title: Transcranial Direct Current Stimulation to Enhance Dual-Task Gait Training in Parkinson's Disease: A Pilot RCT.
abstract: OBJECTIVE
  To investigate the feasibility and safety of a combined anodal transcranial direct current stimulation (tDCS) and dual task gait training intervention in people with Parkinson's Disease (PD) and to provide data to support a sample size calculation for a fully powered trial should trends of effectiveness be present.
  
  
  METHODS
  A pilot, randomized, double-blind, sham-controlled parallel group trial with 12 week follow-up.
  
  
  METHODS
  A university physiotherapy department.
  
  
  METHODS
  Sixteen participants diagnosed with PD received nine dual task gait training sessions over 3 weeks. Participants were randomized to receive either active or sham tDCS applied for the first 20 minutes of each session.
  
  
  METHODS
  The primary outcome was gait speed while undertaking concurrent cognitive tasks (word lists, counting, conversation). Secondary measures included step length, cadence, Timed Up and Go, bradykinesia and motor speed.
  
  
  RESULTS
  Gait speed, step length and cadence improved in both groups, under all dual task conditions. This effect was maintained at follow-up. There was no difference between the active and sham tDCS groups. Time taken to perform the TUGwords also improved, with no difference between groups. The active tDCS group did however increase their correct cognitive response rate during the TUGwords and TUGcount. Bradykinesia improved after training in both groups.
  
  
  CONCLUSIONS
  Three weeks of dual task gait training resulted in improved gait under dual task conditions, and bradykinesia, immediately following training and at 12 weeks follow-up. The only parameter enhanced by tDCS was the number of correct responses while performing the dual task TUG. tDCS applied to M1 may not be an effective adjunct to dual task gait training in PD.
  
  
  BACKGROUND
  Australia-New Zealand Clinical Trials Registry ACTRN12613001093774.
authors.affiliation: Brain Rehabilitation and Neuroplasticity unit, School of Science and Health, Western Sydney University, Penrith, NSW, Australia.
authors.forename: Siobhan M
authors.initials: SM
authors.lastname: Schabrun
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
authors.forename: Robyn M
authors.initials: RM
authors.lastname: Lamont
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Brauer
mesh_terms: D000368:Aged; D003071:Cognition / Q000502:physiology; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D018476:Hypokinesia / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome