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Combining Frontal Transcranial Direct Current Stimulation With Walking Rehabilitation to Enhance Mobility and Executive Function: A Pilot Clinical Trial.

Neuromodulation : journal of the International Neuromodulation Society
July 1, 2021
David J Clark et al. (9 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to assess the feasibility, safety, and preliminary efficacy of combining frontal lobe tDCS with complex walking rehabilitation for improving walking and executive function in older adults.

Results Summary

The intervention was feasible and safe, with low side effects. All groups showed gains in walking performance, with the Sham/Typical group demonstrating the greatest improvements. The Active/Complex group showed the most significant gains in executive function, supported by moderate to large effect sizes.

Population

Older adults

Effective Dosage

Active tDCS was delivered at 2 mA intensity for 20 minutes per session.

Duration

18 sessions

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
active tDCS and rehabilitation with complex walking tasks (Active/Complex)
increase
executive function
participants
moderate to large between-group effect sizes (d = 0.52-1.11)
showed the greatest gains
#1
sham tDCS and rehabilitation with typical walking (Sham/Typical)
increase
walking
participants
based on between-group effect sizes
showed the greatest gains
#2
walking rehabilitation combined with tDCS
neutral
-
older adults
-
is a feasible and safe intervention
#3
frontal tDCS added to walking rehabilitation
increase
executive function
-
preliminary effects size data
indicate a potential improvement
#4
tDCS
decrease
side effects
-
average rating less than two out of 10
side effects of tingling or burning sensations were low
#5
walking rehabilitation combined with tDCS
increase
walking and executive function
-
-
is feasible, safe, and shows preliminary efficacy
#6
all groups
increase
walking performance
participants
within-group effect sizes (d ≥ 0.50)
demonstrated gains
#7
functional near-infrared spectroscopy (fNIRS)
increase
prefrontal cortical activity during walking
-
-
findings suggest improved
#8
Abstract

OBJECTIVES: This pilot study assessed whether frontal lobe transcranial direct current stimulation (tDCS) combined with complex walking rehabilitation is feasible, safe, and shows preliminary efficacy for improving walking and executive function. MATERIALS AND METHODS: Participants were randomized to one of the following 18-session interventions: active tDCS and rehabilitation with complex walking tasks (Active/Complex); sham tDCS and rehabilitation with complex walking tasks (Sham/Complex); or sham tDCS and rehabilitation with typical walking (Sham/Typical). Active tDCS was delivered over F3 (cathode) and F4 (anode) scalp locations for 20 min at 2 mA intensity. Outcome measures included tests of walking function, executive function, and prefrontal activity measured by functional near infrared spectroscopy. RESULTS: Ninety percent of participants completed the intervention protocol successfully. tDCS side effects of tingling or burning sensations were low (average rating less than two out of 10). All groups demonstrated gains in walking performance based on within-group effect sizes (d ≥ 0.50) for one or more assessments. The Sham/Typical group showed the greatest gains for walking based on between-group effect sizes. For executive function, the Active/Complex group showed the greatest gains based on moderate to large between-group effect sizes (d = 0.52-1.11). Functional near-infrared spectroscopy (fNIRS) findings suggest improved prefrontal cortical activity during walking. CONCLUSIONS: Eighteen sessions of walking rehabilitation combined with tDCS is a feasible and safe intervention for older adults. Preliminary effects size data indicate a potential improvement in executive function by adding frontal tDCS to walking rehabilitation. This study justifies future larger clinical trials to better understand the benefits of combining tDCS with walking rehabilitation.

Medical Subject Headings (MeSH)
AgedDouble-Blind MethodExecutive FunctionHumansPilot ProjectsPrefrontal CortexTranscranial Direct Current StimulationWalking
Study Links
Quality Scores
Safety85
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations11
Citations/Year2.8
Relative Citation Ratio1.39
NIH Percentile62.3%
Research Impact Scores
APT Score0.75
Weight Score2.49
Normalized Score0.80
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