The effect of transcranial direct current stimulation combined with task-specific training on spatio-temporal gait parameters and functional mobility in individuals with stroke: a systematic review and meta-analysis.

Introduction: Transcranial direct current stimulation (tDCS) has a priming effect on post- stroke motor rehabilitation. Objective: We verified whether tDCS combined with task-specific training was superior to nonintervention, task-specific training, or simulated intervention in improving spatio-temp...

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Publicado en:Topics in Stroke Rehabilitation Vol. 32; no. 4; pp. 438 - 458
Autores principales: Miranda de Aquino Miranda, Jéssica, Sousa de Andrade, Pedro Henrique, Henrique, Maria Eduarda Salum Aveiro, Henrique de Souza Fonseca, Bruno, Bazan, Rodrigo, Sande de Souza, Luciane Aparecida Pascucci, José Luvizutto, Gustavo
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Taylor & Francis Ltd May2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2025
      vid: 32
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      pub: Taylor & Francis Ltd
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        10.1080/10749357.2024.2411878
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        atl: The effect of transcranial direct current stimulation combined with task-specific training on spatio-temporal gait parameters and functional mobility in individuals with stroke: a systematic review and meta-analysis.
      aug:
        au:
          Miranda de Aquino Miranda, Jéssica
          Sousa de Andrade, Pedro Henrique
          Henrique, Maria Eduarda Salum Aveiro
          Henrique de Souza Fonseca, Bruno
          Bazan, Rodrigo
          Sande de Souza, Luciane Aparecida Pascucci
          José Luvizutto, Gustavo
        affil: Department of Applied Physical Therapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
      sug:
        subj:
          Stroke Physiopathology
          Stroke Complications
          Stroke Rehabilitation
          Gait Disorders, Neurologic Rehabilitation
          Therapeutic Exercise Methods
          Functional Training Methods
          Transcranial Direct Current Stimulation Methods
          Task Performance and Analysis
          Functional Status
          Physical Mobility Evaluation
          Treatment Outcomes
          Human
          Systematic Review
          Meta Analysis
          Medline
          Embase
          CINAHL Database
          Cochrane Library
          Walking Speed
          Confidence Intervals
          Data Analysis Software
          Descriptive Statistics
          Scales
      ab: Introduction: Transcranial direct current stimulation (tDCS) has a priming effect on post- stroke motor rehabilitation. Objective: We verified whether tDCS combined with task-specific training was superior to nonintervention, task-specific training, or simulated intervention in improving spatio-temporal gait parameters and functional mobility in stroke patients. Methods: We searched MEDLINE, EMBASE, CINAHL, Scopus, Cochrane Central, Web of Science, and LILACS for articles published until May 2024, using terms related to stroke, tDCS, and task-specific training. The risk of bias was assessed using the PEDro scale. The Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to classify the certainty of the evidence for each outcome. Meta-analysis was performed using a random-effects model. Results: A total of 1,685 studies were identified, of which 18 were included in the qualitative analysis. Seven studies were included in the meta-analysis; all outcomes were classified as "very low quality." Improvements in walking speed only were associated with tDCS combined with task-specific training (mean difference [MD], 0.06; 95% confidence interval [CI]: 0.04, 0.07; p < 0.001; I = 0%). There were no differences in other spatio-temporal gait parameters or functional mobility. Conclusion: This systematic review provides low-quality evidence that tDCS, in combination with task-specific training, increases speed in individuals after stroke. Both interventions, tDCS and task-specific training, are inexpensive and easy to implement; therefore, the mean estimate may be considered clinically worthwhile, although the CIs spans both clinically trivial and worthwhile effects. Registration: International Prospective Register of Systematic Reviews (PROSPERO; number CRD42023396021). HIGHLIGHTS: The use of tDCS combined with task-specific training resulted in an improved walking speed among stroke patients. The effects of tDCS combined with task-specific training on others spatiotemporal outcomes and functional mobility remain unclear. As tDCS is inexpensive and easy to implement, it may be considered as an adjunct to task-specific training to improve walking speed in people after stroke.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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