Combining transcranial direct current stimulation and peripheral electrical stimulation to improve upper limb function in a patient with acute central cord syndrome: a case report

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  • Hideaki Matsuo
    Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
  • Masafumi Kubota
    Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
  • Yasue Hori
    Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
  • Yuya Izubuchi
    Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
  • Ai Takahashi
    Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
  • Shuji Watanabe
    Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
  • Hideaki Nakajima
    Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
  • Akihiko Matsumine
    Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan

抄録

<jats:p> We report the immediate improvement of weakened muscles after combined treatment with transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) in a patient with acute central cord syndrome (CCS) who presented with severe upper limb motor dysfunction. A 70-year-old man sustained CCS with severe motor deficits in the left upper limb, which did not improve with conventional training until 6 days after injury. On the seventh day after the injury, the left upper limb was targeted with combined tDCS (1 mA for 20 minutes/day, anode on the right, cathode on the left) and PES (deltoid and wrist extensors, 20 minutes/day at the motor threshold), and his performance score immediately improved from 0 to 6 on the Box and Block test. After four sessions, the left upper limb function improved to 32 on the Box and Block test, and manual muscle test scores of the stimulated deltoid and wrist extensors improved from 1 to 2. This improvement of the left upper limb led to improved self-care activities such as eating and changing clothes. Exercise combined with tDCS and PES may be a novel treatment for upper limb movement deficits after acute CCS. </jats:p>

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