de Almeida Fabrício D, Wang Yiyu, de Mello Pedreiro Rodrigo C, Brizzi Ana Carolina B, Campos Shirley F, Sales Melina P, Kennedy Deanna M, Pinto Neto Osmar
Department of Biomedical Engineering, Anhembi Morumbi University, São José dos Campos 12247-016, SP, Brazil.
Department of Anatomy, Federal Rural University of Rio de Janeiro, Seropédica 23890-000, RJ, Brazil.
Neurol Int. 2024 Oct 28;16(6):1223-1238. doi: 10.3390/neurolint16060093.
BACKGROUND/OBJECTIVES: Parkinson's disease (PD) is a neurodegenerative disorder characterized by tremors, balance impairments, and mobility limitations. Innovative approaches like combining transcranial direct current stimulation (tDCS) with exercise show promise in addressing these symptoms. This study investigates the effects of exercise combined with tDCS on mobility and tremor management in PD patients.
Twenty-five individuals aged 60-75 (66.6 ± 7.33), diagnosed with PD (Hoehn and Yahr stage 2-3), were assigned to three groups in a randomized controlled design: exercise with active tDCS ( = 8), exercise with sham tDCS ( = 8), and a control group ( = 9). Dual-task training sessions focusing on walking speed, balance, and force control were conducted over ten sessions.
No significant differences were detected across the groups for grip strength or force control measures ( > 0.05). Significant improvements were observed in the intervention group: the Timed Up and Go (TUG) test showed a significant reduction in time (mean difference = 2.498 s, < 0.001, ηp = 0.331); anterior-posterior displacement significantly increased (mean difference = 21.375 mm, = 0.0269, ηp = 0.303); and force-tremor decoupling improved, with coherence in the 1-4 Hz band significantly decreasing ( = 0.0067). Finally, changes in TUG from post- to pre-treatment values were significantly positively correlated with the changes in coherence (R = 0.468, = 0.018).
Combining tDCS with exercise enhances mobility and tremor management in PD patients. These findings support the potential for such interventions to improve functional outcomes and quality of life for individuals with PD.
背景/目的：帕金森病（PD）是一种神经退行性疾病，其特征为震颤、平衡障碍和行动受限。将经颅直流电刺激（tDCS）与运动相结合等创新方法在解决这些症状方面显示出前景。本研究调查运动联合tDCS对PD患者行动能力和震颤控制的影响。
25名年龄在60 - 75岁（66.6±7.33）、被诊断为PD（Hoehn和Yahr分期为2 - 3期）的个体，采用随机对照设计被分为三组：主动tDCS联合运动组（n = 8）、假tDCS联合运动组（n = 8）和对照组（n = 9）。进行了为期十次的双任务训练课程，重点关注步行速度、平衡和力量控制。
在握力或力量控制测量方面，各组之间未检测到显著差异（P>0.05）。干预组观察到显著改善：计时起立行走（TUG）测试显示时间显著缩短（平均差值 = 2.498秒，P<0.001，ηp = 0.331）；前后位移显著增加（平均差值 = 21.375毫米，P = 0.0269，ηp = 0.303）；力量 - 震颤解耦得到改善，1 - 4赫兹频段的相干性显著降低（P = 0.0067）。最后，TUG从治疗后到治疗前值的变化与相干性的变化显著正相关（R = 0.468，P = 0.018）。
tDCS与运动相结合可增强PD患者的行动能力和震颤控制。这些发现支持了此类干预措施改善PD患者功能结局和生活质量的潜力。
