Background Children with cerebral palsy (CP) exhibit widespread alterations in cortical excitability and present with bilateral alterations in the bi-hemispheric sensorimotor functions, even when the initial brain lesion is unilateral. Objective This study evaluated the feasibility, safety, and preliminary efficacy of combining bilateral anodal transcranial direct current stimulation (tDCS) over the sensorimotor cortices with treadmill training in children with CP. Method A within-subjects case series was conducted with five children with CP. Participants received ten sessions of treadmill training (at 50% of their maximum over-ground speed) concurrently with bilateral anodal tDCS. Outcomes, assessed pre- and post-intervention, included postural alignment (medio-lateral and anterior-posterior), ankle dorsiflexion range of motion, gait variability, walking tolerance (6-minute walk test), motor function (GMFM-66), and hip/knee range of motion. Statistical analysis was performed using paired t-tests and effect sizes (Hedges’ g). Results The intervention was feasible and well-tolerated without any reported side effects. In addition, moderate to large effect sizes were observed in medio-lateral postural alignment (Hedges’ = 0.65) and left ankle passive dorsiflexion (Hedges’ = 1.49). Right ankle dorsiflexion showed a moderate improvement (Hedges’ = 0.77). Anterior-posterior alignment, gait variability, walking tolerance, gross motor function, or other ranges of motion showed minimal improvement. Conclusion Bilateral anodal tDCS stimulation combined with treadmill training therapy is a feasible and safe intervention for children with CP. The preliminary evidence of potentially clinically meaningful treatment effect in specific postural and impairment measures, provide preliminary treatment effect estimates that support the feasibility of conducting future adequately powered randomized controlled trials.
Hadoush et al. (Sat,) studied this question.