Transcranial Direct Current Stimulation Associate to Constraint Induced Movement Therapy Over Premotor Cortex in Severe Stroke

The purpose is to compare the effects of tDCS and constraint induced movement therapy (CIMT) in the premotor cortex vs. primary motor cortex in severely subacute stroke survivors.

Stroke survivors experience one or more movement-related impairments and activity limitations. In this sense, the premotor cortex (PMC) can be considered as an alternative locus for post-stroke rehabilitation. In relation to physical rehabilitation protocols, associate to neuromodulation, the investigators have chosen a standardized physical therapy protocol for this study, the Constraint Induced Movement Therapy (CIMT), which presents evidence of good therapeutic results. The investigators hypothesized that applying tDCS and CIMT over the PMC promotes motor restoration in stroke patients.

Inclusion Criteria:

• Age between 18 and 65 years
• Diagnosis of unilateral, non-recurring, subacute stroke
• Participants also had to be able, by using any method of pinch, to grasp a washcloth from a table top, lift it up a few inches, and release it.

Exclusion Criteria:

• Patients with difficulty to follow the procedures or understand the instructions; cognitive deficits

• tDCS criteria:

  • use of modulators of the Central Nervous System drugs
  • patients with implanted metallic or electronic devices
  • pacemaker
  • seizures
  • pregnancy
  • any other condition that might limit or interfere in the sensorimotor system