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Table 1 Characteristics and design of the included studies

From: Transcranial direct current stimulation combined with robotic therapy for upper and lower limb function after stroke: a systematic review and meta-analysis of randomized control trials

Author (year) Study design Intervention Groups Treatment Parameters Outcomes n° sessions (s)
Sessions/week (s/w)
Follow-up Adverse effects
Geroin C. et al. (2011)297 RCT Double-blinded RAGT + tDCS G1) RAGT + tDCS
G2) RAGT + sham tDCS
G3) Overground-walking exercises
7 min tDCS online + 20 min RAGT + 30 leg strengthening exercise 35 cm2
Anode M1 affected, cathode contralateral SO
1.5 mA. CD = 0.05 mA/cm2
6MWT, 10MWT, SGP,
Rivermead Mobility Index,
MI leg, MAS
10 s
5 s/w
2 weeks No adverse events reported
Hesse S. et al. (2011)2830 RCT Double-blinded Arm robot + anodal tDCS G1) Arm robot + anodal tDCS
G2) Arm robot + cathodal tDCS
G3) Arm robot + sham tDCS
20 min anodal or cathodal tDCS online + Arm Robot training 35 cm2
G1) Anode M1 affected, cathode contralateral SO
G2) Cathode M1 unaffected, contralateral SO
2 mA. CD = 0.07 mA/cm2
FM/ue, MRC, MAS, BI, B&B 30 s
5 s/w
3 months Tingling under the electrodes and transient headaches
Danz et al. (2013)2931 RCT Double-blinded Anodal tDCS + Lokomat G1) Anodal tDCS + Lokomat
G2) Sham tDCS + Lokomat
20 min anodal tDCS
 + 20–40 min Lokomat (20–50% body support)
25 cm2: Anode M1 affected
35 cm2: Cathode contralateral SO
2 mA. CD = 0.05 mA/cm2
10MWT, TUG, BBS, FAC, SIS-16 12 s
3 s/w
1 months No adverse events reported
Triccas et al. (2015)3032 RCT Double-blinded Anodal tDCS + RT G1) Anodal tDCS + RT
G2) Sham tDCS + RT
20 min Anode tDCS online + 1 h Armeo robotic training 35 cm2
Anode M1 affected
Cathode contralateral SO
1 mA. CD = 0.035 mA/cm2
FM/ue, ARAT, MAL-28, SIS 18 s
2-3 s/w
3 months tDCS sensation: itching, tingling, warmth, burning, pain, light flashes and headaches
RT: fatigue, shoulder pain and upper trapezius pain on the affected side
Straudi S et al. (2016)3133 RCT Double-blinded tDCS + upper extremity robot-assisted G1) tDCS + robot-assisted
G2) Sham tDCS + robot-assisted
30 min tDCS + 30 min
upper extremity robot-assisted
35 cm2
Anode M1 affected, cathode M1 contralateral hemisphere, 1 mA. CD = 0.035 mA/cm2
FM/ue, B&B
MAL-14
10 s, 5 s/w Immediately Post-intervention Skin redness, under the site of stimulation (5/1)
Headache (1/1)
Sleepiness (1/0)
Neck pain (0/1)
(tDCS/sham-tDCS)
Seo HG et al
(2017)3234
Pilot RCT, double-blinded tDCS + RAGT G1) tDCS + RAGT
G2) Sham + RAGT
20 min de tDCS + 45 min RAGT 35 cm2
Anode: M1 (leg area) affected. Cathode: contralateral SO
2 mA. CD = 0.07 mA/cm2
FAC, 10MWT, 6MWT, BBS, FMA-LE, MRC
EMG activity: MEP
10 s
5 s/w
4 weeks No mention
Mazzoleni S, et al. (2017)3335 RCT Single blind tDCS + wrist RT G1) tDCS + robot-aided
G2) Sham + robot aided
20 min tDCS online + 30 min
RT
35 cm2
Anode: M1 (hand area) affected. Cathode contralateral orbit
2 mA. CD = 0.07 mA/cm2
(FM/ue, FM/w), MAS, MI, B&B
Kinematic data
30 s
5 s/w
Immediately Post-intervention No adverse events reported
Dehem et al. (2018)3436 RCT Double blind crossover robot upper limb + real tDCS G1) robot upper limb + real tDCS
G2) robot upper limb + Sham tDCS
20 min
tDCS/sham online + RT
35 cm2
Anode M1 affected,
Cathode M1 unaffected
1 mA. CD = 0.035 mA/cm2
B&B, PPT
Upper limb kinematics
2 s
1 s/w
Immediately Post-intervention No adverse events reported
Edwards et al. (2019)3537 RCT Double blind tDCS + Robot G1)Sham + Robot
G2) tDCS + Robot
20 min tDCS/sham + 1 h RT 35 cm2
Anode M1 affected (5 cm lateral to the vertex)
Cathode: contralateral SO
2 mA. CD = 0.07 mA/cm2
FM/ue, Wolf Motor Function Test, BI, MRC, SIS, EMG activity: MEP 36 s
3 s/w
6 months Headache, burning sensation, sleepiness, tingling, redness, trouble concentrating
Mazzoleni et al. (2019)3638 RCT Single blind tDCS + wrist robot-assisted training G1) Sham + robot
G2) tDCS + robot
20 min tDCS/sham online + 30 min
wrist robot-assisted training
35 cm2
Anode: M1 affected
Cathode: contralateral orbit bone
2 mA. CD = 0.07 mA/cm2
FM/ue, FM/w MAS/w, MI, B&B. Wrist kinematic parameters 30 s
5 s/w
Immediately
Post-intervention
No adverse event reported
  1. Randomized controlled trial (RCT). Robot-assisted gait training (RAGT). Transcranial direct current stimulation (tDCS). Group (G). Supraorbital (SO). 6-min walk test (6MWT). 10 min walking test (10MWT). Spatiotemporal gait parameters (SGP). Motricity Index (MI). Modified Ashworth scale (MAS). Fugl-Meyer assessment scale for upper extremities (FM/ue). Barthel Index (BI). Box & block test (B&B). Medical Research Council sum score (MRC). Timed up-and-go test (TUG test). Berg balance scale (BBS). Functional ambulation category (FAC). Stroke impact scale 16 (SIS-16). Robot therapy (RT). Motor activity log 14 items (MAL-14). Action research arm test (ARAT). Motor activity log-28 (MAL-28). Milliamps (mA). Fugl-Meyer assessment scale for wrist (FM/w). Purdue pegboard test (PPT). Electromyography (EMG). Motor-Evoked Potentials (MEP). Modified Ashworth scale on the wrist (MAS/w)