Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review.
To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials.



A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies.



Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions.



The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR. Implications for Rehabilitation tDCS with VR intervention can be an alternative to traditional rehabilitation programs. tDCS with VR is a promising type of intervention with a variety of positive effects. Application of tDCS with VR is appropriated to both healthy and impaired patients. There is no consensus of tDCS with VR application.
a Post-graduate Program in Rehabilitation Sciences - Faculty of Medicine , University of São Paulo , São Paulo , SP , Brazil.
Thais
T
Massetti
b Department of Scientific Writing - Faculty of Medicine ABC , Santo André , SP , Brazil.
Tânia Brusque
TB
Crocetta
c Post-graduate Program in Medicine Cardiology - Paulista Medical School , Federal University of São Paulo , São Paulo , SP , Brazil.
Talita Dias da
TDD
Silva
a Post-graduate Program in Rehabilitation Sciences - Faculty of Medicine , University of São Paulo , São Paulo , SP , Brazil.
Isabela Lopes
IL
Trevizan
c Post-graduate Program in Medicine Cardiology - Paulista Medical School , Federal University of São Paulo , São Paulo , SP , Brazil.
Claudia
0000-0003-2960-0299
C
Arab
a Post-graduate Program in Rehabilitation Sciences - Faculty of Medicine , University of São Paulo , São Paulo , SP , Brazil.
Fátima Aparecida
FA
Caromano
a Post-graduate Program in Rehabilitation Sciences - Faculty of Medicine , University of São Paulo , São Paulo , SP , Brazil.|b Department of Scientific Writing - Faculty of Medicine ABC , Santo André , SP , Brazil.
Carlos Bandeira de Mello
CBM
Monteiro
D006801:Humans; D009422:Nervous System Diseases / Q000534:rehabilitation / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D065908:Transcranial Direct Current Stimulation / Q000379:methods; D000076142:Virtual Reality; D063367:Virtual Reality Exposure Therapy / Q000379:methods
Exposure therapy virtual reality; transcranial stimulation current continues