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NeuroRehabilitation. 2015, 37:181-91. 10.3233\/NRE-151251","journal-title":"NeuroRehabilitation"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-141065","article-title":"Effects of the addition of transcranial direct current stimulation to virtual reality therapy after stroke: a pilot randomized controlled trial","volume":"34","author":"Viana RT","year":"2014","unstructured":"Viana RT, Laurentino GE, Souza RJ, et al.. Effects of the addition of transcranial direct current stimulation to virtual reality therapy after stroke: a pilot randomized controlled trial. NeuroRehabilitation. 2014, 34:437-46. 10.3233\/NRE-141065","journal-title":"NeuroRehabilitation"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2012.07.022","article-title":"Effects on decreasing upper-limb poststroke muscle tone using transcranial direct current stimulation: a randomized sham-controlled study","volume":"94","author":"Wu D","year":"2013","unstructured":"Wu D, Qian L, Zorowitz RD, Zhang L, Qu Y, Yuan Y. Effects on decreasing upper-limb poststroke muscle tone using transcranial direct current stimulation: a randomized sham-controlled study. 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J Physiol. 2000, 527 Pt 3:633-9. 10.1111\/j.1469-7793.2000.t01-1-00633.x","journal-title":"J Physiol"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.162","article-title":"Modulation of brain plasticity in stroke: a novel model for neurorehabilitation","volume":"10","author":"Di Pino G","year":"2014","unstructured":"Di Pino G, Pellegrino G, Assenza G, et al.. Modulation of brain plasticity in stroke: a novel model for neurorehabilitation. Nat Rev Neurol. 2014, 10:597-608. 10.1038\/nrneurol.2014.162","journal-title":"Nat Rev Neurol"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.1177\/1073858413491147","article-title":"Cortical reorganization after stroke: how much and how functional?","volume":"20","author":"Grefkes C","year":"2014","unstructured":"Grefkes C, Ward NS. Cortical reorganization after stroke: how much and how functional?. Neuroscientist. 2014, 20:56-70. 10.1177\/1073858413491147","journal-title":"Neuroscientist"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awl333","article-title":"Functional potential in chronic stroke patients depends on corticospinal tract integrity","volume":"130","author":"Stinear CM","year":"2007","unstructured":"Stinear CM, Barber PA, Smale PR, Coxon JP, Fleming MK, Byblow WD. Functional potential in chronic stroke patients depends on corticospinal tract integrity. Brain. 2007, 130:170-80. 10.1093\/brain\/awl333","journal-title":"Brain"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009645.pub4","article-title":"Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke","volume":"11","author":"Elsner B","year":"2020","unstructured":"Elsner B, Kugler J, Pohl M, Mehrholz J. 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