{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:21:16Z","timestamp":1788182476258,"version":"build-2803163510"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Stroke is a prevalent neurological disorder resulting from cerebral ischemia or hemorrhagic injury. Its pathomechanism varies based on etiology and location, leading to complications such as speech loss, impaired motor function, and cognitive decline. This study examines the innovative roles of trunk rehabilitation exercise (TRE), transcranial direct current stimulation (tDCS), and their combination on serum levels of brain-derived neurotrophic factor (BDNF) in patients with stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 69 stroke survivors were randomized into three intervention groups (IGs): TRE + control intervention (CI) (IG-I,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17), tDCS + CI (IG-II,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17), combined TRE + tDCS + CI (IG-III,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17), and a control group (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 18). The demographic analysis indicated a predominance of males aged 45\u201365 years. Serum BDNF levels were measured using an ELISA kit (SL0371Hu). Statistical analyses included factorial analysis of variance to assess the effects of the interventions on serum BDNF levels, with\n                      <jats:italic toggle=\"yes\">post hoc<\/jats:italic>\n                      Tukey\u2019s tests to identify differences between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The analysis revealed a statistically significant difference in serum BDNF levels among the groups (\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      = 9.530,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001). The combined IG exhibited the highest mean posttest serum BDNF concentration (181.80 pg\/mL), indicating that the combination of TRE and tDCS is more effective than either individual intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These findings highlight the potential of combined rehabilitation strategies to enhance neuroplasticity and recovery in stroke survivors, suggesting that integrating TRE and tDCS may offer improved therapeutic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_230_25","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T17:00:45Z","timestamp":1757955645000},"page":"1208-1215","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The Synergistic Effects of Trunk Rehabilitation Exercise and Transcranial Direct Current Stimulation on Brain-derived Neurotrophic Factor Levels in Stroke Recovery"],"prefix":"10.4103","volume":"25","author":[{"given":"Abdulkareem Muhammad","family":"Umar","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia"},{"name":"Department of Human Physiology, Federal University Dutse, Dutse, Jigawa, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Ariff","family":"Sharifudin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia"},{"name":"Medicine and Healthcare Research Cluster, Office of the Deputy Vice Chancellor (Research and Innovation), Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, 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