Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Physical Therapy for Neuromuscular and Neurosurgery

Background: The brain has an intrinsic capacity to compensate for structural damage through reorganizing of surviving networks. These processes are fundamental for recovery of function after stroke. Objectives: To investigate the combined effect of bihemispheric transcranial direct current stimulation (tDCS) and constraint induced movement therapy (CIMT) on cortical reorganization and functional recovery of the affected upper extremity in chronic stroke patients. In addition, it assessed the correlation between changes of ipsilesional cortical excitability as a measure of reorganization and functional improvements post intervention. Methods: Forty stroke patients with age ranged from 45 to 60 years were randomly assigned to receive 10 consecutive sessions of either 1) bihemispheric tDCS with simultaneous CIMTor 2) sham stimulation with simultaneous CIMT. Outcome measures include changes in fugl-meyer upper extremity motor assessment (FMUE), Motricity Index (MI) and Action Research Arm Test (ARAT). Cortical excitability of pre and post intervention was assessed using motor evoked potential (MEP) amplitude to identify neural correlates of functional improvement

Issued also as CD