Combination of Transcranial Direct Current Stimulation and Neuromuscular Electrical Stimulation Improves Gait Ability in a Patient in Chronic Stage of Stroke.
BACKGROUND
Walking ability is important in stroke patients to maintain daily life. Nevertheless, its improvement is limited with conventional physical therapy in chronic stage. We report the case of a chronic stroke patient showing a remarkable improvement in gait function after a new neurorehabilitation protocol using transcranial direct current stimulation (tDCS) and neuromuscular electrical stimulation (NMES).


METHODS
A 62-year-old male with left putaminal hemorrhage suffered from severe right hemiparesis. He could move by himself with a wheelchair 1 year after the ictus. Anodal tDCS at the vertex (2 mA, 20 min) with NMES at the anterior tibialis muscle had been applied for 3 weeks. The Timed Up and Go test and 10-meter walk test improved after the intervention, which had been maintained for at least 1 month.


CONCLUSIONS
This single case suggests the possibility that tDCS with NMES could be a new rehabilitation approach to improve the gait ability in chronic stroke patients.
Departments of Neurosurgery, Nagahama City Hospital, Nagahama, Japan.
Takeshi
T
Satow
Departments of Rehabilitation Medicine, Nagahama City Hospital, Nagahama, Japan.
Tomotaka
T
Kawase
Departments of Rehabilitation Medicine, Nagahama City Hospital, Nagahama, Japan.
Atsushi
A
Kitamura
Departments of Rehabilitation Medicine, Nagahama City Hospital, Nagahama, Japan.
Yuki
Y
Kajitani
Departments of Rehabilitation Medicine, Nagahama City Hospital, Nagahama, Japan.
Takuya
T
Yamaguchi
Departments of Rehabilitation Medicine, Nagahama City Hospital, Nagahama, Japan.
Nobuhiko
N
Tanabe
Departments of Rehabilitation Medicine, Nagahama City Hospital, Nagahama, Japan.
Reiko
R
Otoi
Departments of Neurosurgery, Nagahama City Hospital, Nagahama, Japan.
Taro
T
Komuro
Departments of Neurosurgery, Nagahama City Hospital, Nagahama, Japan.
Akira
A
Kobayashi
Departments of Neurosurgery, Nagahama City Hospital, Nagahama, Japan.
Hirokazu
H
Nagata
Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Tatsuya
T
Mima
Gait; Neuromuscular electrical stimulation; Rehabilitation; Stroke; Transcranial direct current stimulation