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Transcranial Direct Current Stimulation to Enhance Dual-Task Gait Training in Parkinson's Disease: A Pilot RCT.
PLoS One. 2016; 11(6):e0158497.Plos

Abstract

OBJECTIVE

To investigate the feasibility and safety of a combined anodal transcranial direct current stimulation (tDCS) and dual task gait training intervention in people with Parkinson's Disease (PD) and to provide data to support a sample size calculation for a fully powered trial should trends of effectiveness be present.

DESIGN

A pilot, randomized, double-blind, sham-controlled parallel group trial with 12 week follow-up.

SETTING

A university physiotherapy department.

INTERVENTIONS

Sixteen participants diagnosed with PD received nine dual task gait training sessions over 3 weeks. Participants were randomized to receive either active or sham tDCS applied for the first 20 minutes of each session.

MAIN MEASURES

The primary outcome was gait speed while undertaking concurrent cognitive tasks (word lists, counting, conversation). Secondary measures included step length, cadence, Timed Up and Go, bradykinesia and motor speed.

RESULTS

Gait speed, step length and cadence improved in both groups, under all dual task conditions. This effect was maintained at follow-up. There was no difference between the active and sham tDCS groups. Time taken to perform the TUGwords also improved, with no difference between groups. The active tDCS group did however increase their correct cognitive response rate during the TUGwords and TUGcount. Bradykinesia improved after training in both groups.

CONCLUSION

Three weeks of dual task gait training resulted in improved gait under dual task conditions, and bradykinesia, immediately following training and at 12 weeks follow-up. The only parameter enhanced by tDCS was the number of correct responses while performing the dual task TUG. tDCS applied to M1 may not be an effective adjunct to dual task gait training in PD.

TRIAL REGISTRATION

Australia-New Zealand Clinical Trials Registry ACTRN12613001093774.

Authors+Show Affiliations

Brain Rehabilitation and Neuroplasticity unit, School of Science and Health, Western Sydney University, Penrith, NSW, Australia.School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27359338

Citation

Schabrun, Siobhan M., et al. "Transcranial Direct Current Stimulation to Enhance Dual-Task Gait Training in Parkinson's Disease: a Pilot RCT." PloS One, vol. 11, no. 6, 2016, pp. e0158497.
Schabrun SM, Lamont RM, Brauer SG. Transcranial Direct Current Stimulation to Enhance Dual-Task Gait Training in Parkinson's Disease: A Pilot RCT. PLoS One. 2016;11(6):e0158497.
Schabrun, S. M., Lamont, R. M., & Brauer, S. G. (2016). Transcranial Direct Current Stimulation to Enhance Dual-Task Gait Training in Parkinson's Disease: A Pilot RCT. PloS One, 11(6), e0158497. https://doi.org/10.1371/journal.pone.0158497
Schabrun SM, Lamont RM, Brauer SG. Transcranial Direct Current Stimulation to Enhance Dual-Task Gait Training in Parkinson's Disease: a Pilot RCT. PLoS One. 2016;11(6):e0158497. PubMed PMID: 27359338.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transcranial Direct Current Stimulation to Enhance Dual-Task Gait Training in Parkinson's Disease: A Pilot RCT. AU - Schabrun,Siobhan M, AU - Lamont,Robyn M, AU - Brauer,Sandra G, Y1 - 2016/06/30/ PY - 2015/12/13/received PY - 2016/06/15/accepted PY - 2016/7/1/entrez PY - 2016/7/1/pubmed PY - 2017/7/25/medline SP - e0158497 EP - e0158497 JF - PloS one JO - PLoS One VL - 11 IS - 6 N2 - OBJECTIVE: To investigate the feasibility and safety of a combined anodal transcranial direct current stimulation (tDCS) and dual task gait training intervention in people with Parkinson's Disease (PD) and to provide data to support a sample size calculation for a fully powered trial should trends of effectiveness be present. DESIGN: A pilot, randomized, double-blind, sham-controlled parallel group trial with 12 week follow-up. SETTING: A university physiotherapy department. INTERVENTIONS: Sixteen participants diagnosed with PD received nine dual task gait training sessions over 3 weeks. Participants were randomized to receive either active or sham tDCS applied for the first 20 minutes of each session. MAIN MEASURES: The primary outcome was gait speed while undertaking concurrent cognitive tasks (word lists, counting, conversation). Secondary measures included step length, cadence, Timed Up and Go, bradykinesia and motor speed. RESULTS: Gait speed, step length and cadence improved in both groups, under all dual task conditions. This effect was maintained at follow-up. There was no difference between the active and sham tDCS groups. Time taken to perform the TUGwords also improved, with no difference between groups. The active tDCS group did however increase their correct cognitive response rate during the TUGwords and TUGcount. Bradykinesia improved after training in both groups. CONCLUSION: Three weeks of dual task gait training resulted in improved gait under dual task conditions, and bradykinesia, immediately following training and at 12 weeks follow-up. The only parameter enhanced by tDCS was the number of correct responses while performing the dual task TUG. tDCS applied to M1 may not be an effective adjunct to dual task gait training in PD. TRIAL REGISTRATION: Australia-New Zealand Clinical Trials Registry ACTRN12613001093774. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/27359338/Transcranial_Direct_Current_Stimulation_to_Enhance_Dual_Task_Gait_Training_in_Parkinson's_Disease:_A_Pilot_RCT_ L2 - https://dx.plos.org/10.1371/journal.pone.0158497 DB - PRIME DP - Unbound Medicine ER -