This study investigated whether the sequential and concurrent combination of transcranial direct current stimulation (tDCS) and mirror therapy (MT) engenders greater benefits than MT alone in stroke patients.

Thirty patients with stroke were randomized into one of the three groups: sequentially applying tDCS and MT group (SEQ), concurrently applying tDCS with MT group (CON), and MT with sham tDCS group (SHAM). The interventions were carried out 90minutes per day, 5 days per week, for 4 weeks. Motor control was evaluated using kinematic variables of a reaching movement. Motor performance was measured by the Fugl–Meyer Assessment (FMA), and the daily function was assessed by the functional independence measure (FIM).

A significant group difference was found in motor control. The post-hoc analysis demonstrated that the CON group had smoother reaching trajectories in the reaching task than the SHAM group. No significant differences were noted in motor performance and daily function among groups. However, within-group comparisons of the SEQ and the CON group revealed significant improvements in the motor function of the proximal and distal upper extremity after the interventions, but not in the SHAM group. Similarly, the CON group increased the functional independence in the domain of social cognition after the interventions, but no significant improvement was noted in the SHAM group.

Applying tDCS with MT exerted significant effects on the motor control strategy in stroke patients. Future studies using large sample size are warranted to identify possible effects of the combination of tDCS and MT on motor performance and daily function.