Non-invasive Neuromodulation NESA Application in the Rehabilitation of Stroke Sequelae

Primary outcomes

1. Change in Pain assessed by VAS

   Time frame: Up to 7 weeks

   The instrument will be used to measure the change of pain before and after the intervention will be the Visual Analogue Scale (VAS).

   Participants will be asked to mark the level of their pain on a 100 mm, no hatched VAS scale marked at one end as "no pain" and at the other as "worst pain imaginable".

2. Change in Sleep quality

   Time frame: Up to 7 weeks

   The Pittsburgh Sleep Quality Index (PSQI) will be used. It consists of 19 self-administered questions and 5 questions assessed by the patient's partner or roommate (if available). Only the self-administered questions are included in the score.

   The higher the total score, the worse the sleep quality. Thus, a total score less than or equal to five on the Pittsburgh scale indicates that, in general, your sleep quality is optimal, while a total score greater than five suggests that you have sleep problems, of greater or lesser severity.

3. Changes in quality of life

   Time frame: Up to 7 weeks

   The Stroke-specific quality of life scale ( ECVI-38) is a specific scale for stroke patients. This instrument includes 38 items divided into eight subgroups: physical status, communication, cognition, emotions, feelings, basic activities of daily living, common activities of daily living and socio-familial functioning.

   The format presents five response possibilities: 5 represents the worst situation and 1 represents the absence of the problem.

4. Changes in the level of autonomy

   Time frame: Up to 7 weeks

   The Barthel index for the level of independence in performing activities of daily living.

   The purpose of this questionnaire is to assign a score to each patient based on his or her degree of dependence in performing a series of basic activities. The values assigned to each activity depend on the time taken to perform them and the need for aids to complete them.

   activity of daily living include: eating, transferring between chair and bed, personal grooming, toileting, bathing/showering, transferring, going up/down stairs, dressing/dressing, stool control and urine control.

   The activities are assessed by assigning a score between 0, 5, 10 and 15 points and the final result can vary between 0 (completely dependent) and 100 points (completely independent).

5. Changes in their ability to balance

   Time frame: Up to 7 weeks

   The Berg balance scale will be used:

   A quantitative measure of functional balance status in the elderly that has proven to be a valid, reliable and sensitive tool in hemiplegic patients.

   The Berg scale includes 14 items (scored between 0-4) and total scores range from 0 (severe balance impairment) to 56 (optimal balance status).

6. Changes in muscle tone

   Time frame: Up to 7 weeks

   The modified Ashworth scale for spasticity will be used. A scale used in the clinic to assess muscle spasticity, the modification adds a level that incorporates the angle at which resistance appears and monitors the speed of passive movement with a one-second count.

   This scale is easy to use and can assess all joints, has a high degree of reliability and reproducibility. The score is interpreted as follows:

   0 No increase in tone

   1 slight increase in tone giving a catch when slight increase in muscle tone, manifested by the limb was moved in flexion or extension.

   1+ slight increase in muscle tone, manifested by a catch followed by minimal resistance throughout (ROM )

   2 more marked increase in tone but more marked increased in muscle tone through most limb easily flexed

   3 considerable increase in tone, passive movement difficult

   4 limb rigid in flexion or extension