Combined effect of hydrotherapy and transcranial direct-current stimulation on children with cerebral palsy

Abstract

Background: Cerebral palsy (CP) is a neurodevelopmental disorder caused by a brain injury resulting in poor coordination and motor control deficits, which is one of the most common physical disabilities in children. CP brings a heavy burden on families and society and becomes a significant public health issue. In recent years, hydrotherapy, and transcranial direct current stimulation (tDCS) as a physical therapy for CP is developing rapidly. When hydrotherapy and tDCS are used to treat separately, it has positive therapeutic effect in children with CP. The development of new therapies in combination with physical rehabilitation approaches is critical to optimize functional outcomes. tDCS has attracted interest in this context, because of significant functional improvements have been demonstrated in individuals with brain injuries after a short period of cerebral stimulation. Since the onset of this work, tDCS has been used in combination with constraint-induced therapy, virtual reality therapy to potentiate the treatment effect. Up to now, there are no studies on the effect of a combined application of hydrotherapy and tDCS in children with CP. We will conduct a 2-arm parallel clinical trial to investigate the effect of a combined application of tDCS and hydrotherapy. Methods and analysis: This study is an outcome assessor and data analyst-blinded, randomized, controlled superiority trial during the period from October 2021 to December 2023. CP patients meeting the inclusion criteria will be allocated in a 1:1 ratio into the treatment group (hydrotherapy plus tDCS), or the control group (treatment as usual). All participants will receive 30 sessions of treatment over 10 weeks. The primary outcomes will be the difference in the Gross Motor Function Assessment and Pediatric Balance Scale during rest and activity. The secondary outcomes will be the difference in adverse effects between the control and treatment groups. Conclusions: This study aims to estimate the efficacy of a combined application of tDCS and hydrotherapy in patients with CP. Trial Registration: This study protocol was registered in Chinese ClinicalTrials.gov, ID: ChiCTR2100047946.

Hydrotheraphy terhadap Spastik Otot Anak Cerebral Palsy di Sekolah Luar Biasa

“…Menurut data statistik di China pada tahun 2018, terdapat sekitar 5,3 juta pasien dengan Cerebral Palsy, dan data tersebut meningkat sekitar 50.000 per tahun. Laporan investigasi anak-anak dengan Cerebral palsy di 12 provinsi di Cina menunjukkan bahwa kejadian Cerebral palsy pada anakanak berusia 1 hingga 6 tahun adalah 2,48‰, dan jenis Cerebral palsy yang paling umum adalah Cerebral palsy spastik, yaitu 58,86% anak-anak dengan Cerebral palsy (Chen et al, 2021).…”

“…Therapy dimaksudkan untuk membantu anak-anak dengan Cerebral Palsy untuk memaksimalkan kemampuan berupa kemandirian dan kesehatan fisik mereka, serta meminimalkan dampak cedera fisik yang lebih lanjut. Pengobatan rehabilitasi Cerebral Palsy terutama didasarkan pada latihan Phisiotheraphy, yang meliputi terapi olahraga, hidroterapi, terapi okupasi, dan tDCS (Chen et al, 2021).…”

“…Berdasarkan literatur, secara luas hydrotherapy dapat digunakan untuk meningkatkan kekebalan, memulihkan rasa sakit, fungsi kardiovaskular dan pernapasan dan mengatasi kelelahan, obesitas, stres dan kecemasan (Bairaktaridou et al, 2021). Tinjauan sistematis lain yang diterbitkan pada tahun 2021 menunjukkan bahwa hidroterapi dapat membantu meningkatkan fungsi motorik dan aktivitas anak-anak dan remaja dengan CP, dan dapat meningkatkan kualitas hidup mereka, yang mencakup 9 uji coba terkontrol secara acak (RCT) (Chen et al, 2021).…”