Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study

Abstract

Background: Transcranial direct-current stimulation (tDCS) has been widely studied with the aim of enhancing local synaptic efficacy and modulating the electrical activity of the cortex in patients with neurological disorders. Objective: The purpose of the present study was to determine the effect of a single session of tDCS regarding immediate changes in spatiotemporal gait and oscillations of the center of pressure (30 seconds) in children with cerebral palsy (CP). Method:A randomized controlled trial with a blinded evaluator was conducted involving 20 children with CP between six and ten years of age. Gait and balance were evaluated three times: Evaluation 1 (before the stimulation), Evaluation 2 (immediately after stimulation), and Evaluation 3 (20 minutes after the stimulation). The protocol consisted of a 20-minute session of tDCS applied to the primary motor cortex at an intensity of 1 mA. The participants were randomly allocated to two groups: experimental group - anodal stimulation of the primary motor cortex; and control group - placebo transcranial stimulation. Results: Significant reductions were found in the experimental group regarding oscillations during standing in the anteroposterior and mediolateral directions with eyes open and eyes closed in comparison with the control group (p<0.05). In the intra-group analysis, the experimental group exhibited significant improvements in gait velocity, cadence, and oscillation in the center of pressure during standing (p<0.05). No significant differences were found in the control group among the different evaluations. Conclusion: A single session of tDCS applied to the primary motor cortex promotes positive changes in static balance and gait velocity in children with cerebral palsy.

The effects of cerebellar transcranial direct current stimulation on static and dynamic postural stability in older individuals: a randomized double‐blind sham‐controlled study

“…The findings of the current study supported this hypothesis and indicated that participants who received cerebellar a‐tDCS had significantly less postural sway in AP and ML directions in the static conditions, which means a better static postural control. Due to lack of comparable studies in the literature, the findings in the current study will only be compared with a‐tDCS studies which investigated static postural stability of the individuals with postural disorders (Duarte et al ., ; Grecco et al ., ; Dumont et al ., ). In line with the findings in the current study, literature supports positive effect of a‐tDCS of M1 on the static postural control (Duarte et al ., ; Grecco et al ., ; Dumont et al ., ).…”

“…Participants were asked to randomly stand on the static and dynamic platforms of BBS and maintain balance for 30 s (Sherafat et al ., ; Ehsani et al ., ,b). After performing balance tests and saving the BBS baseline data, participants were asked to sit on a chair to receive a‐tDCS intervention for 20 min (Grecco et al ., ). Then, the balance assessments by BBS were randomly repeated immediately after the intervention to obtain BBS intervention data.…”

Protocol study for a randomised, controlled, double-blind, clinical trial involving virtual reality and anodal transcranial direct current stimulation for the improvement of upper limb motor function in children with Down syndrome

“…29 30 Moreover, a non-invasive brain stimulation method (tDCS) will be employed to facilitate motor cortical excitability in the areas subjacent to stimulation to enhance the effects of motor control and learning. [37][38][39][40][41][42] Lazzari et al 37 demonstrated the efficacy of the combination of tDCS and VR in potentiating motor effects on balance and functional mobility in children with cerebral palsy. 37 This document offers a detailed description of a randomised, controlled, double-blind, clinical trial designed to determine the effectiveness of VR training combined with tDCS on upper limb movements in individuals with DS.…”

“…The results of clinical trials have demonstrated its considerable potential in the treatment of neurological disorders and the investigation of processes of cortical excitability modulation. [37][38][39][40][41][42] Moreover, this type of intervention offers a better condition for sham stimulation, which confers greater specificity to the findings. 39 40 In the rehabilitation process, the aim of neuromodulating techniques is to enhance local synaptic efficiency and alter the maladaptive plasticity pattern that emerges after a cortical injury.…”

“…39 40 In the rehabilitation process, the aim of neuromodulating techniques is to enhance local synaptic efficiency and alter the maladaptive plasticity pattern that emerges after a cortical injury. [41][42][43][44][45] Although DS is one of the most prevalent diseases in the paediatric population, no studies were found on the effects of tDCS on children with this syndrome. Thus, the lack of investigations on anodal tDCS over the primary motor cortex during motor training for children with DS constitutes a gap in the scientific literature.…”