2/3 • Number of events 2 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
66.7%
2/3 • Number of events 8 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
0.00%
0/3 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
Musculoskeletal and connective tissue disorders
Pain
100.0%
3/3 • Number of events 6 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
66.7%
2/3 • Number of events 11 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
33.3%
1/3 • Number of events 13 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
Nervous system disorders
Sleepiness
66.7%
2/3 • Number of events 5 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
33.3%
1/3 • Number of events 3 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.
66.7%
2/3 • Number of events 3 • 06 months
Data about adverse effect were collected in each session of treatment, for each different intervention - tDCS, Physical Therapy, and motor therapy (Robotic therapy or Occupational Therapy). All minor adverse events related (tingling, pinching, fatigue, pain, sleepiness, fatigue and pain) were considered treatment-related and reported to Ethical Committee. Two events of fall outside the hospital were related and considered non-treatment-related.

Additional Information

Professor Adriana Bastos Conforto

Neurostimulation Laboratory, Hospital das Clínicas/São Paulo University, Brazil

Phone: +55 11 2661-7955

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place