Date of Award

2024

Degree Type

Thesis

Degree Name

Master of Science in Kinesiology

Department

Kinesiology

First Advisor

Susan E. D’Andrea

Abstract

Stroke rehabilitation is a critical yet challenging aspect of recovery due to the complex nature of post-stroke motor function impairment, encompassing gait and mobility deficiencies (Langhorne, Bernhardt, and Kwakkel 2011). Traditional physical therapy, predominantly characterized by repetitive, task-specific exercises, frequently fails to fully address the nuanced rehabilitative needs of stroke survivors (Pollock et al. 2014). This thesis explores the potential of integrating two emerging technologies, Virtual Reality (VR) and Transcranial Direct Current Stimulation (tDCS), proposing that their combined use could significantly enhance post-stroke rehabilitation outcomes. This integrated approach aims to influence VR's engaging, immersive experiences with tDCS's neuroplasticity-promoting effects, potentially exceeding traditional rehabilitation methods in effectiveness.

To better understand the effectiveness of tDCS and VR therapy on stroke rehabilitation, this pilot study was conducted with four chronic stroke patients, randomized to receive either anodal tDCS or sham stimulation alongside VR treadmill training. The intervention comprised ten 30-minute sessions over two weeks, with effectiveness measured via clinical assessments such as the Dynamic Gait Index (DGI), Berg Balance Scale (BBS), Four Square Step Test (FSST), and the Timed Up and Go Test (TUG) (Shumway-Cook and Woollacott 2007). The University of Rhode Island IRB approved this study.

Results revealed that all participants, irrespective of receiving anodal or sham tDCS, demonstrated improvements in clinical assessments post-intervention. Notably, all four participants showed clinically significant improvements in assessments, specifically between the DGI and TUG. These clinically significant results, along with other observable improvements highlight the potential of the combined VR and tDCS intervention to make meaningful strides in stroke rehabilitation, particularly in improving gait and mobility outcomes.

Chapter 1, Review of Literature, provides background information about stroke’s impact on motor function, the inadequacies of traditional rehabilitation techniques and the potential of VR and tDCS technologies to enhance post-stroke recovery.

Chapter 2, Anodal tDCS and virtual reality gait rehabilitation in individuals with chronic stroke, presents the manuscript for this project. In this study, the effectiveness of anodal and sham tDCS with VR therapy was evaluated, in terms of multiple clinical gait and mobility assessments. The results indicated improvements, irrespective of receiving anodal or sham tDCS. The implications of this study’s findings for future research are addressed. This manuscript is in preparation for submission to Frontiers in Neuroscience.

Chapter 3, Summary, provides a review of the results and limitations, and discusses potential directions for future research.

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