Effect of Transcutaneous Spinal Direct Current Stimulation (TsDCS) Combined with Other Therapies on Walking Capacity in Patients with Neurological Disorders: A Systematic Review

Introduction: Neuromodulation has been used for walking difficulty as a therapeutic approach and, as transcutaneous spinal direct current stimulation (TsDCS) is emerging as a novel tool for patients with neurological disorders when combined with transcutaneous direct current stimulation (tDCS) and/or gait training, it seems to have a promising effect; therefore, a systematic review may provide a better insight into the efficacy of the results. This systematic review aims to assess the effects of TsDCS when applied in combination with different therapies in neurological disorder patients . Methods : Databases (Pubmed, CENTRAL, and Web of Science) were used for searching studies since inception. With the guidance of reviewers, one author extracted data. Two independent reviewers assessed qualities of the randomized controlled trials (RCTs). Results : Five studies from an initial yield of 256 studies met the inclusion criteria. TsDCS might improve walking capacity when combined with tDCS and/or gait training in stroke (TsDCS with gait training and tDCS), cerebral palsy (tDCS with gait training), and cerebellar ataxia (TsDCS with tDCS). Conclusion: The result suggests that more studies are needed for concluding the therapeutic potential. Future studies should emphasize standard stimulation protocol and determining its efficacy in other outcome parameters of gait and in patients with different neurological disorders.