Effect of transcranial direct current stimulation combined with a smart hand joint training device on hand dysfunction in patients with early stroke

Introduction
The aim of this study was to investigate the effect of transcranial direct current stimulation (tDCS) combined with a smart hand joint training device on hand dysfunction in patients with early stroke.

Material and methods
This study was a randomized controlled trial, which was conducted in the neurology department in our hospital. From March 2019 to January 2021, 60 patients diagnosed with early stroke hand dysfunction were selected. A random number table method was used to divide patients equally into control group (smart hand joint training device group) and intervention group (tDCS and smart hand joint training device group). Before and after treatment, Brunnstrom six-level staging, Fugl-Meyer motor function score (wrist hand part), hemiplegic finger function examination, and hemiplegic hand function classification evaluation were applied in both groups. Main outcome measures were Brunnstrom motor function staging (hand part), functional evaluation of hemiplegic fingers, and Fugl-Meyer motor function score (wrist hand part).

Results
After treatment, compared with control group, the results in intervention group of Brunnstrom six-level staging and hemiplegic hand function classification evaluation showed obvious improvement (p = 0.000), and the result of hemiplegic fingers’ functional evaluation also improved (p = 0.026). After treatment, Fugl-Meyer motor function scores were 6.73 ±6.65 (control group) and 9.8 ±6.66 (intervention group). Slight tDCS-related adverse events occurred in one patient (3.33%) in intervention group. None in either group discontinued treatment.

Conclusions
Both the smart hand joint training device alone and tDCS combined with the smart hand joint training device can improve hand function of patients with early stroke to varying degrees, but the treatment effect of tDCS combined with the smart hand joint training device is more significant.