Gülser Cinbaz, Zübeyir Sarı, Semra Oğuz, Lütfü Hanoğlu, Juan Jose Fernández-Pérez, Julio Gómez-Soriano
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引用次数: 0
Abstract
Background and purpose: Multiple sclerosis (MS) presents significant challenges due to its inflammatory and degenerative nature, often manifesting in debilitating symptoms such as gait disturbances. Non-invasive stimulation techniques, such as trans-spinal direct current stimulation (tsDCS), offer promising avenues for enhancing functional recovery, but evidence on tsDCS effectiveness in neurological disorders remains sparse. This study aimed to investigate the effects of cathodal tsDCS on gait function and fatigue in people with MS (pwMS) compared to sham tsDCS.
Methods: Twenty-two pwMS received 6 sessions of 20-minute cathodal tsDCS (n = 11) or sham tsDCS (n = 11) in addition to a physiotherapy program. The primary outcomes were the Timed 25-Foot Walk (T25-FW), Timed Up and Go test (TUG), gait speed, and the Multiple Sclerosis Walking Scale-12 (MSWS-12) evaluated before and after treatment. The secondary outcome was fatigue, measured with the Fatigue Severity Scale (FSS) and Fatigue Impact Scale (FIS).
Results: Intergroup comparisons showed a significant improvement in the cathodal tsDCS group compared to the sham tsDCS group. Specifically, there was a greater reduction in pre-post values for T25-FW (Median: -4.43; Range: -12.1 to -1.0), MSWS-12 (-16.70; -31.7 to -5.0), TUG (-6.03; -20.8 to -0.7), FSS (-0.30; -2.2 to 0.1), and FIS-Physical (4.00; -13.0 to 0.0). Additionally, walking speed increased significantly (0.15; 0.02 to 0.24) in the cathodal tsDCS group. Moreover, all gait-related outcomes and FSS showed large effect sizes (r > 0.5), indicating a strong intervention effect.
Discussion and conclusions: Incorporating cathodal tsDCS into a physiotherapy program improved walking function and fatigue in pwMS. Although replication is warranted, these results hold promise for clinical applications, highlighting tsDCS as a potential tool for enhancing motor function and reducing fatigue in pwMS.
Video abstract available: for more insights from the authors (see Supplemental Digital Content available at http://links.lww.com/JNPT/A542).
期刊介绍：
The Journal of Neurologic Physical Therapy (JNPT) is an indexed resource for dissemination of research-based evidence related to neurologic physical therapy intervention. High standards of quality are maintained through a rigorous, double-blinded, peer-review process and adherence to standards recommended by the International Committee of Medical Journal Editors. With an international editorial board made up of preeminent researchers and clinicians, JNPT publishes articles of global relevance for examination, evaluation, prognosis, intervention, and outcomes for individuals with movement deficits due to neurologic conditions. Through systematic reviews, research articles, case studies, and clinical perspectives, JNPT promotes the integration of evidence into theory, education, research, and practice of neurologic physical therapy, spanning the continuum from pathophysiology to societal participation.
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