Article

OBJECTIVE: To improve gait and balance in patients with Parkinson's disease by
combining anodal transcranial direct current stimulation with physical training.
DESIGN: In a double-blind design, one group (physical training; n = 8) underwent
gait and balance training during transcranial direct current stimulation (tDCS;
real/sham). Real stimulation consisted of 15 minutes of 2 mA transcranial direct
current stimulation over primary motor and premotor cortex. For sham, the current
was switched off after 30 seconds. Patients received the opposite stimulation
(sham/real) with physical training one week later; the second group (No physical
training; n = 8) received stimulation (real/sham) but no training, and also
repeated a sequential transcranial direct current stimulation session one week
later (sham/real). SETTING: Hospital Srio Libanes, Buenos Aires, Argentina.
SUBJECTS: Sixteen community-dwelling patients with Parkinson's disease.
INTERVENTIONS: Transcranial direct current stimulation with and without
concomitant physical training. MAIN MEASURES: Gait velocity (primary gait
outcome), stride length, timed 6-minute walk test, Timed Up and Go Test
(secondary outcomes), and performance on the pull test (primary balance outcome).
RESULTS: Transcranial direct current stimulation with physical training increased
gait velocity (mean = 29.5%, SD = 13; p < 0.01) and improved balance (pull test:
mean = 50.9%, SD = 37; p = 0.01) compared with transcranial direct current
stimulation alone. There was no isolated benefit of transcranial direct current
stimulation alone. Although physical training improved gait velocity (mean =
15.5%, SD = 12.3; p = 0.03), these effects were comparatively less than with
combined tDCS + physical therapy (p < 0.025). Greater stimulation-related
improvements were seen in patients with more advanced disease. CONCLUSIONS:
Anodal transcranial direct current stimulation during physical training improves
gait and balance in patients with Parkinson's disease. Power calculations
revealed that 14 patients per treatment arm (alpha = 0.05; power = 0.8) are
required for a definitive trial.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS