IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-8-6-19440 Original Research Paper Optimizing Hand Function with simultaneous application of Bihemispheric Transcranial direct current stimulation (tDCS) and Therapist Assisted sensorymotor task specific Training (TASTT) in subacute stroke survivors –Single Case Report Midha Dr. June 2019 8 6 01 02 ABSTRACT

Individuals across every age, race or socioeconomic background are affected with stroke which is more prevalent in women than men.(1) Stroke is the third leading cause of mortality worldwide and can cause significant disability, such as paralysis, speech difficulties, and emotional problems.(2) A great percentile o stroke survivors land up into severe consequences as a result of persistent disability, who require more effective therapeutic strategies. The role of a physiotherapist is very crucial with respect to the rehabilitation point of view especially in the initial months in which there is maximum potential for recovery. However after which, this potential declines.(3) A fully Functioned hand is vitally important for quality of everyday life. The acquisition of hand motor skills following stroke depends upon the cortical synchrony and the integrity of iplsilesional and contralesional motor circuits in the cerebral hemispheres.(4) Stroke survivors can partially recover their motor function control from rehabilitation that involves task–specific and repetitive motor exercises. (3) Advances in brain–computer interface (BCI) technology have enabled stroke survivors to interact with the environment using their brain signals. Since, Brain is an electrical organ and expends considerable energy maintaining a specific cellular resting potential. Not surprisingly therefore electrical intervention have potential to modify brain function to improve outcomes after stroke (5) Hand repertoire exercises as the part of neurorehabilitation leads to partial recovery. Cortical motor map reorganization as a result of skilled arm and hand training suggests that neuroplasticity mechanisms are involved in motor learning . The challenge for improving stroke recovery is to understand how to optimally engage and modify surviving neuronal networks, to provide new response strategies that compensate for the loss due to injury in the brain. In general best recoveries are associated with greatest return towards normal state of brain functional organization, reorganization of central nervous system. Thus Enhancing stroke recovery by facilitating brain plasticity with the direct application of a physical modality to the cerebral cortex was the key motive for conducting the present study.