Brain Neurorehabil.  2018 Mar;11(1):e10. 10.12786/bn.2018.11.e10.

The Effect of Repetitive Arm Cycling Training Priming with Transcranial Direct Current Stimulation on Post-Stroke: Pilot Study

  • 1Neurophysiology department, Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia.
  • 2Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
  • 3Department of Neurology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • 4Section of Neurology, Department of Medicine, Aga Khan University Hospital Karachi, Karachi, Pakistan.
  • 5Department of Neurology, Aga Khan University, Karachi, Pakistan.
  • 6Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.


Transcranial direct current stimulation (tDCS) is a noninvasive method that may increase the rehabilitation effects in stroke. The objective of the study was to test whether tDCS priming with training on an arm ergometer boosts motor performance in chronic stroke patients. Three chronic subcortical stroke patients had continued a sole unilateral stroke 30-36 months formerly. They had some voluntary control of the arm in the affected side underwent a cycling training on an arm ergometer for 20 minutes a day, during 5 days a week priming with cathodal tDCS stimulation of unaffected hemisphere. They were tested during 4 sessions 1 week before, at the beginning, at the end, and 1 week after the end of the training priming with tDCS. We executed; 1) Rivermead Motorik Assessment (global function, arm and leg), 2) the Modified Ashworth Scale of the elbow flexors and extensors, 3) the minimum torque on the lesion side, 4) grip strength, and 5) pegboard performance at each time of testing the patients. All patients tolerated tDCS very well during experiment. Patients showed significant (p = 0.01) improved of force and spasticity (p = 0.03). The grip strength and pegboard performance improved significantly too after DCS priming with training. These results showed that cathodal tDCS is a useful device for rehabilitation when priming with motor training in stroke patients. These patients proved the clinical relevance of the results.


Neuroplasticity; Stroke Rehabilitation; Transcranial Direct Current Stimulation; Hemiparesis

MeSH Terms

Hand Strength
Muscle Spasticity
Neuronal Plasticity
Pilot Projects*
Transcranial Direct Current Stimulation*
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