Efficacy of Cranial Electrical Stimulation and Rational Emotive Behavior Therapy in Improving Psychological Illness among Chronic Stroke Survivors: A Pilot Randomized Controlled Trial

Abstract

Background: Stroke survivors suffer from significant neuropsychiatric disturbances and these disturbances act as barrier in the motor recovery. Medication is the common treatment but it has adverse effects. Hence, there is a need to find out effective treatments with or without minimal side effects for gross motor recovery of the patient.

Objectives: Cranial electrical stimulation (CES) and rational emotive behavior therapy (REBT) are used as treatment approaches for depression, anxiety, stress, and irrational beliefs in the general population. In the present study, the efficacy of two psycho-therapeutic modalities (CES and REBT) along with conventional physiotherapy management was evaluated on psychological illness, motor recovery, and quality of life among chronic stroke (CS) survivors.

Materials and methods: A total of 18 patients with CS who scored >10 on Beck Depression Inventory Scale, scored >23 on Mini-Mental state examination scale, and having stroke of duration >6 months-2 years were included in the study. They were divided into two groups, A and B. Group A received CES while Group B received REBT. Both the interventions were given 5 days in a week for 4 weeks. Conventional physiotherapy for 30 min was added to both groups as common intervention. Depression, Anxiety, Stress scale (DASS-42), Pittsburgh Sleep Quality Index (PSQI), and Shortened General Attitude and Belief Scale (SGABS) were used for measuring depression, anxiety, and stress, sleep, attitude and beliefs, respectively, 4 weeks postintervention.

Results: Patients with CS in Group A demonstrated significant improvement, P < 0.05, in Depression, Anxiety, Stress scale-24, PSQI, and MSSI when compared to those of Group B.

Conclusion: CES has the potential to improve psychological illness such as depression, anxiety, stress, attitudes, belief, and thereby quality of life among CS survivors than REBT.

Keywords: Anxiety; attitude; depression; electrical stimulation; quality of life.

Figure 1

Consolidated Standards of Reporting Trials diagram describing the study flow

Figure 2

Depression, Anxiety, Stress scale-24 for depression at baseline, 11^th day, and 21^st day postintervention between Group A and Group B

Figure 3

Depression, Anxiety, Stress scale-24 for anxiety at baseline, 11^th day, and 21^st day postintervention between Group A and Group B

Figure 4

Depression, Anxiety, Stress scale-24 for stress at baseline, 11^th day, and 21^st day postintervention between Group A and Group B

Figure 5

Pittsburgh Sleep Quality Index at baseline, 11^th day, and 21^st day postintervention between Group A and Group B

Figure 6

Shortened General Attitude and Belief Scale at baseline, 11^th day, and 21^st day postintervention between Group A and Group B