Neurological patients:
1. Main objective: The aim of the study is to see whether the use of tDCS stimulation
incorporated into a rehabilitation programme in post-stroke patients and patients
with spinal cord and nerve root dysfunction following neurosurgery and non-surgery
will improve upper and lower limb function.
2. Specific aim: To test whether the application of 1, 5 or 10 tDCS stimulations is
sufficient to achieve improvements in upper and lower limb function, taking into
account the dominant limb.
3. Description of the study group. The study will include women and men after stroke and spinal cord and nerve root
dysfunction admitted for rehabilitation after surgery and not qualified for surgery,
as well as healthy subjects. Study participants will be aged between 20-90 years.
Post-stroke subjects with spinal cord and nerve root dysfunction will undergo
individual rehabilitation using the PNF (Proprioceptive Neuromuscular Facilitation,
Polish for proprioceptive neuromuscular facilitation) neurophysiological method
performing upper and lower limb patterns. Rehabilitation will last between one and
three months. Inclusion criterion: impairments of upper and lower limb function.
Exclusion criterion: no written consent to participate in the study. Due to the
assessment to be carried out, participants will be divided into groups:
- - women and men after stroke with and without tDCS stimulation 1, 5 or 10
treatments,
- women and men with spinal cord and nerve root disorders after surgery with and
without tDCS stimulation 1, 5 or 10 treatments,
- women and men with spinal cord and nerve root disorders not qualified for
surgery with tDCS stimulation 1.5 or 10 treatments and without,
- healthy women and men undergoing all procedures including tDCS stimulation 1.5
or 10 without rehabilitation,
- women and healthy men undergoing all procedures without tDCS stimulation and
rehabilitation.
4. Methods used in the research:
For the purpose of the study to be conducted, the subjects will have an assessment of:
- - body weight, body height, body composition using the Tanita BC-418 MA device before
the start of the study, the subject stands barefoot on the electrodes in the shape
of the foot, in his/her hand he/she also grasps the electrodes while being only in
underwear and a measurement is taken, body composition indicators like BMI (Body
Mass Index), muscle mass, fat mass, lean body mass and water content will be
assessed, measured before the start of the study.
- - biomechanical and viscoelastic properties of the skin using the MyotonPRO: during
the measurement the subject will be in a standing position, the limbs of the subject
will be exposed, the skin of both upper limbs (arm and forearm) and lower limbs
(thigh and shank) will be assessed, on the anterior, posterior, lateral and medial
sides, measurement before and after the test,
- postural stability using the stabilometric platform Coordination, the subject will
stand on the platform barefoot only in underwear, upper limbs placed along the
torso, measurement will be done with eyes open and closed for a period of 30
seconds, measurement before and after the test,
- upper limb reaction time using the Witty SEM Microgate, taking into account the
dominant and non-dominant upper limb, the test person will stand in front of special
sensors (semaphores) which will display letters and numbers in different colours,
when ready the test person will have to find the small green letter 'a' 20 times as
fast as possible.
The total time of the test will be counted, the test person will
be advised to be in comfortable sportswear (not restricting the movement of the
upper limbs), the dominant and non-dominant limbs will be evaluated separately,
measuring before and after the test,
- - assessment of the squeezing force of the right and left limb (hand dynamometer),
test subjects will be asked to grasp the dynamometer and squeeze their hand with
maximum force within 5 seconds.
- - lower limb reaction time using the Balance Toutor MedTouch platform, the test person
will be in comfortable clothing, will be attached by a special harness to the
device's extension arm to avoid a possible fall during the test, the test time for
one person will last five minutes, the test person will walk on the device's
treadmill at a speed of 3 m/s for two minutes, in order to adapt to the walking
pace, in front of him/her on a monitor the test subject will see an image of the
path in the forest on which he/she is walking in order to divert his/her attention,
the device will then elicit a simulated fall reaction in forward, backward and
sideways taking into account the test for the dominant and non-dominant lower limb,
at the end of the test a record will be obtained for each test subject, recorded by
the device in reaction time values, the test will be performed before and after the
test,
- tDCS Sooma DUO stimulation, the subject will be subjected to neuromodulation of the
motor cortex, the treatment will be carried out in the sitting position, the subject
will wear a cap with electrodes attached to the head, the treatment time will be
20-30 minutes, the maximum direct current will be 2 mA, the number of treatments
will be 1, 5 or 10 (5 or 10 treatments daily from Monday to Friday) in the
afternoon.
Before and after the neuromodulation, tests will be carried out for the
dominant and non-dominant hand: tapping on a tablet for 30 seconds, reflex flop test
on a tablet (there will be glowing points that the subject must touch, the shorter
the time to touch all the points, the better the score) and nine-hole peg test. In
the course of neurostimulation, after 10 minutes the test person will perform mirror
therapy, i.e. The subject will then perform mirror therapy, i.e. movements of the
dominant hand controlled in the mirror image (wrist extension
- - 1 minute and 30
seconds pause, wrist flexion - 1 minute and 30 seconds pause, finger flexion and
extension - 1 minute and 30 seconds pause, fist clenching and opening - 1 minute and
30 seconds pause, finger inversion and adduction - 1 minute and 30 seconds pause,
middle finger tapping - 1 minute and 30 seconds pause, all fingers tapping - 1
minute).
Completion of questionnaires, the questionnaires used are:
- - Roland-Morris disability questionnaire, the questionnaire is completed by the
examiner before and after examinations in patients with spinal cord and nerve root
disorders,
- Barthel scale, a questionnaire to be filled in by the examiner before and after
examinations in stroke patients,
- ASIA scale classification of spinal cord injuries, questionnaire to be filled in by
the examiner before and after examinations in patients with spinal cord and nerve
root disorders.
- - Oswestry questionnaire assessment of lumbar spine pain intensity in various
activities, questionnaire to be completed by the subject before and after the study,
- Neck Disability Index questionnaire for cervical spine pain before and after the
study,
- Sexual Satisfaction Scale for Women (SSS - W - R15), assessment of satisfaction with
current sexual life as well as communication with partner and sexual adjustment,
questionnaire to be completed by the subject before and after the study,
- male sex life evaluation questionnaire IIEF-5 is filled in by the subject before and
after the study,
- Katz scale is filled in by the subject before and after the study,
- Lawton scale is filled in by the subject before and after the study,
- WHOQOL BREF quality of life questionnaire to be completed by the subject before and
after the study.
Planned procedures:
1. recruitment of study participants,
2. completion of questionnaires and scales,
3. assessment of weight, height and body composition,
4. ocean biomechanical and viscoelastic properties of the skin using MyotonPRO,
5. assessment of postural stability using the stabilometric platform Coordination,
6. upper limb reaction time using the Witty Sem Macro Gait device taking into account
the dominant and non-dominant limb,
7. middle finger tapping test,
8. squeeze strength assessment,
9. lower limb reaction time using the Balance Toutor MedTouch platform,
10. tDCS stimulation.
Gynaecology patients:
1. The aim of the study is to test the effect on pain reduction in women with
gynaecological conditions such as endometriosis, painful menstruation, dyspareunia,
polycystic ovary syndrome, who have had no treatment other than tDCS stimulation.
2. Specific objective: application of stimulation in quantities; 3 treatments, 5
treatments and 10 treatments.
3. Inclusion criterion: women with selected gynaecological conditions (endometriosis,
painful menstruation, dyspareunia, polycystic ovary syndrome) not using any
treatment other than tDCS stimulation.
Exclusion criterion: use of treatment other than tDCS stimulation, no written consent to
participate in the study.
Patients who do not consent to tDCS stimulation will be placed in the control group.
Gynaecological patients will be asked to complete anonymously standardised questionnaires
before and after stimulation, i.e. after 3 or 5 or 10.
Age of female respondents 18-70.For the purpose of the study to be conducted, the subjects will have an assessment of:
body weight, body height, body composition using the Tanita BC-418 MA device before the
start of the study, the subject stands barefoot on the electrodes in the shape of the
foot, in his/her hand he/she also grasps the electrodes while being only in underwear and
a measurement is taken, body composition indicators like BMI (Body Mass Index), muscle
mass, fat mass, lean body mass and water content will be assessed, measured before the
start of the study biomechanical and viscoelastic properties of the skin using the
MyotonPRO: during the measurement the subject will be in a standing position, the limbs
of the subject will be exposed, the skin of both upper limbs (arm and forearm) and lower
limbs (thigh and shank) will be assessed, on the anterior, posterior, lateral and medial
sides, measurement before and after the test,
Standardised questionnaires:
1. quality of life questionnaire WHOQOL-BREF.
2. women's sexual satisfaction scale SSS-W-15 and Female Sexual Function Index. 3. Oswestry questionnaire. 4. Insomnia Severity Index.
Planned procedures:
1. recruitment of study participants,
2. completion of questionnaires and scales,
3. assessment of weight, height and body composition,
4. assessment of postural stability using the stabilometric platform Coordination,
5. tDCS stimulation. Postural stability using the stabilometric platform Koordynacja,
the subject will stand on the platform barefoot in underwear only, upper limbs
placed along the torso, measurement will be taken with eyes open and closed for a
period of 30 seconds, pre- and post-test measurement, In gynaecological patients of
each stimulation is 20 minutes, current intensity to individual patient feeling, not
exceeding 2 mA. Stimulation will be performed in a seated position.
Planned use of research results It is planned to present the obtained results in the form
of publications in punctuated scientific journals and at Polish and foreign scientific
conferences/congresses/symposia. Upon completion of the research experiment, the research
participants will receive the results of the research along with their interpretation.
