title: The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in sub-acute stroke: A pilot study.
abstract: OBJECTIVE
  Non-invasive brain stimulation with transcranial direct current stimulation (tDCS) modulates cortical excitability and improves upper limb motor performance when applied to chronic stroke patients. The objective was to evaluate whether tDCS can influence gait function in sub-acute stroke patients.
  
  
  METHODS
  We assessed the effect of single session, bi-cephalic tDCS on gait performance in 14 subacute patients with stroke involving the cerebral hemisphere (2-8 weeks post-stroke) in a double-blinded, sham-controlled study. Patients were randomly allocated to receive either active (n = 7) or sham (n = 7) tDCS. The anodal electrode was placed on the scalp over the ipsilesional lower limb primary motor cortex and the cathode was placed over the contralesional leg motor cortex. Gait performance was measured using the Timed Up and Go test and the Performance Oriented Mobility Assessment before and after active or sham tDCS.
  
  
  RESULTS
  The tDCS group was significantly quicker in the Timed Up and Go test in the tDCS group, compared to the sham group (p = 0.018). The Performance Oriented Mobility Assessment was not different between groups (p = 0.897).
  
  
  CONCLUSIONS
  This is the first study to examine the effects of tDCS on gait in stroke patients in the sub-acute stage. Active tDCS improved gait performance (Timed Up and Go) in stroke patients, despite no changes to limb biomechanics of the hemiparetic side (Performance Oriented Mobility Assessment), as compared to sham stimulation. These results suggest that tDCS could be used as a therapeutic adjunct for gait rehabilitation following stroke.
authors.affiliation: Division of Brain Sciences, Imperial College London, London, UK.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Tahtis
authors.affiliation: Division of Brain Sciences, Imperial College London, London, UK.
authors.forename: Diego
authors.initials: D
authors.lastname: Kaski
authors.affiliation: Division of Brain Sciences, Imperial College London, London, UK.
authors.forename: Barry M
authors.initials: BM
authors.lastname: Seemungal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020127:Recovery of Function; D020521:Stroke / Q000150:complications*; D065908:Transcranial Direct Current Stimulation; D016896:Treatment Outcome
keywords: Stroke; gait; rehabilitation; subacute; transcranial direct current stimulation