Effect of Transcutaneous spinal direct current stimulation (TsDCS) combined with other therapies on walking capacity in patients with Neurological disorders: A Systematic Review
Keywords:Keywords: transcutaneous spinal cord stimulation, non-invasive spinal direct current stimulation, gait, walking, locomotion
Introduction: Neuromodulation has been used for walking difficulty as a therapeutic approach and as TsDCS is emerging as novel tool for patients with neurological disorders when combined with transcutaneous direct current stimulation (tDCS) and/or gait training, it seems to have a promising effect therefore; a systematic review may provide a better insight into the efficacy of the results. This systematic review aims to assess the effects of TsDCS when applied in combination with different therapies in neurological disorder patients. Methods: Databases (Pubmed, CENTRAL, and Web of Science) were used for searching studies since inception. With the guidance of reviewers, one author extracted data. Two independent reviewers assessed qualities of the RCTs. Results: 5 studies from an initial yield of 256 studies met the inclusion criteria. TsDCS might improve walking capacity when combined with tDCS and/or gait training in stroke (TsDCS with gait training and tDCS), cerebral palsy (tDCS with gait training), and cerebellar ataxia (TsDCS with tDCS). Conclusion: The result suggests that more studies are needed for concluding the therapeutic potential. Future studies should emphasize standard stimulation protocol and determining its efficacy in other outcome parameters of gait and in patients with different neurological disorders.
Awosika, O. O., Sandrini, M., Volochayev, R., Thompson, R. M., Wu, T., Floeter, M. K., Hallett, M., Cohen, L. G., Physiology, C., Section, N., Unit, N. D., Section, M. C., Unit, T., & Medicine, R. (2020). HHS Public Access. 12(3), 628–634. https://doi.org/10.1016/j.brs.2019.01.017.Transcutaneous
Benussi, A., Dell’Era, V., Cantoni, V., Bonetta, E., Grasso, R., Manenti, R., Cotelli, M., Padovani, A., & Borroni, B. (2018). Cerebello-spinal tDCS in ataxia A randomized, double-blind, sham-controlled, crossover trial. Neurology, 91(12), E1090–E1101. https://doi.org/10.1212/WNL.0000000000006210
Cosentino, G., Brighina, F., Alfonsi, E., & Sandrini, G. (2018). Effects of neuromodulation on gait. In Biosystems and Biorobotics (Vol. 19, pp. 367–397). Springer International Publishing. https://doi.org/10.1007/978-3-319-72736-3_26
De Paz, R. H., Serrano-Muñoz, D., Pérez-Nombela, S., Bravo-Esteban, E., Avendaño-Coy, J., & Gómez-Soriano, J. (2019). Combining transcranial direct-current stimulation with gait training in patients with neurological disorders: A systematic review. In Journal of NeuroEngineering and Rehabilitation (Vol. 16, Issue 1, p. 114). BioMed Central Ltd. https://doi.org/10.1186/s12984-019-0591-z
Fregni, F., Grecco, L., Li, S., Michel, S., Castillo-Saavedra, L., Mourdoukoutas, A., & Bikson, M. (2015). Transcutaneous spinal stimulation as a therapeutic strategy for spinal cord injury: state of the art. Journal of Neurorestoratology, 3, 73. https://doi.org/10.2147/JN.S77813
Megía García, A., Serrano-Muñoz, D., Taylor, J., Avendaño-Coy, J., & Gómez-Soriano, J. (2020). Transcutaneous Spinal Cord Stimulation and Motor Rehabilitation in Spinal Cord Injury: A Systematic Review. Neurorehabilitation and Neural Repair, 34(1), 3–12. https://doi.org/10.1177/1545968319893298
Picelli, A., Brugnera, A., Filippetti, M., Mattiuz, N., Chemello, E., Modenese, A., Gandolfi, M., Waldner, A., Saltuari, L., & Smania, N. (2019). Effects of two different protocols of cerebellar transcranial direct current stimulation combined with transcutaneous spinal direct current stimulation on robot-assisted gait training in patients with chronic supratentorial stroke: A single blind, randomi. Restorative Neurology and Neuroscience, 37(2), 97–107. https://doi.org/10.3233/RNN-180895
Picelli, A., Chemello, E., Castellazzi, P., Filippetti, M., Brugnera, A., Gandolfi, M., Waldner, A., Saltuari, L., & Smania, N. (2018). Combined effects of cerebellar transcranial direct current stimulation and transcutaneous spinal direct current stimulation on robot-assisted gait training in patients with chronic brain stroke: A pilot, single blind, randomized controlled trial. Restorative Neurology and Neuroscience, 36(2), 161–171. https://doi.org/10.3233/RNN-170784.
Picelli, A., Chemello, E., Castellazzi, P., Roncari, L., Waldner, A., Saltuari, L., & Smania, N. (2015). Combined effects of transcranial direct current stimulation (tDCS) and transcutaneous spinal direct current stimulation (TsDCS) on robot-assisted gait training in patients with chronic stroke: A pilot, double blind, randomized controlled trial. Restorative Neurology and Neuroscience, 33(3), 357–368. https://doi.org/10.3233/RNN-140474.
Solopova, I. A., Sukhotina, I. A., Zhvansky, D. S., Ikoeva, G. A., Vissarionov, S. V., Baindurashvili, A. G., Edgerton, V. R., Gerasimenko, Y. P., & Moshonkina, T. R. (2017). Effects of spinal cord stimulation on motor functions in children with cerebral palsy. Neuroscience Letters, 639, 192–198. https://doi.org/10.1016/j.neulet.2017.01.003
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