Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region.
Brain Res. 2025 Jan 1;1846:149255. doi: 10.1016/j.brainres.2024.149255. Epub 2024 Oct 5.
Successful execution of normal activities in various populations warrants the performance of dual tasks (DTs). DTs involve motor and cognitive tasking with the involvement of various brain areas. Transcranial direct current stimulation (tDCS) has been used for regulating the excitability of brain cortical regions. The purpose of this review was to evaluate the available scientific evidence on the effects of tDCS combined with concurrent DT walking on mobility, gait and cognition in older adults (OAs) with and without Parkinson's disease (PD).
The PubMed, PEDro, Cochrane Library, Embase and Web databases of Science were searched for relevant articles published from their beginning until date. Randomized controlled trials were retrieved, and their methodological quality and risk of bias were evaluated using the PEDro scale and the Cochrane risk-of-bias tool respectively. Qualitative and quantitative synthesis were used to analyze the data.
Five studies were included in the review. The results revealed that in individuals with PD, active tDCS with concurrent DT walking has more potential to significantly improve DT cost to gait speed (p < 0.05), and the proportion of correct responses during DT time up and go test (TUG) (p = 0.004). DT walking with concurrent tDCS has potential to significantly improve DT [gait speed (p = 0.03), cadence (p = 0.0005), double limb support time (DBST) (p < 0.0001), and single-task (ST) cadence (p = 0.008)]. Significant improvements were observed in the DT costs for stride time (p < 0.0001), DBST (p = 0.03), stride time variability (p < 0.00001), and swing time variability (p = 0.002) with the active tDCS combined with concurrent DT training in OAs.
The effects of tDCS combined with concurrent DT walking or training on cognitive, gait and mobility outcomes in OAs with or without PD can be better explained by the DTW training itself. However, tDCS could produce some specific effects in particular outcomes and scenarios.
在不同人群中成功执行正常活动需要执行双重任务(DT)。DT 涉及运动和认知任务,涉及大脑的各个区域。经颅直流电刺激(tDCS)已被用于调节皮质脑区的兴奋性。本综述的目的是评估现有科学证据,评估 tDCS 联合同步 DT 行走对有和无帕金森病(PD)的老年人移动性、步态和认知的影响。
在 PubMed、PEDro、Cochrane 图书馆、Embase 和 Web of Science 数据库中检索了从开始到现在发表的相关文章。检索到随机对照试验,并分别使用 PEDro 量表和 Cochrane 偏倚风险工具评估其方法学质量和偏倚风险。使用定性和定量综合分析数据。
综述纳入了 5 项研究。结果表明,在 PD 患者中,主动 tDCS 联合同步 DT 行走更有可能显著改善 DT 对步态速度的影响(p<0.05),以及 DT 时间向上和去测试(TUG)中正确反应的比例(p=0.004)。DT 行走与同步 tDCS 联合使用具有改善 DT[步态速度(p=0.03)、步频(p=0.0005)、双肢支撑时间(DBST)(p<0.0001)和单任务(ST)步频(p=0.008)]的潜力。在 DT 步长时间(p<0.0001)、DBST(p=0.03)、步长时间变异性(p<0.00001)和摆动时间变异性(p=0.002)方面,主动 tDCS 联合同步 DT 训练可观察到显著改善,在 OAs 中。
tDCS 联合同步 DT 行走或训练对有和无 PD 的老年人认知、步态和移动性结局的影响,可以更好地用 DTW 训练本身来解释。然而,tDCS 可能在特定结果和情况下产生一些特定的影响。