{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T03:37:23Z","timestamp":1785814643957,"version":"3.56.0"},"reference-count":62,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background: Transcranial direct current stimulation (tDCS) and functional electrical stimulation (FES) are established interventions to enhance upper limb motor function (ULMF) in people with stroke (PwS). However, evidence supporting their combined use remains limited and inconsistent. This systematic review aims to evaluate the effectiveness of combined tDCS and FES for improving ULMF, activity, and participation in PwS. Methods: A systematic search was conducted across MEDLINE, CINAHL, SPORTDiscus, CENTRAL, SCOPUS, and Web of Science from inception to December 2024. Randomized and controlled clinical trials (RCTs) involving adults (\u226518 years) with acute, subacute, or chronic stroke undergoing combined tDCS and FES interventions were included. Methodological quality was assessed with the PEDro scale, and risk of bias was evaluated using the Cochrane RoB2 tool. A qualitative synthesis was performed employing a five-level evidence grading system. Results: Five RCTs involving 148 participants (mean age range: 50.6\u201361.2 years; 26% female) were included. Stroke chronicity ranged from 7.6 days to 27.5 months post-onset. Four studies reported significant ULMF improvements with the combined intervention. However, activity and participation outcomes were inconsistently assessed, and results remained inconclusive. Methodological quality varied, with one study rated as excellent, two as good, one as fair, and one as poor. The risk of bias was rated high or with concerns in four out of five studies. Conclusions: Based on qualitative synthesis, moderate-level evidence supports the combined use of tDCS and FES for improving ULMF in PwS. However, high variability in protocols, small sample sizes, and the increased risk of bias in most studies limit the strength of these conclusions. Standardized protocols and larger high-quality RCTs are needed to confirm the effectiveness of this combined intervention.<\/jats:p>","DOI":"10.3390\/neurolint17060089","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T09:13:01Z","timestamp":1749460381000},"page":"89","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Combined Transcranial Direct Current Stimulation and Functional Electrical Stimulation for Upper Limbs in Individuals with Stroke: A Systematic Review"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7337-8747","authenticated-orcid":false,"given":"Alfredo","family":"Ler\u00edn-Calvo","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Neurociencias Aplicadas a la Rehabilitaci\u00f3n (GINARE), 28923 Alcorc\u00f3n, Spain"},{"name":"Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Aut\u00f3noma de Madrid, Aravaca, 28023 Madrid, Spain"},{"name":"Grupo de Investigaci\u00f3n Cl\u00ednico Docente Sobre Ciencias de la Rehabilitaci\u00f3n (INDOCLIN), CSEU La Salle, UAM, Aravaca, 28023 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0557-2222","authenticated-orcid":false,"given":"Juan Jos\u00e9","family":"Fern\u00e1ndez-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Neurociencias Aplicadas a la Rehabilitaci\u00f3n (GINARE), 28923 Alcorc\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5495-8458","authenticated-orcid":false,"given":"Ra\u00fal","family":"Ferrer-Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Aut\u00f3noma de Madrid, Aravaca, 28023 Madrid, Spain"},{"name":"Grupo de Investigaci\u00f3n Cl\u00ednico Docente Sobre Ciencias de la Rehabilitaci\u00f3n (INDOCLIN), CSEU La Salle, UAM, Aravaca, 28023 Madrid, Spain"},{"name":"Centro de Salud Entrev\u00edas, Gerencia Asistencial de Atenci\u00f3n Primaria de la Comunidad de Madrid, 28023 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aitor","family":"Mart\u00edn-Odriozola","sequence":"additional","affiliation":[{"name":"Fesia Technology, 20009 Donostia-San Sebasti\u00e1n, Spain"},{"name":"Fesia Clinic, 20014 Donostia-San Sebasti\u00e1n, Spain"},{"name":"Physiology Department, University of the Basque Country (UPV\/EHU), 48940 Leioa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1177\/17474930211065917","article-title":"World Stroke Organization (WSO): Global Stroke Fact Sheet 2022","volume":"17","author":"Feigin","year":"2022","journal-title":"Int. J. Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.1212\/WNL.0000000000012781","article-title":"Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions","volume":"97","author":"Saini","year":"2021","journal-title":"Neurology"},{"key":"ref_3","unstructured":"Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, A.L., Longo, D.L., and Loscalzo, J. (2018). Harrison\u2019s Principles of Internal Medicine, McGraw-Hill Education. [20th ed.]."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1177\/15459683211028240","article-title":"Challenges of Estimating Accurate Prevalence of Arm Weakness Early After Stroke","volume":"35","author":"Simpson","year":"2021","journal-title":"Neurorehabil. Neural Repair."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.apmr.2012.11.031","article-title":"Functional Recovery of the Paretic Upper Limb after Stroke: Who Regains Hand Capacity?","volume":"94","author":"Houwink","year":"2013","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Veerbeek, J.M., Van Wegen, E., Van Peppen, R., Van Der Wees, P.J., Hendriks, E., Rietberg, M., and Kwakkel, G. (2014). What Is the Evidence for Physical Therapy Poststroke? A Systematic Review and Meta-Analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0087987"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/S1474-4422(04)00851-8","article-title":"Strategies for Stroke Rehabilitation","volume":"3","author":"Dobkin","year":"2004","journal-title":"Lancet Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1038\/nrneurol.2010.200","article-title":"Neuroplasticity in the Context of Motor Rehabilitation after Stroke","volume":"7","author":"Dimyan","year":"2011","journal-title":"Nat. Rev. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.11124\/JBISRIR-2017-003635","article-title":"The Economic Cost of Robotic Rehabilitation for Adult Stroke Patients: A Systematic Review Protocol","volume":"16","author":"Lo","year":"2018","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"ref_10","first-page":"e45873","article-title":"Adaptive Neuroplasticity in Brain Injury Recovery: Strategies and Insights","volume":"15","author":"Zotey","year":"2023","journal-title":"Cureus"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3706","DOI":"10.1161\/STROKEAHA.121.034348","article-title":"Timing and Dose of Upper Limb Motor Intervention After Stroke: A Systematic Review","volume":"52","author":"Hayward","year":"2021","journal-title":"Stroke"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Thair, H., Holloway, A.L., Newport, R., and Smith, A.D. (2017). Transcranial Direct Current Stimulation (tDCS): A Beginner\u2019s Guide for Design and Implementation. Front. Neurosci., 11.","DOI":"10.3389\/fnins.2017.00641"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.clinph.2016.10.087","article-title":"Evidence-Based Guidelines on the Therapeutic Use of Transcranial Direct Current Stimulation (tDCS)","volume":"128","author":"Lefaucheur","year":"2017","journal-title":"Clin. Neurophysiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.12786\/bn.2023.16.e18","article-title":"Clinical Practice Guideline for Stroke Rehabilitation in Korea\u2014Part 1: Rehabilitation for Motor Function (2022)","volume":"16","author":"Kim","year":"2023","journal-title":"Brain Neurorehabil."},{"key":"ref_15","first-page":"496","article-title":"The Efficacy of Transcranial Direct Current Stimulation on Upper Extremity Motor Function after Stroke: A Systematic Review and Comparative Meta-analysis of Different Stimulation Polarities","volume":"16","year":"2024","journal-title":"PMR"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s13643-017-0435-5","article-title":"Effectiveness of Upper Limb Functional Electrical Stimulation after Stroke for the Improvement of Activities of Daily Living and Motor Function: A Systematic Review and Meta-Analysis","volume":"6","author":"Eraifej","year":"2017","journal-title":"Syst. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Wolf, D.N., and Schearer, E.M. (2017, January 17\u201320). Evaluating an Open-Loop Functional Electrical Stimulation Controller for Holding the Shoulder and Elbow Configuration of a Paralyzed Arm. Proceedings of the 2017 International Conference on Rehabilitation Robotics (ICORR), London, UK.","DOI":"10.1109\/ICORR.2017.8009344"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Xie, Y., Yang, Y., Jiang, H., Duan, X.-Y., Gu, L., Qing, W., Zhang, B., and Wang, Y. (2022). Brain-Machine Interface-Based Training for Improving Upper Extremity Function after Stroke: A Meta-Analysis of Randomized Controlled Trials. Front. Neurosci., 16.","DOI":"10.3389\/fnins.2022.949575"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Khan, M.A., Fares, H., Ghayvat, H., Brunner, I.C., Puthusserypady, S., Razavi, B., Lansberg, M., Poon, A., and Meador, K.J. (2023). A Systematic Review on Functional Electrical Stimulation Based Rehabilitation Systems for Upper Limb Post-Stroke Recovery. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1272992"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12984-024-01304-1","article-title":"Brain Computer Interface Training with Motor Imagery and Functional Electrical Stimulation for Patients with Severe Upper Limb Paresis after Stroke: A Randomized Controlled Pilot Trial","volume":"21","author":"Brunner","year":"2024","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"6221","DOI":"10.4081\/ejtm.2016.6221","article-title":"Feasibility of Using Lokomat Combined with Functional Electrical Stimulation for the Rehabilitation of Foot Drop","volume":"26","author":"Laursen","year":"2016","journal-title":"Eur. J. Transl. Myol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1113\/JP278298","article-title":"Neuromuscular Electrical Stimulation-promoted Plasticity of the Human Brain","volume":"599","author":"Carson","year":"2021","journal-title":"J. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1093\/brain\/awaf099","article-title":"Combinatorial Approaches Increasing Neuronal Activity Accelerate Recovery after Spinal Cord Injury","volume":"6","author":"Chen","year":"2025","journal-title":"Brain"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1053\/apnr.2002.34181","article-title":"Popping the (PICO) Question in Research and Evidence-Based Practice","volume":"15","author":"Stone","year":"2002","journal-title":"Appl. Nurs. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A Revised Tool for Assessing Risk of Bias in Randomised Trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"363","DOI":"10.2307\/2529786","article-title":"An Application of Hierarchical Kappa-Type Statistics in the Assessment of Majority Agreement among Multiple Observers","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"529","DOI":"10.2519\/jospt.2008.2861","article-title":"Evaluation of the Scope and Quality of Systematic Reviews on Nonpharmacological Conservative Treatment for Patellofemoral Pain Syndrome","volume":"38","author":"Barton","year":"2008","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1097\/01.BRS.0000065484.95996.AF","article-title":"Updated Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group","volume":"28","author":"Furlan","year":"2003","journal-title":"Spine"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Spooren, A.I., Timmermans, A.A., and Seelen, H.A. (2012). Motor Training Programs of Arm and Hand in Patients with MS According to Different Levels of the ICF: A Systematic Review. BMC Neurol., 12.","DOI":"10.1186\/1471-2377-12-49"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Anttila, H., Autti-R\u00e4m\u00f6, I., Suoranta, J., M\u00e4kel\u00e4, M., and Malmivaara, A. (2008). Effectiveness of Physical Therapy Interventions for Children with Cerebral Palsy: A Systematic Review. BMC Pediatr., 8.","DOI":"10.1186\/1471-2431-8-14"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s12984-017-0270-x","article-title":"Markerless Motion Capture Systems as Training Device in Neurological Rehabilitation: A Systematic Review of Their Use, Application, Target Population and Efficacy","volume":"14","author":"Knippenberg","year":"2017","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_33","first-page":"323","article-title":"Effects of Concomitant Neuromuscular Electrical Stimulation during Repetitive Transcranial Magnetic Stimulation before Repetitive Facilitation Exercise on the Hemiparetic Hand","volume":"45","author":"Etoh","year":"2019","journal-title":"NeuroRehabilitation"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s00455-023-10595-w","article-title":"Effectiveness of Conventional Dysphagia Therapy (CDT), Neuromuscular Electrical Stimulation (NMES), and Transcranial Direct Current Stimulation (tDCS) in Acute Post-Stroke Dysphagia: A Comparative Evaluation","volume":"39","author":"Bengisu","year":"2024","journal-title":"Dysphagia"},{"key":"ref_35","first-page":"e79112","article-title":"Constraint-Induced Movement Therapy Combined With Anodal Transcranial Direct Current Stimulation and Peripheral Neuromuscular Electrical Stimulation in Poststroke Patients: A Retrospective Study","volume":"17","author":"Umeji","year":"2025","journal-title":"Cureus"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1159\/000444167","article-title":"Combination of Transcranial Direct Current Stimulation and Neuromuscular Electrical Stimulation Improves Gait Ability in a Patient in Chronic Stage of Stroke","volume":"8","author":"Satow","year":"2016","journal-title":"Case Rep. Neurol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Takebayashi, T., Takahashi, K., Moriwaki, M., Sakamoto, T., and Domen, K. (2017). Improvement of Upper Extremity Deficit after Constraint-Induced Movement Therapy Combined with and without Preconditioning Stimulation Using Dual-Hemisphere Transcranial Direct Current Stimulation and Peripheral Neuromuscular Stimulation in Chronic Stroke Patients: A Pilot Randomized Controlled Trial. Front. Neurol., 8.","DOI":"10.3389\/fneur.2017.00568"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Shaheiwola, N., Zhang, B., Jia, J., and Zhang, D. (2018). Using tDCS as an Add-On Treatment Prior to FES Therapy in Improving Upper Limb Function in Severe Chronic Stroke Patients: A Randomized Controlled Study. Front. Hum. Neurosci., 12.","DOI":"10.3389\/fnhum.2018.00233"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"685931","DOI":"10.15406\/jnsk.2019.09.00364","article-title":"Combined Effect of Transcranial Direct Current Stimulation (tDCS) and Functional Electrical Stimulation (FES) on Upper Limb Recovery in Patients with Subacute Stroke","volume":"9","author":"Devi","year":"2019","journal-title":"J. Neurol. Stroke"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"205031212094054","DOI":"10.1177\/2050312120940546","article-title":"Feasibility of Single and Combined with Other Treatments Using Transcranial Direct Current Stimulation for Chronic Stroke: A Pilot Study","volume":"8","author":"Hyakutake","year":"2020","journal-title":"SAGE Open Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.rehab.2019.05.004","article-title":"Bi-Cephalic Transcranial Direct Current Stimulation Combined with Functional Electrical Stimulation for Upper-Limb Stroke Rehabilitation: A Double-Blind Randomized Controlled Trial","volume":"63","author":"Salazar","year":"2020","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_42","first-page":"177","article-title":"Effect of Transcranial Direct Current Stimulation Combined with a Smart Hand Joint Training Device on Hand Dysfunction in Patients with Early Stroke","volume":"60","author":"Zhao","year":"2022","journal-title":"Randomized Control. Trial"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Leonardi, M., Lee, H., Kostanjsek, N., Fornari, A., Raggi, A., Martinuzzi, A., Y\u00e1\u00f1ez, M., Almborg, A.-H., Fresk, M., and Besstrashnova, Y. (2022). 20 Years of ICF\u2014International Classification of Functioning, Disability and Health: Uses and Applications around the World. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191811321"},{"key":"ref_44","first-page":"743","article-title":"Meta-Analysis of Functional Electrical Stimulation Combined with Occupational Therapy on Post-Stroke Limb Functional Recovery and Quality of Life","volume":"53","author":"Sun","year":"2023","journal-title":"Cerebrovasc. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1177\/1747493019897843","article-title":"Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation Following Stroke. Part One: Rehabilitation and Recovery Following Stroke; 6th Edition Update 2019","volume":"15","author":"Teasell","year":"2020","journal-title":"Int. J. Stroke"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1080\/02699052.2022.2163289","article-title":"Transcranial Direct Current Stimulation (tDCS) Effects on Upper Limb Motor Function in Stroke: An Overview Review of the Systematic Reviews","volume":"37","author":"Tedla","year":"2023","journal-title":"Brain Inj."},{"key":"ref_47","first-page":"283","article-title":"Effects of Repetitive Transcranial Magnetic Stimulation Combined with Functional Electrical Stimulation on Hand Function of Stroke: A Randomized Controlled Trial","volume":"51","author":"Yang","year":"2022","journal-title":"NeuroRehabilitation"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1186\/s12984-024-01486-8","article-title":"Repetitive Peripheral Magnetic Stimulation Alone or in Combination with Repetitive Transcranial Magnetic Stimulation in Poststroke Rehabilitation: A Systematic Review and Meta-Analysis","volume":"21","author":"Wang","year":"2024","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12984-024-01341-w","article-title":"Synergistic Efficacy of Repetitive Peripheral Magnetic Stimulation on Central Intermittent Theta Burst Stimulation for Upper Limb Function in Patients with Stroke: A Double-Blinded, Randomized Controlled Trial","volume":"21","author":"Chang","year":"2024","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/1545968309349939","article-title":"Does Functional Electrical Stimulation for Foot Drop Strengthen Corticospinal Connections?","volume":"24","author":"Everaert","year":"2010","journal-title":"Neurorehabil Neural Repair."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.brs.2017.09.017","article-title":"Bilateral Extracephalic Transcranial Direct Current Stimulation Improves Endurance Performance in Healthy Individuals","volume":"11","author":"Angius","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Kristiansen, M., Thomsen, M.J., N\u00f8rgaard, J., Aaes, J., Knudsen, D., and Voigt, M. (2021). Anodal Transcranial Direct Current Stimulation Increases Corticospinal Excitability, While Performance Is Unchanged. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0254888"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1002\/ana.10848","article-title":"Influence of Interhemispheric Interactions on Motor Function in Chronic Stroke","volume":"55","author":"Murase","year":"2004","journal-title":"Ann. Neurol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1038\/nrneurol.2014.162","article-title":"Modulation of Brain Plasticity in Stroke: A Novel Model for Neurorehabilitation","volume":"10","author":"Pellegrino","year":"2014","journal-title":"Nat. Rev. Neurol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.neulet.2008.07.026","article-title":"Cortical Effect and Functional Recovery by the Electromyography-Triggered Neuromuscular Stimulation in Chronic Stroke Patients","volume":"442","author":"Shin","year":"2008","journal-title":"Neurosci. Lett."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"89","DOI":"10.2220\/biomedres.33.89","article-title":"Effect of Electrical Stimulation Therapy on Upper Extremity Functional Recovery and Cerebral Cortical Changes in Patients with Chronic Hemiplegia","volume":"33","author":"Sasaki","year":"2012","journal-title":"Biomed. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1161\/01.STR.0000149623.24906.63","article-title":"Functional Electrical Stimulation Improves Motor Recovery of the Lower Extremity and Walking Ability of Subjects With First Acute Stroke: A Randomized Placebo-Controlled Trial","volume":"36","author":"Yan","year":"2005","journal-title":"Stroke"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"5157","DOI":"10.1007\/s10072-024-07633-2","article-title":"Effects of Home-Based Neurostimulation on Outcomes after Stroke: A Systematic Review and Meta-Analysis","volume":"45","author":"Abdullahi","year":"2024","journal-title":"Neurol. Sci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1080\/09638288.2024.2334444","article-title":"Electrotherapy in Stroke Rehabilitation Can Improve Lower Limb Muscle Characteristics: A Systematic Review and Meta-Analysis","volume":"47","author":"Debeuf","year":"2024","journal-title":"Disabil. Rehabil."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.jocn.2021.06.028","article-title":"Effects of Paired Associated Stimulation with Different Stimulation Position on Motor Cortex Excitability and Upper Limb Motor Function in Patients with Cerebral Infarction","volume":"90","author":"Sui","year":"2021","journal-title":"J. Clin. Neurosci."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.clinph.2023.06.016","article-title":"Can We Manipulate Brain Connectivity? A Systematic Review of Cortico-Cortical Paired Associative Stimulation Effects","volume":"154","author":"Wang","year":"2023","journal-title":"Clin. Neurophysiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"137070","DOI":"10.1016\/j.neulet.2023.137070","article-title":"Paired Associative Stimulation on the Soleus H-Reflex Using Motor Point and Peripheral Nerve Stimulation","volume":"797","author":"Fok","year":"2023","journal-title":"Neurosci. Lett."}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/6\/89\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:48:57Z","timestamp":1760032137000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/6\/89"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,9]]},"references-count":62,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["neurolint17060089"],"URL":"https:\/\/doi.org\/10.3390\/neurolint17060089","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,9]]}}}