Effect of tDCS Timing on Motor Recovery in Acute Stroke Rehabilitation

The WMFT assesses upper limb motor function using timed and functional tasks. The primary outcome is the change in WMFT performance (time and/or functional score) between baseline and Day 5, comparing the three timing conditions of active tDCS (before, during, after rehabilitation).

The Wolf Motor Function Test (WMFT) will be used to assess upper-limb motor performance. The Functional Ability Scale ranges from 0 to 5, with higher scores indicating better functional movement quality. Performance Time is measured from 0 to 120 seconds, with lower times indicating better performance.

The SWMT evaluates cutaneous sensory thresholds using calibrated monofilaments. The outcome is the change in sensory detection thresholds between baseline and Day 5.

The Semmes-Weinstein Monofilament Test will be used to assess cutaneous pressure sensitivity. Monofilaments range from approximately 0.008 g to 300 g. Lower detectable force values indicate better tactile sensitivity, whereas higher detectable force values indicate worse sensory function.

The Tardieu Scale assesses spasticity by measuring muscle reaction to passive stretch at different velocities. The outcome is the change in Tardieu scores (e.g., angle of catch, quality of muscle reaction) between baseline and Day 5.

The Tardieu Spasticity Scale will be used to assess spasticity. It includes two components: (1) the Quality of Muscle Reaction score (0-4, where higher scores indicate worse spasticity), and (2) the Angle of Muscle Reaction, measured in degrees from 0° to the joint's full passive range, where higher values indicate a better outcome.

The Barthel Index measures independence in activities of daily living. The outcome is the change in total Barthel score between baseline and Day 5.

"The Barthel Index of Activities of Daily Living will be used to assess functional independence. Scores range from 0 to 100, with higher scores indicating better independence and lower scores indicating greater dependency.

The Tinetti test evaluates balance and gait performance and estimates fall risk. The outcome is the change in Tinetti total score between baseline and Day 5.

The Tinetti Assessment Tool (Performance-Oriented Mobility Assessment) will be used to evaluate balance and gait. The Balance Subscale ranges from 0 to 16 and the Gait Subscale from 0 to 12. The total score ranges from 0 to 28. In all cases, higher scores indicate better performance and lower fall risk.

The Stroke Impact Scale is a patient-reported questionnaire assessing multiple domains affected by stroke (e.g., physical function, emotion, participation). The outcome is the change in SIS scores between baseline and Day 5.

The Stroke Impact Scale (Version 3.0) will be used to assess patient-reported impact of stroke across multiple functional domains. Items are scored from 1 to 5, with higher scores indicating better perceived function. Domain scores are transformed to a 0-100 scale, where higher values indicate better outcomes.

The HADS evaluates symptoms of anxiety and depression using a 14-item questionnaire. The outcome is the change in anxiety and depression subscale scores between baseline and Day 5.

"The Hospital Anxiety and Depression Scale will be used to assess symptoms of anxiety and depression. Each subscale ranges from 0 to 21, with higher scores indicating worse symptoms. The optional total score ranges from 0 to 42, with higher values indicating greater emotional distress.

Number, type, and severity of adverse events potentially related to tDCS (e.g., headache, skin irritation, discomfort, dizziness) recorded at each session using standardized questioning and observation.