Grecco Luanda A C, Duarte Natália A C, Zanon Nelci, Galli Manuela, Fregni Felipe, Oliveira Claudia S
Universidade Nove de Julho, São Paulo, SP, Brazil.
Centro de Neurocirurgia Pediátrica, São Paulo, SP, Brazil.
Braz J Phys Ther. 2014 Sep-Oct;18(5):419-27. doi: 10.1590/bjpt-rbf.2014.0053. Epub 2014 Oct 10.
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.
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).
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.
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.
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.
经颅直流电刺激(tDCS)已被广泛研究,旨在增强局部突触效能并调节神经系统疾病患者的皮质电活动。
本研究的目的是确定单次tDCS对脑瘫(CP)儿童时空步态和压力中心振荡(30秒)即时变化的影响。
进行了一项由盲法评估者参与的随机对照试验,纳入了20名6至10岁的CP儿童。对步态和平衡进行了三次评估:评估1(刺激前)、评估2(刺激后立即)和评估3(刺激后20分钟)。方案包括以1 mA的强度对初级运动皮质进行20分钟的tDCS治疗。参与者被随机分为两组:实验组——对初级运动皮质进行阳极刺激;对照组——安慰剂经颅刺激。
与对照组相比,实验组在睁眼和闭眼站立时前后方向和内外侧方向的振荡明显减少(p<0.05)。在组内分析中,实验组在步态速度、步频和站立时压力中心振荡方面有显著改善(p<0.05)。对照组在不同评估之间未发现显著差异。
对初级运动皮质进行单次tDCS治疗可促进脑瘫儿童静态平衡和步态速度的积极变化。