Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study.
BACKGROUND
Transcranial direct-current stimulation (tDCS) has been widely studied with the aim of enhancing local synaptic efficacy and modulating the electrical activity of the cortex in patients with neurological disorders.


OBJECTIVE
The purpose of the present study was to determine the effect of a single session of tDCS regarding immediate changes in spatiotemporal gait and oscillations of the center of pressure (30 seconds) in children with cerebral palsy (CP).


METHODS
A randomized controlled trial with a blinded evaluator was conducted involving 20 children with CP between six and ten years of age. Gait and balance were evaluated three times: Evaluation 1 (before the stimulation), Evaluation 2 (immediately after stimulation), and Evaluation 3 (20 minutes after the stimulation). The protocol consisted of a 20-minute session of tDCS applied to the primary motor cortex at an intensity of 1 mA. The participants were randomly allocated to two groups: experimental group - anodal stimulation of the primary motor cortex; and control group - placebo transcranial stimulation.


RESULTS
Significant reductions were found in the experimental group regarding oscillations during standing in the anteroposterior and mediolateral directions with eyes open and eyes closed in comparison with the control group (p<0.05). In the intra-group analysis, the experimental group exhibited significant improvements in gait velocity, cadence, and oscillation in the center of pressure during standing (p<0.05). No significant differences were found in the control group among the different evaluations.


CONCLUSIONS
A single session of tDCS applied to the primary motor cortex promotes positive changes in static balance and gait velocity in children with cerebral palsy.
Universidade Nove de Julho, São Paulo, SP, Brazil.
Luanda A C
LA
Grecco
Universidade Nove de Julho, São Paulo, SP, Brazil.
Natália A C
NA
Duarte
Centro de Neurocirurgia Pediátrica, São Paulo, SP, Brazil.
Nelci
N
Zanon
Dipartimento di Bioingegneria, Politecnico di Milano, Milan, Italy.
Manuela
M
Galli
Center of Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States.
Felipe
F
Fregni
Universidade Nove de Julho, São Paulo, SP, Brazil.
Claudia S
CS
Oliveira
D002547:Cerebral Palsy / Q000503:physiopathology* / Q000628:therapy*; D002648:Child; D003430:Cross-Sectional Studies; D004311:Double-Blind Method; D006801:Humans; D026741:Physical Therapy Modalities; D004856:Postural Balance; D065908:Transcranial Direct Current Stimulation