Background: One of the most disabling problems in Parkinson disease (PD) is gait impairment. Noninvasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS), have been introduced as a therapeutic alternative for coping with PD motor problems. However, the effects of tDCS on gait performance in PD have not yet been fully established. Therefore, the main objective of this study was to evaluate whether a single session of tDCS modifies gait kinematics in individuals with PD. Methods: Twenty-one individuals with PD were included in this randomized, double-blinded, sham-controlled design study. They were randomly allocated in one real (N = 8) or sham (N = 9) tDCS group. Real tDCS comprises a 2-mA anodic current applied over 15 minutes in the supplementary motor area and medial areas of the primary motor cortices through a bipolar electrode montage. Gait kinematics and the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) were assessed before and immediately after a single stimulation session. Pre- minus poststimulation (Δ) values were computed and compared through a Mann-Whitney test. Data are shown as the median (lower, upper quartile). Results: There was a significant group difference with a large effect size for Δ values of gait cadence (P = .014, d = 0.87), indicating its reduction after anodic stimulation in the real (−0.28 [−1.16, 0.01] steps/s) compared with sham tDCS group (0.17 [0.00, 0.40] steps/s). No other significant effect was found. Conclusion: The findings of this study suggest that anodic tDCS administered in a single session improves gait cadence in PD individuals.
Background and Purpose The motor impairments related to gait and balance have a huge impact on the life of individuals with spinocerebellar ataxia (SCA). Here, the aim was to assess the possibility of retraining gait, improving cardiopulmonary capacity, and challenging balance during gait in SCA using a partial body weight support (BWS) and a treadmill. Also, the effects of this training over functionality and quality of life were investigated. Methods Eight SCA patients were engaged in the first stage of the study that focused on gait training and cardiovascular conditioning. From those, five took part in a second stage of the study centered on dynamic balance training during gait. The first and second stages lasted 8 and 10 weeks, respectively, both comprising sessions of 50 min (2 times per week). Results The results showed that gait training using partial BWS significantly increased gait performance, treadmill inclination, duration of exercise, and cardiopulmonary capacity in individuals with SCA. After the second stage, balance improvements were also found. Conclusion Combining gait training and challenging tasks to the postural control system in SCA individuals is viable, well tolerated by patients with SCA, and resulted in changes in capacity for walking and balance.
[Purpose] Spinocerebellar ataxia consists of a group of autosomal dominant disorders that cause progressive degeneration, mainly in the cerebellum and its connections. Falls, which are a significant concern of this condition, reduce patients’ mobility, deteriorate their health and have physical and social consequences. The aim of this study was to test the effectiveness of a modified protocol for improving balance and diminishing the fall risk of spinocerebellar ataxia patients exclusively. [Subjects and Methods] Exercises aiming to improve static and dynamic balance, whole body movements, measures to prevent falls and falling strategies were performed twice per week for four weeks by 11 spinocerebellar ataxia patients. Balance was evaluated using the Berg Balance Scale. [Results] The results show that there was a significant increase in Berg Balance Scale scores after the interventions (Wilcoxon p=0.0034). [Conclusion] This study demonstrated that the modified protocol is effective at reducing the fall risk of spinocerebellar ataxia patients. This protocol may be a useful option for appropriately coping with falls caused by spinocerebellar ataxia.
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