The effect of transcranial direct current stimulation associated with video game training on the postural balance of older women in the community: A blind, randomized, clinical trial.

IF 1.5 Q3 REHABILITATION

Physiotherapy Research International Pub Date : 2024-01-01 Epub Date: 2023-08-22 DOI:10.1002/pri.2046

Fernanda Ishida Corrêa, Andre Issao Kunitake, Wellington Segheto, Max Duarte de Oliveira, Felipe Fregni, João Carlos Ferrari Corrêa

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Abstract

Background: Falls are frequent in older adults and can cause trauma, injury, and death. Fall prevention with virtual reality presents good results in improving postural control. Transcranial Direct Current Stimulation (tDCS) has been used with the same aim; however, the combination of the two techniques has still been little studied.

Purpose: To assess whether tDCS can enhance the effect of video game training (VGT) on improving the postural balance of healthy older women.

Method: A blinded, randomized, controlled clinical trial was conducted with 57 older women who were randomized to three balance training groups: Control Group (VGT), Anodal Group (VGT combined with anodic tDCS-atDCS), and Sham Group (VGT combined with sham tDCS-stDCS). Balance training was performed twice a week for four weeks, totalizing eight 20-min sessions using VGT associated with tDCS. Postural balance was assessed pre-and post-training and 30 days after the end of the eight sessions using the Mini-Balance Evaluation Systems Test.

Results: Compared to pre-intervention the Mini BEST test increased similarly in the three groups in post-intervention (control: pre 23.7 ± 2.8 to post 27.0 ± 2.2; anodal: pre 24.4 ± 1 to post 27.7 ± 0.8 and sham: pre 24.2 ± 1.9 to post 26.5 ± 1.6; p < 0.001) and follow-up (control: pre 23.7 ± 2.8 to follow-up 26.8 ± 2.3; anodal: pre 24.4 ± 1 to follow-up 27.3 ± 1.4 and sham: pre 24.2 ± 1.9 to follow-up 26.8 ± 1.5; p < 0.001).

Conclusion: There was an improvement in the postural balance of the three training groups that were independent of tDCS.

Discussion: Some studies have shown the positive tDCS effects associated with other tasks to improve balance. However, these results convey the effects of only anodic-tDCS compared to sham-tDCS. Possibly, the effect of VGT surpassed the tDCS effects, promoting a ceiling effect from the combination of these two therapies. However, studies with other therapies combined with tDCS for older adults deserve to be investigated, as well as in frail older people.

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经颅直流电刺激与电子游戏训练对社区老年妇女姿势平衡的影响：盲法随机临床试验

背景：老年人经常摔倒，可导致创伤、受伤和死亡。利用虚拟现实技术预防跌倒在改善姿势控制方面取得了良好效果。目的：评估经颅直流电刺激（transcranial Direct Current Stimulation，tDCS）能否增强视频游戏训练（VGT）对改善健康老年妇女姿势平衡的效果：方法：对 57 名老年妇女进行了一项盲法随机对照临床试验，将她们随机分为三个平衡训练组：对照组（VGT）、阳极组（VGT 与阳极 tDCS-atDCS 相结合）和虚假组（VGT 与虚假 tDCS-stDCS 相结合）。平衡训练每周进行两次，为期四周，共八次，每次 20 分钟，使用 VGT 和 tDCS。在训练前、训练后以及八次训练结束后的 30 天内，使用迷你平衡评估系统测试对姿势平衡进行评估：结果：与干预前相比，三组的迷你平衡评估系统测试结果在干预后都有类似的提高（对照组：从干预前的 23.7 ± 2.8 提高到干预后的 27.0 ± 2.2；阳极组：从干预前的 24.4 ± 1 提高到干预后的 27.7 ± 0.8；假体组：从干预前的 24.2 ± 1.9 提高到干预后的 26.5 ± 1.6；P 结论：在干预后，三组的姿势平衡能力都有提高：三个训练组的姿势平衡均有改善，且与 tDCS 无关：讨论：一些研究表明，与其他任务相关的 tDCS 对改善平衡有积极作用。然而，这些结果只反映了阳极-tDCS 与假-tDCS 相比的效果。可能是 VGT 的效果超过了 tDCS 的效果，这两种疗法的结合产生了天花板效应。不过，针对老年人以及体弱老年人的其他疗法与 tDCS 的结合研究值得研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physiotherapy Research International REHABILITATION-

CiteScore

3.30

自引率

5.90%

发文量

期刊介绍： Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.