Investigating Neurophysiological Effects of Transcranial Direct Current Stimulation Combined with Action Observation Therapy on Hand Muscle Neuroplasticity in Chronic Stroke

What this Trial Is About

Researchers are evaluating how the combined use of transcranial direct current stimulation (tDCS) and action observation therapy (AOT) may help improve hand motor recovery in people who have had a stroke. This study focuses on understanding the brain mechanisms involved when these two therapies are used together, as both have shown promise separately for stroke rehabilitation. The trial is a randomised controlled study involving 60 participants with chronic stroke from Sabah, Malaysia. Participants will be randomly assigned to one of three groups: one group will receive active anodal tDCS with AOT, another will receive sham (placebo) tDCS with AOT, and the third will receive active tDCS alone. The treatment involves 10 sessions over two weeks in a clinic, where tDCS is applied for 20 minutes and AOT or control videos are watched for 30 minutes during each session. After the clinic phase, participants will continue home-based AOT or control video practice for 30 minutes a day, five days a week, for eight weeks. During the 10-week study, participants will attend outpatient sessions monitored by a physiotherapist to ensure proper participation and will be assessed at baseline, after two weeks, and at the end of 10 weeks. Researchers will measure changes in brain motor pathways using motor evoked potentials (MEPs) and evaluate clinical hand function using standard tests. Participant activity levels will be tracked using a perceived exertion scale, and safety and compliance will be closely monitored throughout the study.

Brain Stimulation Combined With Watching Hand Movements to Improve Hand Recovery in Chronic Stroke