Motor effects of transcranial direct current stimulation associated with physiotherapy in children with cerebral palsy: a systematic review

Cerebral palsy (CP) is a prevalent cause of motor, cognitive, communicative, and behavioral impairments in children, imposing significant limitations on their daily lives. Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique employing low-intensity electrical currents to alter neuronal activity, and it can be effectively integrated into physiotherapy regimens. The objective of this study was to assess the motor effects of tDCS in children and adolescents diagnosed with CP. A comprehensive literature search was performed across the PubMed, MEDLINE, and Physiotherapy Evidence Database (PEDro). The methodological quality of the included studies was evaluated using the PEDro scale. The analysis incorporated four studies, encompassing a total of 113 children aged between 5 to 12 years, of both sexes, diagnosed with spastic CP. These studies spanned various levels of the Gross Motor Function Classification System (GMFCS), ranging from I to III, and included children classified at levels I or II of the Manual Ability Classification System (MACS). The intervention groups receiving tDCS demonstrated positive outcomes. The findings from this review confirm that tDCS, when combined with conventional physiotherapeutic techniques, significantly enhances motor functions in children with cerebral palsy.