Effect of Dual Site Transcranial Direct Current Stimulation on Motor Proficiency and Spasticity in Children with Cerebral Palsy

A bstract Background: Cerebral palsy (CP) is a movement disorder affecting balance and posture in children. The transcranial direct current stimulation (tDCS) intervention applies a steady, low-intensity direct current via electrodes on the head. This study aimed to compare the effects of tDCS and neurodevelopmental therapy (NDT) on motor proficiency and spasticity in children aged 4–12 years with CP. Materials and Methods: Twenty-six children with CP attending a tertiary care hospital were randomly assigned to receive five sessions of either tDCS or NDT. A pre–post study design was used to analyze the data. Primary outcome measures included the Bruininks–Oseretsky Test of Motor Proficiency (BOT™-2) and the Tardieu Scale. Statistical analyses included the likelihood ratio test, independent t test, Mann–Whitney U test, Wilcoxon signed-rank test, and paired t test. Results: Significant between-group differences were found, only in strength and agility (median difference = 2, IQR 3.5–15, P = 0.04), indicating a relatively better improvement with tDCS. Both groups showed pre-to-post improvements in fine motor precision (FMP), manual dexterity, and strength. Additionally, the tDCS group showed improvements in fine motor integration, bilateral coordination, balance, and body coordination, while the NDT group showed improvement in total body composite. Conclusions: Five sessions of tDCS significantly enhanced strength and agility, suggesting improved balance and coordination in children with CP compared to NDT alone. These findings highlight the added potential of tDCS as an effective tool in neurodevelopmental rehabilitation.