Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursery, Castilla La Mancha University, 45071, Toledo, Spain.
J Neuroeng Rehabil. 2019 Sep 14;16(1):114. doi: 10.1186/s12984-019-0591-z.
Transcranial direct-current stimulation (tDCS) is an easy-to-apply, cheap, and safe technique capable of affecting cortical brain activity. However, its effectiveness has not been proven for many clinical applications.
The aim of this systematic review was to determine whether the effect of different strategies for gait training in patients with neurological disorders can be enhanced by the combined application of tDCS compared to sham stimulation. Additionally, we attempted to record and analyze tDCS parameters to optimize its efficacy.
A search in Pubmed, PEDro, and Cochrane databases was performed to find randomized clinical trials that combined tDCS with gait training. A chronological filter from 2010 to 2018 was applied and only studies with variables that quantified the gait function were included.
A total of 274 studies were found, of which 25 met the inclusion criteria. Of them, 17 were rejected based on exclusion criteria. Finally, 8 trials were evaluated that included 91 subjects with stroke, 57 suffering from Parkinson's disease, and 39 with spinal cord injury. Four of the eight assessed studies did not report improved outcomes for any of its variables compared to the placebo treatment.
There are no conclusive results that confirm that tDCS can enhance the effect of the different strategies for gait training. Further research for specific pathologies, with larger sample sizes and adequate follow-up periods, are required to optimize the existing protocols for applying tDCS.
经颅直流电刺激（tDCS）是一种易于应用、廉价且安全的技术，能够影响皮质脑活动。然而，其在许多临床应用中的有效性尚未得到证实。
本系统评价旨在确定与假刺激相比，tDCS 联合步态训练是否能增强神经障碍患者不同步态训练策略的效果。此外，我们试图记录和分析 tDCS 参数以优化其疗效。
在 Pubmed、PEDro 和 Cochrane 数据库中进行搜索，以找到结合 tDCS 与步态训练的随机临床试验。应用了 2010 年至 2018 年的时间过滤，仅纳入了量化步态功能的变量的研究。
共发现 274 项研究，其中 25 项符合纳入标准。其中，17 项根据排除标准被拒绝。最终评估了 8 项试验，共纳入 91 例脑卒中患者、57 例帕金森病患者和 39 例脊髓损伤患者。8 项评估研究中，有 4 项与安慰剂治疗相比，其任何变量的结果均未得到改善。
没有确凿的结果证实 tDCS 可以增强不同步态训练策略的效果。需要针对特定的病理情况进行进一步的研究，增加样本量并进行充分的随访，以优化现有的 tDCS 应用方案。
