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KMID : 1035420210090030087
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Journal of The Korean Society of Integrative Medicine
2021 Volume.9 No. 3 p.87 ~ p.97
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Effects of Transcranial Direct Current Stimulation on Lower Extremity Function of Stroke Patients : A meta-analysis of domastic research
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Lee Jeong-Woo
Lim Ji-Sun
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Abstract
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Purpose : The purpose of this meta-analysis was to examine the effects of transcranial direct current stimulation on lower extremity function of stroke patients.
Methods : Domestic databases (DBpia, KCI, KISS, Kmbase, NDSL and RISS) were searched for studies that conducted clinical trials associated with transcranial direct current stimulation and its impact on lower extremity function with stroke patients. A total of 592 studies published between 2012 and 2019 were identified, with 7 studies satisfying the inclusion data. The studies were classified according to patient, intervention, comparison, and outcome (PICO). The search outcomes were items associated with muscle activity, balance, muscle strength and walking ability. The 7 studies that were included in the study were evaluated using R meta-analysis (version 4.0). The quality of 3 randomized control trials was evaluated using Cochrane risk of bias (ROB). The quality of 4 non-randomized control trial was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger’s regression and ‘trim-and-fill’ tests were carried out to analyze the publishing bias.
Results : The following factors had a large total effect size (Hedges’s g=2.10, 95 %CI=1.54~2.66) involving transcranial direct current stimulation on stroke patients: muscle activity (Hedges’s g=2.38, 95 %CI=1.08~3.68), balance (Hedges’s g=2.41, 95 %CI=1.33~3.60), walking ability (Hedges’s g=1.54, 95 %CI=0.49~2.59), and muscle strength (Hedges’s g=2.45, 95 % CI: 0.85~4.05). Egger’s regression test showed that the publishing bias had statistically significant differences but ‘trim-and-fill’ test showed that there was still statistically difference.
Conclusion : This study provides evidence for the effectiveness of transcranial direct current stimulation on lower extremity such as muscle activity, balance, walking ability, and muscle strength in stroke patients. However, due to the low quality studies and high heterogeneity, the results of our study should be interpreted cautiously.
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KEYWORD
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stroke, transcranial direct current stimulation, lower extremity function, meta-analysis
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