Doctoral and Master's Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil.
Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Physiother Res Int. 2024 Jan;29(1):e2046. doi: 10.1002/pri.2046. Epub 2023 Aug 22.
Falls are frequent in older adults and can cause trauma, injury, and death. Fall prevention with virtual reality presents good results in improving postural control. Transcranial Direct Current Stimulation (tDCS) has been used with the same aim; however, the combination of the two techniques has still been little studied.
To assess whether tDCS can enhance the effect of video game training (VGT) on improving the postural balance of healthy older women.
A blinded, randomized, controlled clinical trial was conducted with 57 older women who were randomized to three balance training groups: Control Group (VGT), Anodal Group (VGT combined with anodic tDCS-atDCS), and Sham Group (VGT combined with sham tDCS-stDCS). Balance training was performed twice a week for four weeks, totalizing eight 20-min sessions using VGT associated with tDCS. Postural balance was assessed pre-and post-training and 30 days after the end of the eight sessions using the Mini-Balance Evaluation Systems Test.
Compared to pre-intervention the Mini BEST test increased similarly in the three groups in post-intervention (control: pre 23.7 ± 2.8 to post 27.0 ± 2.2; anodal: pre 24.4 ± 1 to post 27.7 ± 0.8 and sham: pre 24.2 ± 1.9 to post 26.5 ± 1.6; p < 0.001) and follow-up (control: pre 23.7 ± 2.8 to follow-up 26.8 ± 2.3; anodal: pre 24.4 ± 1 to follow-up 27.3 ± 1.4 and sham: pre 24.2 ± 1.9 to follow-up 26.8 ± 1.5; p < 0.001).
There was an improvement in the postural balance of the three training groups that were independent of tDCS.
Some studies have shown the positive tDCS effects associated with other tasks to improve balance. However, these results convey the effects of only anodic-tDCS compared to sham-tDCS. Possibly, the effect of VGT surpassed the tDCS effects, promoting a ceiling effect from the combination of these two therapies. However, studies with other therapies combined with tDCS for older adults deserve to be investigated, as well as in frail older people.
老年人经常跌倒，可能导致创伤、伤害和死亡。虚拟现实防跌倒在改善姿势控制方面效果良好。经颅直流电刺激（tDCS）也有同样的目的；然而，这两种技术的结合仍研究较少。
评估 tDCS 是否可以增强视频游戏训练（VGT）对改善健康老年女性姿势平衡的效果。
进行了一项盲、随机、对照临床试验，共纳入 57 名老年女性，随机分为三组平衡训练：对照组（VGT）、阳极组（VGT 联合阳极 tDCS-atDCS）和假刺激组（VGT 联合假刺激 tDCS-stDCS）。平衡训练每周进行两次，共四周，总计进行 8 次 20 分钟的 VGT 训练，同时进行 tDCS。使用 Mini-Balance Evaluation Systems Test 在训练前、训练后和八次疗程结束后 30 天评估姿势平衡。
与干预前相比，三组在干预后（对照组：干预前 23.7±2.8 至干预后 27.0±2.2；阳极组：干预前 24.4±1 至干预后 27.7±0.8，假刺激组：干预前 24.2±1.9 至干预后 26.5±1.6；p<0.001）和随访（对照组：干预前 23.7±2.8 至随访 26.8±2.3；阳极组：干预前 24.4±1 至随访 27.3±1.4，假刺激组：干预前 24.2±1.9 至随访 26.8±1.5；p<0.001）时 Mini BEST 测试均显著增加。
三组训练组的姿势平衡均有改善，与 tDCS 无关。
一些研究表明 tDCS 与其他任务联合应用具有积极作用，可改善平衡。然而，这些结果仅传达了与假刺激相比阳极-tDCS 的效果。可能是 VGT 的效果超过了 tDCS 的效果，从而使这两种疗法的联合产生了上限效应。然而，值得研究其他与 tDCS 联合用于老年人的疗法，以及用于虚弱老年人的疗法。
