经颅直流电刺激联合行走康复训练对提高运动能力和执行功能的影响：一项初步临床试验。
Combining Frontal Transcranial Direct Current Stimulation With Walking Rehabilitation to Enhance Mobility and Executive Function: A Pilot Clinical Trial.
机构信息
Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA.
Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA.
出版信息
Neuromodulation. 2021 Jul;24(5):950-959. doi: 10.1111/ner.13250. Epub 2020 Aug 18.
OBJECTIVES
This pilot study assessed whether frontal lobe transcranial direct current stimulation (tDCS) combined with complex walking rehabilitation is feasible, safe, and shows preliminary efficacy for improving walking and executive function.
MATERIALS AND METHODS
Participants were randomized to one of the following 18-session interventions: active tDCS and rehabilitation with complex walking tasks (Active/Complex); sham tDCS and rehabilitation with complex walking tasks (Sham/Complex); or sham tDCS and rehabilitation with typical walking (Sham/Typical). Active tDCS was delivered over F3 (cathode) and F4 (anode) scalp locations for 20 min at 2 mA intensity. Outcome measures included tests of walking function, executive function, and prefrontal activity measured by functional near infrared spectroscopy.
RESULTS
Ninety percent of participants completed the intervention protocol successfully. tDCS side effects of tingling or burning sensations were low (average rating less than two out of 10). All groups demonstrated gains in walking performance based on within-group effect sizes (d ≥ 0.50) for one or more assessments. The Sham/Typical group showed the greatest gains for walking based on between-group effect sizes. For executive function, the Active/Complex group showed the greatest gains based on moderate to large between-group effect sizes (d = 0.52-1.11). Functional near-infrared spectroscopy (fNIRS) findings suggest improved prefrontal cortical activity during walking.
CONCLUSIONS
Eighteen sessions of walking rehabilitation combined with tDCS is a feasible and safe intervention for older adults. Preliminary effects size data indicate a potential improvement in executive function by adding frontal tDCS to walking rehabilitation. This study justifies future larger clinical trials to better understand the benefits of combining tDCS with walking rehabilitation.
目的
本初步研究评估了额叶经颅直流电刺激（tDCS）联合复杂步行康复是否可行、安全，并初步显示出改善步行和执行功能的疗效。
材料和方法
参与者被随机分配到以下 18 个疗程的干预措施之一：主动 tDCS 联合复杂步行任务康复（主动/复杂）；假 tDCS 联合复杂步行任务康复（假/复杂）；或假 tDCS 联合常规步行康复（假/常规）。主动 tDCS 在 2 mA 强度下，通过头皮 F3（阴极）和 F4（阳极）位置进行 20 分钟。评估指标包括步行功能、执行功能和功能性近红外光谱测量的前额叶活动。
结果
90%的参与者成功完成了干预方案。tDCS 的副作用为刺痛或烧灼感，发生率低（平均评分低于 10 分中的 2 分）。所有组均表现出基于组内效应大小（d≥0.50）的步行表现改善，其中一项或多项评估结果显示。假/常规组的步行表现改善最大，基于组间效应大小。对于执行功能，主动/复杂组基于中等至大的组间效应大小（d=0.52-1.11）显示出最大的改善。功能性近红外光谱（fNIRS）结果表明，在步行过程中前额叶皮质活动得到改善。
结论
18 次步行康复联合 tDCS 对老年人来说是一种可行和安全的干预措施。初步的效果大小数据表明，通过在步行康复中添加额叶 tDCS，可能会改善执行功能。本研究为未来更大规模的临床试验提供了依据，以更好地理解 tDCS 与步行康复相结合的益处。
Zotero 插件