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Motor Effects of Intervention With Transcranial Direct Current Stimulation for Physiotherapy Treatment in Children
Anna Izabel Cangussu1,2, Beatriz Lucarini1, Igor de Freitas Melo1
1Faculdade de Medicina da Universidade Federal de Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Insights
This study investigates if transcranial direct current stimulation (tDCS) enhances physiotherapy for children with cerebral palsy (CP). Results will clarify tDCS’s role in CP rehabilitation for improved motor function and quality of life.
Area of Science:
- Neuroscience
- Pediatrics
- Rehabilitation Medicine
Background:
- Children with cerebral palsy (CP) often face motor function and daily living challenges.
- Noninvasive brain stimulation techniques like transcranial direct current stimulation (tDCS) show promise for improving motor function.
Purpose of the Study:
- To evaluate the additional benefits of combining physiotherapy with tDCS in children with CP.
- To compare outcomes of physiotherapy with tDCS versus physiotherapy alone.
Main Methods:
- A 2-arm randomized controlled trial comparing tDCS + physiotherapy to physiotherapy alone.
- Participants: Children with CP (Gross Motor Function Classification System levels I-II).
- Outcomes: Assessed via Gross Motor Function Measure (GMFM) and quality of life scores; 10-day tDCS protocol over 2 weeks.
Main Results:
- Data collection is ongoing, with completion expected by January 2025.
- The study anticipates a homogeneous sample and clear outcomes to define tDCS efficacy in CP.
- Potential to identify optimal candidates for tDCS therapy.
Conclusions:
- A well-evidenced study with clear outcomes could establish the optimal use of neurostimulation in pediatric CP.
- Findings may guide future therapeutic strategies for children with CP.
- This research may open new avenues for neurostimulation applications in CP management.
Background:
Children diagnosed with cerebral palsy (CP) often experience various limitations, particularly in gross motor function and activities of daily living. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that has been used to improve movement, gross motor function, and activities of daily living.
Objective:
This study aims to evaluate the potential additional effects of physiotherapy combined with tDCS in children with CP in comparison with physiotherapy only.
Methods:
This is a 2-arm randomized controlled trial that will compare the effects of tDCS as an adjunctive treatment during rehabilitation sessions to rehabilitation without tDCS. Children with CP classified by the Gross Motor Function Classification System as levels I and II will be randomly assigned to either the sham + rehabilitation group or the tDCS + rehabilitation group. The primary outcome will be the motor skills assessed using the Gross Motor Function Measure domain E scores, and the secondary outcome will be the measurement scores of the children's quality of life. The intervention will consist of a 10-day stimulation protocol with tDCS spread over 2 weeks, with stimulation or sham tDCS administered for 20 minutes at a frequency of 1 Hz, in combination with physiotherapy. Physical therapy exercises will be conducted in a circuit based on each child's baseline Gross Motor Function Measure results. The participants' changes will be evaluated and compared in both groups. Intervenient features will be tested.
Results:
Data collection is ongoing and is expected to be completed by January 2025. A homogeneous sample and clear outcomes may be a highlight of this protocol, which may allow us to understand the potential use of tDCS and for whom it should or should not be used.
Conclusions:
A study with good evidence and clear outcomes in children with CP might open an avenue for the potential best use of neurostimulation.
Trial Registration:
Brazilian Registry of Clinical Trials RBR-104h4s4y; https://tinyurl.com/47r3x2e4.
International Registered Report Identifier (Irrid):
PRR1-10.2196/52922.
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