Using clinical and robotic assessment tools to examine the feasibility of pairing tDCS with upper extremity physical therapy in patients with stroke and TBI: A consideration-of-concept pilot study

Addie Middleton, Stacy L. Fritz, Derek M. Liuzzo, Roger Newman-Norlund, Troy M. Herter

Research output: Contribution to journalArticle

21 Scopus citations


BACKGROUND: Transcranial direct current stimulation (tDCS) may provide a safe, non-invasive technique for modulating neural excitability during neurorehabilitation. OBJECTIVE: 1) Assess feasibility and potential effectiveness of tDCS as an adjunct to standard upper extremity (UE) physical therapy (PT) for motor impairments resulting from neurological insult. 2) Determine sustainability of improvements over a six month period. METHODS: Five participants with chronic neurologic insult (stroke or traumatic brain injury > 6 months prior) completed 24 sessions (40 minutes, three times/week) of UE-PT combined with bihemispheric tDCS delivered at 1.5 mA over the motor cortex during the first 15 minutes of each PT session. Outcomes were assessed using clinical (UE Fugl-Meyer, Purdue Pegboard, Box and Block, Stroke Impact Scale) and robotic (unimanual and bimanual motor control) measures. Change in scores and associated effects sizes from Pre-test to Post-test and a six month Follow-up were calculated for each participant and group as a whole. RESULTS: Scores on UE Fugl-Meyer, Box and Block, Purdue Pegboard, Stroke Impact Scale, and robotic measures improved from Pre- to Post-test. Improvements on UE Fugl-Meyer, Box and Block, and robotic measures were largely sustained at six months. CONCLUSIONS: Combining bihemispheric tDCS with UE-PT in individuals with neurological insult warrants further investigation.

Original languageEnglish (US)
Pages (from-to)741-754
Number of pages14
Issue number4
StatePublished - 2014
Externally publishedYes



  • rehabilitation
  • stroke
  • TBI
  • tDCS
  • upper extremity

ASJC Scopus subject areas

  • Clinical Neurology
  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

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