Farzamfar Pegah, Heirani Ali, Amiri Ehsan, Sedighi Mustafa, da Silva Machado Daniel Gomes
Department Motor behavior and Corrective Exercises. Faculty of Sport Sciences. Razi University, Kermanshah, Iran.
Exercise Metabolism and Performance lab (EMPL), Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, Iran.
Iran J Child Neurol. 2024 Fall;18(4):93-106. doi: 10.22037/IJCN.V18I4.45110. Epub 2024 Sep 29.
This study investigated the effects of transcranial direct current stimulation (tDCS) before and during the mirror visual feedback (MVF) on hand grip strength (HGS) and range of motion of the affected hand in children with spastic hemiplegia cerebral palsy (SHCP).
MATERIALS & METHODS: Twelve children with SHCP participated in this randomized, crossover, and double-blind study. They were randomly exposed to one of four intervention conditions, including 1) a-tDCS-offline, 2) s-tDCS-offline, 3) a-tDCS-online, and 4) s-tDCS-online, with a one-week interval. Participants in the online condition received either anodal or sham tDCS during MVF, while those in the offline condition received tDCS before performing MVF. The tDCS was applied over the M1 area of the affected hemisphere for 20 minutes at 1 mA intensity. The HGS and range of motion of the wrist and elbow (ROM-W and ROM-E) of the affected limb were measured before (pre) and immediately after (post) interventions in each session.
The results showed that the HGS was significantly higher under a-tDCS-offline (), s-tDCS-offline (), and s-tDCS-online () compared to the a-tDCS-online. Moreover, the ROM-W was significantly higher under a-tDCS-offline (), s-tDCS-offline (0.011), and s-tDCS-online () compared to the a-tDCS-online. Eventually, the ROM-E was significantly higher under a-tDCS-offline, s-tDCS-offline, and s-tDCS-online compared to the a-tDCS-online ( , respectively).
The results might have practical implications regarding the timing of the application of tDCS in conjunction with MVF in children with SHCP.
本研究调查了在镜像视觉反馈（MVF）之前及期间进行经颅直流电刺激（tDCS）对痉挛性偏瘫型脑瘫（SHCP）儿童的握力（HGS）和患侧手活动范围的影响。
12名SHCP儿童参与了这项随机、交叉、双盲研究。他们被随机分配到四种干预条件之一，包括1）离线阳极tDCS，2）离线假tDCS，3）在线阳极tDCS，4）在线假tDCS，间隔一周。在线条件下的参与者在MVF期间接受阳极或假tDCS，而离线条件下的参与者在进行MVF之前接受tDCS。以1 mA的强度在患侧半球的M1区域施加tDCS 20分钟。在每个疗程的干预前（pre）和干预后立即（post）测量患侧肢体的HGS以及手腕和肘部的活动范围（ROM-W和ROM-E）。
结果显示，与在线阳极tDCS相比，离线阳极tDCS、离线假tDCS和在线假tDCS条件下的HGS显著更高。此外，与在线阳极tDCS相比，离线阳极tDCS、离线假tDCS（0.011）和在线假tDCS条件下的ROM-W显著更高。最终，与在线阳极tDCS相比，离线阳极tDCS、离线假tDCS和在线假tDCS条件下的ROM-E显著更高（分别为 ）。
这些结果可能对SHCP儿童中tDCS与MVF联合应用的时机具有实际意义。
