Cochrane · systematic review · CD009645
Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke
Elsner, B, Kugler, J, Pohl, M, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
17
No studies
9
Included studies
NR
No studies 9 · 34.6%Ungraded 0 · 0%Very low 1 · 3.8%Low 4 · 15.4%Moderate 11 · 42.3%High 1 · 3.8%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlytDCS versus any type of placebo or passive control intervention for improving activities of daily living, and physical and cognitive functioning at the end of intervention period, in people after stroke
Population: people with stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome measure: mean ADL at the end of the intervention periodMeasures of activities of daily living. Scale from: 0 to infinity. tDCS vs any type of placebo or passive control intervention | no estimate extracted | 19 studies · 686 participants | Moderate |
Secondary outcome measure: mean upper extremity function at the end of the intervention periodClinical measures of upper extremity function. Scale from: 0 to infinity. tDCS vs any type of placebo or passive control intervention | no estimate extracted | 24 studies · 792 participants | Moderate |
Secondary outcome measure: mean lower extremity function at the end of the intervention period Clinical measures of lower extremity function. Scale from: 0 to infinity. tDCS vs any type of placebo or passive control intervention | no estimate extracted | 8 studies · 204 participants | Moderate Downgraded: imprecision |
Secondary outcome measure: mean muscle strength at the end of the intervention period Clinical measures of muscle strength. Scale from: 0 to infinity. tDCS vs any type of placebo or passive control intervention | no estimate extracted | 13 studies · 437 participants | High |
Secondary outcome measure: mean cognitive abilities at the end of the intervention period Clinical measures of cognitive abilities. Scale from: 0 to infinity. tDCS vs any type of placebo or passive control intervention | no estimate extracted | 2 studies · 56 participants | Low Downgraded: imprecision, publication bias |
Secondary outcome measure: mean hemispatial neglect at the end of intervention period tDCS vs any type of placebo or passive control intervention | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Secondary outcome measure: dropouts, adverse events and deaths during the intervention periodNumber of adverse events, dropouts and deaths during the intervention period tDCS vs any type of placebo or passive control intervention | RR 1.25 [0.74, 2.13] | 47 studies · 1330 participants | Moderate |
tDCS versus any type of active control intervention for improving activities of daily living, and physical and cognitive functioning at the end of intervention period, in people after stroke
Population: people with stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome measure: mean ADL at the end of the intervention periodBarthel Index. Scale from: 0 to 100. tDCS vs any type of active control intervention | no estimate extracted | 3 studies · 121 participants | Low Downgraded: risk of bias, imprecision |
Secondary outcome measure: mean upper extremity function at the end of the intervention periodClinical measures of upper extremity function. Scale from: 0 to infinity. tDCS vs any type of active control intervention | no estimate extracted | 5 studies · 124 participants | Low Downgraded: risk of bias, imprecision |
Secondary outcome measure: mean lower extremity function at the end of the intervention period tDCS vs any type of active control intervention | no estimate extracted | 3 studies · 66 participants | Moderate Downgraded: imprecision |
Secondary outcome measure: mean muscle strength at the end of the intervention period tDCS vs any type of active control intervention | no estimate extracted | 2 studies · 57 participants | Low Downgraded: risk of bias, imprecision |
Secondary outcome measure: cognitive abilities at the end of the intervention period tDCS vs any type of active control intervention | no estimate extracted | NR | No studies |
Secondary outcome measure: spatial neglect at the end of the intervention period tDCS vs any type of active control intervention | no estimate extracted | 1 study · 12 participants | Moderate Downgraded: imprecision |
Secondary outcome measure: dropouts, adverse events and deaths during the intervention periodAdverse events, dropouts and deaths during the intervention period tDCS vs any type of active control intervention | RR 1.76 [0.43, 7.17] | 7 studies · 209 participants | Moderate Downgraded: imprecision |
tDCS versus any type of placebo or passive control intervention for improving activities of daily living, and physical and cognitive functioning at the end of follow‐up, in people after stroke
Population: patients with improving activities of daily living, and physical and cognitive functioning at the end of follow‐up, in people after stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome measure: mean ADL until the end of tDCS vs any type of placebo or passive control intervention | no estimate extracted | 6 studies · 269 participants | Moderate Downgraded: imprecision |
Secondary outcome measure: mean upper extremity function to the end of tDCS vs any type of placebo or passive control intervention | no estimate extracted | 5 studies · 211 participants | Moderate Downgraded: imprecision |
Secondary outcome measure: lower extremity function to the end of tDCS vs any type of placebo or passive control intervention | no estimate extracted | NR | No studies |
Secondary outcome measure: mean muscle strength at the end of tDCS vs any type of placebo or passive control intervention | no estimate extracted | 3 studies · 156 participants | Moderate Downgraded: imprecision |
Secondary outcome measure: cognitive abilities at the end of tDCS vs any type of placebo or passive control intervention | no estimate extracted | NR | No studies |
Secondary outcome measure: hemispatial neglect at the end of tDCS vs any type of placebo or passive control intervention | no estimate extracted | NR | No studies |
tDCS versus any type of active control intervention for improving activities of daily living, and physical and cognitive functioning at the end of follow‐up, in people after stroke
Population: people with stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome measure: mean ADL at the end of tDCS vs any type of active control intervention | no estimate extracted | NR | No studies |
Secondary outcome measure: mean upper extremity function to the end of tDCS vs any type of active control intervention | no estimate extracted | 1 study · 32 participants | Moderate Downgraded: imprecision |
Secondary outcome measure: lower extremity function at the end of tDCS vs any type of active control intervention | no estimate extracted | NR | No studies |
Secondary outcome measure: muscle strength at the end of tDCS vs any type of active control intervention | no estimate extracted | NR | No studies |
Secondary outcome measure: cognitive abilities at the end of tDCS vs any type of active control intervention | no estimate extracted | NR | No studies |
Secondary outcome measure: hemispatial neglect at the end of tDCS vs any type of active control intervention | no estimate extracted | NR | No studies |
tDCS versus any type of placebo or passive control intervention for improving function, and activities of daily living, cognitive abilities and neglect in people after stroke
Population: people with improving function, and activities of daily living, cognitive abilities and neglect after stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome measure: ADLs at the end of the intervention period ‐ absolute values Measures of activities of daily living. Scale from: 0 to infinity tDCS vs any type of placebo or passive control intervention | no estimate extracted | 9 studies · 396 participants | Moderate Downgraded: risk of bias |
Primary outcome measure: ADLs at the end of the intervention period ‐ change scores Measures of activities of daily living. Scale from: 0 to infinity. tDCS vs any type of placebo or passive control intervention | no estimate extracted | 1 study · 11 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome measure: ADLs until the end of tDCS vs any type of placebo or passive control intervention | no estimate extracted | 6 studies · 269 participants | Moderate Downgraded: risk of bias |
Secondary outcome measure: upper extremity function at the end of the intervention period ‐ absolute values Clinical measures of upper extremity function. Scale from: 0 to infinity tDCS vs any type of placebo or passive control intervention | no estimate extracted | 12 studies · 431 participants | Low Downgraded: risk of bias |
Secondary outcome measure: upper extremity function at the end of the intervention period ‐ change scores Clinical measures of upper extremity function. Scale from: 0 to infinity tDCS vs any type of placebo or passive control intervention | no estimate extracted | 4 studies · 53 participants | Low Downgraded: risk of bias |
Secondary outcome measure: upper extremity function to the end of tDCS vs any type of placebo or passive control intervention | no estimate extracted | 4 studies · 187 participants | Low Downgraded: imprecision |
Secondary outcome measure: dropouts, adverse events and deaths during the intervention period Number of adverse events, dropouts and deaths during the intervention period tDCS vs any type of placebo or passive control intervention | no estimate extracted | 23 studies · 664 participants | Low Downgraded: risk of bias |
tDCS versus any type of active control intervention for improving function, activities of daily living, cognitive abilities and neglect in people after stroke
Population: people with improving function, activities of daily living, cognitive abilities and neglect after stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome measure: ADLs at the end of the intervention period, absolute values Measures of activities of daily living. Scale from: 0 to 100 tDCS vs any type of active control intervention | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision |
Secondary outcome measure: upper extremity function at the end of the intervention period Clinical measures of upper extremity function. Scale from: 0 to 66 tDCS vs any type of active control intervention | no estimate extracted | 1 study · 20 participants | Low Downgraded: risk of bias, imprecision |
Secondary outcome measure: lower extremity function at the end of the intervention period Clinical measures of lower extremity function. Scale from: 0 to 34 tDCS vs any type of active control intervention | no estimate extracted | 1 study · 20 participants | Low Downgraded: risk of bias, imprecision |
Secondary outcome measure: dropouts, adverse events and deaths during the intervention period Adverse events, dropouts and deaths during the intervention period tDCS vs any type of active control intervention | no estimate extracted | 2 studies · 70 participants | Ungraded |
Transcranial direct current stimulation (tDCS) for function and activities of daily living (ADLs) in patients after stroke
Population: patients with function and activities of daily living (ADLs) after stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Generic activities of daily living at the end of the intervention phase, absolute values Barthel Index | no estimate extracted | 6 studies · 435 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Generic activities of daily living until the end of | no estimate extracted | 3 studies · 99 participants | Low Downgraded: risk of bias |
Upper extremity function as measured by Fugl‐Meyer Score (UE‐FM) at the end of the intervention phase Upper Extremity Fugl‐Meyer Assessment | no estimate extracted | 6 studies · 302 participants | Low Downgraded: risk of bias |
Upper extremity function as measured by Fugl‐Meyer Score (UE‐FM) to the end of | no estimate extracted | 2 studies · 68 participants | Very low Downgraded: risk of bias |
Dropouts, adverse events and deaths during intervention phase Numbers of dropouts, adverse events and deaths from all causes | no estimate extracted | 11 studies · 427 participants | High |