Does transcranial direct current stimulation plus concurrent activity lessen dual task cost in people with Parkinson’s disease?

Criminger, Christina; Swank, Chad; Mehta, Jyutika

doi:10.1016/j.brs.2017.01.202

Cited by 1 publication

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“…Among 25 studies included in the systematic review, four of which [ 41 – 44 ] included more than one comparison. Seventeen trials used real tDCS compared with sham tDCS [ 41 – 54 ], and another fourteen trials compared real tDCS plus other rehabilitative therapies with sham tDCS plus other rehabilitation therapies, such as gait training [ 41 , 55 – 57 ], physical therapy [ 58 – 60 ], repetitive transcranial magnetic stimulation (rTMS) [ 61 , 62 ], aerobic exercise [ 63 ], dual-task [ 51 , 64 ], visual cueing [ 65 ], and biking and Wii games [ 42 ]. In the studies that combined two interventions, the participants received tDCS protocols either simultaneously with or before with other therapies.…”

Section: Resultsmentioning

confidence: 99%

Effects of transcranial direct current stimulation alone and in combination with rehabilitation therapies on gait and balance among individuals with Parkinson’s disease: a systematic review and meta-analysis

Nguyen,

Mai,

Chang

et al. 2024

J NeuroEngineering Rehabil

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Background Parkinson’s disease (PD) is a neurogenerative disorder implicated in dysfunctions of motor functions, particularly gait and balance. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation offered as a potential adjuvant therapy for PD. This systematic review and meta-analysis were conducted to identify whether tDCS alone and combined with additional rehabilitation therapies improve gait and balance among individuals with PD. Methods We searched PubMed, Embase, Web of Science, and relevant databases for eligible studies from inception to December 2022. Studies with a comparative design investigating the effects of tDCS on motor functions, including gait and balance among individuals with PD, were included. A meta-analysis was performed for each outcome using a random effects model for subgroup analysis and pooling of overall effect sizes. Results A total of 23 studies were included in the meta-analysis. The pooled results revealed that tDCS has moderate overall effects on gait, measured by gait speed (standardized mean deviation [SMD] = 0.238; 95% confidence interval [CI] − 0.026 to 0.502); stride length (SMD = 0.318; 95% CI − 0.015 to 0.652); cadence (SMD = − 0.632; 95% CI − 0.932 to − 0.333); freezing of gait questionnaire scores (SMD = − 0.360; 95% CI − 0.692 to − 0.027); step length (SMD = 0.459; 95% CI − 0.031 to 0.949); walking time (SMD = − 0.253; 95% CI − 0.758 to 0.252); stride time (SMD = − 0.785; 95% CI: − 1.680 to 0.111); double support time (SMD = 1.139; 95% CI − 0.244 to 0.523); and balance, measured by timed up and go (TUG) test (SMD = − 0.294; 95% CI − 0.516 to − 0.073), Berg balance scale (BBS) scores (SMD = 0.406; 95% CI − 0.059 to 0.87), and dynamic gait index (SMD = 0.275; 95% CI − 0.349 to 0.898). For the subgroup analysis, gait and balance demonstrated moderate effect sizes. However, only cadence, stride time, and TUG indicated a significant difference between real and sham tDCS (P = 0.027, P = 0.002, and P = 0.023, respectively), whereas cadence and BBS (P < 0.01 and P = 0.045, respectively) significantly differed after real tDCS plus other therapies rather than after sham tDCS plus other therapies. Conclusions Our results indicated that tDCS is significantly associated with gait and balance improvements among individuals with PD. The findings of this study provide more proof supporting the effectiveness of tDCS, encouraging tDCS to be utilized alone or in combination with other therapies in clinical practice for PD rehabilitation.

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