Treadmill training combined with transcranial direct current stimulation over the primary motor cortex in a child with cerebral palsy and hydrocephalus: A case report.
Rezenda, Fernanda Lobo; Duarte, Natália de Almeida Carvalho; Grecco, Luanda André Collange; Oliveira, Claudia Santos
Abstract
Introduction: Transcranial direct current stimulation (tDCS) is a promising technique that stimulates the cortex with a direct, low-intensity electric current and can potentiate motor learning. Objective: Describe the results of an intervention protocol involving anodal stimulation over the primary motor cortex combined with treadmill training in a child with cerebral palsy. Method: The intervention was comprised of ten sessions of anodal tDCS (1mA) over the primary motor cortex during the treadmill training. Stabilometric analysis was evaluated one week before and one week after the intervention. Results: A reduction in oscillations of the COP was found under both conditions (eyes opened and eyes closed. Conclusion: Our findings suggest that anodal tDCS over primary motor cortex can potentiate the results of treadmill training.
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References
1. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109(suppl 109):8-14.
2. Jucá CEB, Lins Neto A, Oliveira RSd, Machado HR. Tratamento de hidrocefalia com derivação ventrículo-peritoneal: análise de 150 casos consecutivos no Hospital das Clínicas de Ribeirão Preto. Acta cir bras. 2002;17(supl. 3):59-63.
3. Warf BC. Hydrocephalus in Uganda: the predominance of infectious origin and primary management with endoscopic third ventriculostomy. Journal of Neurosurgery: Pediatrics. 2005;102(1):1-15.
4. Warf BC, Mugamba J, Kulkarni AV. Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus in Uganda: report of a scoring system that predicts success: Clinical article. Journal of Neurosurgery: Pediatrics. 2010;5(2):143-8.
5. Kulkarni AV, Drake JM, Mallucci CL, Sgouros S, Roth J, Constantini S. Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus. The Journal of pediatrics. 2009;155(2):254-9. e1.
6. Kavčič A, Vodušek D. A historical perspective on cerebral palsy as a concept and a diagnosis. European journal of neurology. 2005;12(8):582-7.
7. Rose J, Wolff DR, Jones VK, Bloch DA, Oehlert JW, Gamble JG. Postural balance in children with cerebral palsy. Developmental Medicine & Child Neurology. 2002;44(01):58-63.
8. Berg K. Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada. 1989;41(6):304-11.
9. Roque AH, Kanashiro MG, Kazon S, Grecco LAC, Salgado ASI, Oliveira CSd. Analysis of static balance in children with cerebral palsy spastic diparetic type with and without the use of orthoses. Fisioterapia em Movimento. 2012;25(2):311-6.
10. de AC Duarte N, Grecco LAC, Franco RC, Zanon N, Oliveira CS. Correlation between Pediatric Balance Scale and functional test in children with cerebral palsy. Journal of Physical Therapy Science. 2014;26(6):849.
11. Valentin-Gudiol M, Bagur-Calafat C, Girabent-Farrés M, Hadders-Algra M, Mattern-Baxter K, Angulo-Barroso R. Treadmill interventions with partial body weight support in children under six years of age at risk of neuromotor delay: a report of a Cochrane systematic review and meta-analysis. European journal of physical and rehabilitation medicine. 2013;49(1):67-91.
12. Grecco LAC, Zanon N, Sampaio LMM, Oliveira CS. A comparison of treadmill training and overground walking in ambulant children with cerebral palsy: randomized controlled clinical trial. Clinical rehabilitation. 2013:0269215513476721.
13. Grecco LAC, Tomita SM, Christovão TC, Pasini H, Sampaio LM, Oliveira CS. Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial. Brazilian journal of physical therapy. 2013;17(1):17-23.
14. Grecco LAC, Duarte NdAC, Mendonça ME, Cimolin V, Galli M, Fregni F, et al. Transcranial direct current stimulation during treadmill training in children with cerebral palsy: A randomized controlled double-blind clinical trial. Research in developmental disabilities. 2014;35(11):2840-8.
15. Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain stimulation. 2012;5(3):175-95.
16. Nitsche MA, Schauenburg A, Lang N, Liebetanz D, Exner C, Paulus W, et al. Facilitation of implicit motor learning by weak transcranial direct current stimulation of the primary motor cortex in the human. Journal of Cognitive Neuroscience. 2003;15(4):619-26.
17. Duarte NdAC, Grecco LAC, Galli M, Fregni F, Oliveira CS. Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PloS one. 2014;9(8):e105777.
18. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine & Child Neurology. 1997;39(4):214-23.
19. Yam WKL, Leung MSM. Interrater reliability of Modified Ashworth Scale and Modified Tardieu Scale in children with spastic cerebral palsy. Journal of child neurology. 2006;21(12):1031-5.
20. Homan RW, Herman J, Purdy P. Cerebral location of international 10–20 system electrode placement. Electroencephalography and clinical neurophysiology. 1987;66(4):376-82.
21. Grecco LA, Duarte NA, Zanon N, Galli M, Fregni F, Oliveira CS. Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study. Brazilian journal of physical therapy. 2014(AHEAD):00-.
22. Kaski D, Dominguez RO, Allum JH, Bronstein AM. Improving Gait and Balance in Patients With Leukoaraiosis Using Transcranial Direct Current Stimulation and Physical Training An Exploratory Study. Neurorehabilitation and neural repair. 2013;27(9):864-71.
23. Madhavan S, Weber II KA, Stinear JW. Non-invasive brain stimulation enhances fine motor control of the hemiparetic ankle: implications for rehabilitation. Experimental brain research. 2011;209(1):9-17.
24. Stagg CJ, Bachtiar V, O’Shea J, Allman C, Bosnell RA, Kischka U, et al. Cortical activation changes underlying stimulation-induced behavioural gains in chronic stroke. Brain. 2011:awr313.
25. Kaski D, Quadir S, Patel M, Yousif N, Bronstein AM. Enhanced locomotor adaptation aftereffect in the “broken escalator” phenomenon using anodal tDCS. Journal of neurophysiology. 2012;107(9):2493-505.