Effects of continuous current stimulation (tDCS) associated with FES in tibial anterior muscle, in postural control of individuals with hemiparesia from stroke - randomized, controlled and double blind study

Abstract

Tibial anterior muscle (TA), a sequel to the stroke, leads to decreased ankle control and consequently decreased postural control. To strengthen this muscle functional electrical stimulation (FES) can be used. It is suggested that the associated direct current brain stimulation (tDCS) may potentiate this effect. Thus, the objective of the study is to evaluate the effects of tDCS on motor cortex associated with FES on TA and postural control of hemiparetic patients due to stroke. Methods: Clinical, controlled, randomized, double-blind trial with 36 chronic hemiparetic individuals due to stroke. Evaluation: Postural control by the Mini-Balance Evaluation System (Mini-BESTest), evaluated in the pre-treatment, after 10 sessions (2 weeks) and 30 days after the end of the interventions. Patients will be randomized into 3 groups: active FESa + FESs (Ea + Fa), tDCS placebo + active FES (Es + Fa) and active tDCS + FES sham (Ea + Fs). ETCC procedures: Anode electrode on C1 or C2 motor cortex, according to injured hemisphere and cathode contralateral to the anode (C1 or C2), intensity 2mA, for 20 minutes associated with FES on TA muscle paired. FES with parameters of Ton 6sec + active contraction of TA, Toff 12sec, frequency of 50 Hz, 250 pulses, for 30 min.