Luanda André Collange Grecco1, Natália de Almeida Carvalho Duarte2, Mariana E Mendonça3, Manuela Galli4, Felipe Fregni5, Claudia Santos Oliveira2. 1. Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil Pediatric Neurosurgical Center (CENEPE), São Paulo, Brazil Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA luandagrecco@hotmail.com. 2. Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil. 3. Neurosciences and Behavior, Psychology Institute, University of Sao Paulo, São Paulo, Brazil. 4. Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy Gait Analysis Laboratory, IRCCS San Raffaele Pisana, Rome, Italy. 5. Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.
Abstract
OBJECTIVE: To compare the effects of anodal vs. sham transcranial direct current stimulation combined with virtual reality training for improving gait in children with cerebral palsy. DESIGN: A pilot, randomized, controlled, double-blind, clinical trial. SETTING: Rehabilitation clinics. SUBJECTS: A total of 20 children with diparesis owing to cerebral palsy. INTERVENTIONS: The experimental group received anodal stimulation and the control group received sham stimulation over the primary motor cortex during virtual reality training. All patients underwent the same training programme involving a virtual reality (10 sessions). Evaluations were performed before and after the intervention as well as at the one-month follow-up and involved gait analysis, the Gross Motor Function Measure, the Pediatric Evaluation Disability Inventory and the determination of motor evoked potentials. RESULTS: The experimental group had a better performance regarding gait velocity (experimental group: 0.63 ±0.17 to 0.85 ±0.11 m/s; control group: 0.73 ±0.15 to 0.61 ±0.15 m/s), cadence (experimental group: 97.4 ±14.1 to 116.8 ±8.7 steps/minute; control group: 92.6 ±10.4 to 99.7 ±9.7 steps/minute), gross motor function (dimension D experimental group: 59.7 ±12.8 to 74.9 ±13.8; control group: 58.9 ±10.4 to 69.4 ±9.3; dimension E experimental group: 59.0 ±10.9 to 79.1 ±8.5; control group: 60.3 ±10.1 to 67.4 ±11.4) and independent mobility (experimental group: 34.3 ±5.9 to 43.8 ±75.3; control group: 34.4 ±8.3 to 37.7 ±7.7). Moreover, transcranial direct current stimulation led to a significant increase in motor evoked potential (experimental group: 1.4 ±0.7 to 2.6 ±0.4; control group: 1.3 ±0.6 to 1.6 ±0.4). CONCLUSION: These preliminary findings support the hypothesis that anodal transcranial direct current stimulation combined with virtual reality training could be a useful tool for improving gait in children with cerebral palsy.
RCT Entities:
OBJECTIVE: To compare the effects of anodal vs. sham transcranial direct current stimulation combined with virtual reality training for improving gait in children with cerebral palsy. DESIGN: A pilot, randomized, controlled, double-blind, clinical trial. SETTING: Rehabilitation clinics. SUBJECTS: A total of 20 children with diparesis owing to cerebral palsy. INTERVENTIONS: The experimental group received anodal stimulation and the control group received sham stimulation over the primary motor cortex during virtual reality training. All patients underwent the same training programme involving a virtual reality (10 sessions). Evaluations were performed before and after the intervention as well as at the one-month follow-up and involved gait analysis, the Gross Motor Function Measure, the Pediatric Evaluation Disability Inventory and the determination of motor evoked potentials. RESULTS: The experimental group had a better performance regarding gait velocity (experimental group: 0.63 ±0.17 to 0.85 ±0.11 m/s; control group: 0.73 ±0.15 to 0.61 ±0.15 m/s), cadence (experimental group: 97.4 ±14.1 to 116.8 ±8.7 steps/minute; control group: 92.6 ±10.4 to 99.7 ±9.7 steps/minute), gross motor function (dimension D experimental group: 59.7 ±12.8 to 74.9 ±13.8; control group: 58.9 ±10.4 to 69.4 ±9.3; dimension E experimental group: 59.0 ±10.9 to 79.1 ±8.5; control group: 60.3 ±10.1 to 67.4 ±11.4) and independent mobility (experimental group: 34.3 ±5.9 to 43.8 ±75.3; control group: 34.4 ±8.3 to 37.7 ±7.7). Moreover, transcranial direct current stimulation led to a significant increase in motor evoked potential (experimental group: 1.4 ±0.7 to 2.6 ±0.4; control group: 1.3 ±0.6 to 1.6 ±0.4). CONCLUSION: These preliminary findings support the hypothesis that anodal transcranial direct current stimulation combined with virtual reality training could be a useful tool for improving gait in children with cerebral palsy.
Authors: A Antal; I Alekseichuk; M Bikson; J Brockmöller; A R Brunoni; R Chen; L G Cohen; G Dowthwaite; J Ellrich; A Flöel; F Fregni; M S George; R Hamilton; J Haueisen; C S Herrmann; F C Hummel; J P Lefaucheur; D Liebetanz; C K Loo; C D McCaig; C Miniussi; P C Miranda; V Moliadze; M A Nitsche; R Nowak; F Padberg; A Pascual-Leone; W Poppendieck; A Priori; S Rossi; P M Rossini; J Rothwell; M A Rueger; G Ruffini; K Schellhorn; H R Siebner; Y Ugawa; A Wexler; U Ziemann; M Hallett; W Paulus Journal: Clin Neurophysiol Date: 2017-06-19 Impact factor: 3.708
Authors: Mustafa Q Hameed; Sameer C Dhamne; Roman Gersner; Harper L Kaye; Lindsay M Oberman; Alvaro Pascual-Leone; Alexander Rotenberg Journal: Curr Neurol Neurosci Rep Date: 2017-02 Impact factor: 5.081
Authors: Ana Sánchez-Kuhn; Cristian Pérez-Fernández; Rosa Cánovas; Pilar Flores; Fernando Sánchez-Santed Journal: Biomed Eng Online Date: 2017-08-18 Impact factor: 2.819
Authors: Georgia H O'Leary; Dorothea D Jenkins; Patricia Coker-Bolt; Mark S George; Steve Kautz; Marom Bikson; Bernadette T Gillick; Bashar W Badran Journal: Prog Brain Res Date: 2021-02-23 Impact factor: 2.624
Authors: Bernadette T Gillick; Andrew M Gordon; Tim Feyma; Linda E Krach; Jason Carmel; Tonya L Rich; Yannick Bleyenheuft; Kathleen Friel Journal: Front Pediatr Date: 2018-03-16 Impact factor: 3.418