Schabrun Siobhan M, Lamont Robyn M, Brauer Sandra G
Brain Rehabilitation and Neuroplasticity unit, School of Science and Health, Western Sydney University, Penrith, NSW, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
PLoS One. 2016 Jun 30;11(6):e0158497. doi: 10.1371/journal.pone.0158497. eCollection 2016.
To investigate the feasibility and safety of a combined anodal transcranial direct current stimulation (tDCS) and dual task gait training intervention in people with Parkinson's Disease (PD) and to provide data to support a sample size calculation for a fully powered trial should trends of effectiveness be present.
A pilot, randomized, double-blind, sham-controlled parallel group trial with 12 week follow-up.
A university physiotherapy department.
Sixteen participants diagnosed with PD received nine dual task gait training sessions over 3 weeks. Participants were randomized to receive either active or sham tDCS applied for the first 20 minutes of each session.
The primary outcome was gait speed while undertaking concurrent cognitive tasks (word lists, counting, conversation). Secondary measures included step length, cadence, Timed Up and Go, bradykinesia and motor speed.
Gait speed, step length and cadence improved in both groups, under all dual task conditions. This effect was maintained at follow-up. There was no difference between the active and sham tDCS groups. Time taken to perform the TUGwords also improved, with no difference between groups. The active tDCS group did however increase their correct cognitive response rate during the TUGwords and TUGcount. Bradykinesia improved after training in both groups.
Three weeks of dual task gait training resulted in improved gait under dual task conditions, and bradykinesia, immediately following training and at 12 weeks follow-up. The only parameter enhanced by tDCS was the number of correct responses while performing the dual task TUG. tDCS applied to M1 may not be an effective adjunct to dual task gait training in PD.
Australia-New Zealand Clinical Trials Registry ACTRN12613001093774.
探讨联合阳极经颅直流电刺激（tDCS）与双任务步态训练干预对帕金森病（PD）患者的可行性和安全性，并在出现有效性趋势时提供数据以支持全功率试验的样本量计算。
一项为期12周随访的试点、随机、双盲、假对照平行组试验。
一所大学的物理治疗系。
16名被诊断为PD的参与者在3周内接受了9次双任务步态训练课程。参与者被随机分配在每次课程的前20分钟接受主动或假tDCS。
主要结局是在进行并发认知任务（单词列表、计数、对话）时的步态速度。次要测量指标包括步长、步频、起立行走测试、运动迟缓及运动速度。
在所有双任务条件下，两组的步态速度、步长和步频均有所改善。这种效果在随访时得以维持。主动tDCS组和假tDCS组之间没有差异。完成单词列表起立行走测试所需的时间也有所改善，两组之间没有差异。然而，主动tDCS组在单词列表起立行走测试和计数起立行走测试期间确实提高了正确的认知反应率。两组训练后运动迟缓均有所改善。
为期3周的双任务步态训练可使双任务条件下的步态以及运动迟缓在训练后即刻和12周随访时得到改善。tDCS增强的唯一参数是在进行双任务起立行走测试时的正确反应数量。应用于M1的tDCS可能不是PD患者双任务步态训练的有效辅助手段。
澳大利亚-新西兰临床试验注册中心ACTRN12613001093774。
