Effectiveness of using reward strategies combined with transcranial direct current stimulation(RstDCS) on motivation in chronic stroke patients with upper limb disorders:study protocol for a randomized controlled trial

Abstract

Abstract: Introduction Stroke survivors tend to have low motivation for rehabilitation, which prevent them from completing the rehabilitation training task effectively and participating in daily activities. Reward strategies can stimulate patients' motivation for rehabilitation, but the duration of their effect is unknown. tDCS is a technique capable of promoting plastic changes and functional reorganization of cortical functional areas.When it acts on dlPFC, it can improve the functional connectivity of brain areas associated with goal-directed behavior. Reward strategies combined with tDCS(RstDCS)have been shown to make normal individuals work harder at performing tasks. However, there are no studies on whether this combined strategy improves motivation in stroke patients and whether it has a long-lasting effect on motivation maintenance. Methods and analysis 87 stroke survivors who have low motivation and upper extremity dysfunction will be randomized to receive conventional, Rs, or RstDCS treatment. Patients in each group will undertake 15 sessions of tDCS real or sham stimulation of the left dlPFC for 3 weeks in conjunction with conventional rehabilitation or reward strategy training. Following this, the RS treatment group and RstDCS treatment group will be given a 3-week outpatient self-monitoring training program, while the conventional group will be given home rehabilitation instruction prior to discharge. Rehabilitation motivation is the primary outcome measure and will be assessed using RMS. RMS,FMA, FIM and ICF activity and social engagement scale will be compared at baseline, 3 weeks, 6 weeks, and 3 months after enrollment. Ethics and dissemination The study has been approved by the Ethics Committee of Yueyang Hospital of Integrated Chinese and Western Medicine Affiliated to SHUTCM (2021-122). All participating patients will provide written informed consent. The results will be disseminated through (open access) peer-reviewed publications, networks of scientists, professionals, and the public. Trial registration number: ChiCTR2300069068 Keywords: Stroke,Rehabilitation medicine,Social cognition,Patient-centered care,Electric Stimulation Therapy

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

ChiCTR2300069068

Funding Statement

This project was funded by the Key project of the National Ministry of Science and Technology "Neuroregulation and limb movement synergistic Enhancement rehabilitation Technology Research" (2020YFC2004202).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

the Ethics Committee of Yueyang Hospital of Integrated Chinese and Western Medicine Affiliated to SHUTCM gave ethical approval for this work

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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