序贯经颅直流电刺激(tDCS)和物理治疗(PT)治疗有跌倒风险的老年人的可行性和安全性:一项随机试点可行性研究

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation Pub Date : 2023-12-01 DOI:10.1016/j.arrct.2023.100288

On-Yee Lo PhD , Sarah Charest OTR/L , Heather Margulis PT, MSPT , Lewis Lipsitz MD , Brad Manor PhD

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引用次数: 0

摘要

目的确定在对有跌倒风险的老年人进行物理治疗（PT）之前立即实施经颅直流电刺激（tDCS）的可行性和安全性。主要结果测量报告了可行性、安全性和功能性结果，为设计更大型、更明确的试验提供参考。结果6名跌倒者（88.8±5.0岁/o，5F）完成了研究，接受了82.3%的可能刺激疗程，这表明在PT训练之前立即增加20分钟的刺激疗程以及前后评估是可行的。盲法是成功的，所有报告的副作用都是预期的和短暂的。这项试验虽然可行且安全，但也遇到了许多挑战，包括选择偏差、时间和精力的投入以及功能表现的巨大差异，在设计和实施更大规模、更明确的试验时必须考虑到这些挑战。

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Feasibility and Safety of Sequential Transcranial Direct Current Stimulation and Physical Therapy in Older Adults at Risk of Falling: A Randomized Pilot Study

Objective

To establish the feasibility and safety of administering transcranial direct current stimulation (tDCS) immediately prior to physical therapy (PT) sessions in older adults at risk of falls.

Design

A pilot randomized controlled study.

Setting

Outpatient geriatric physical therapy clinic.

Participants

Ten older adults living within supportive housing facilities (86.8±7.9 y/o, 8F) were enrolled in the study.

Interventions

Participants received tDCS or sham stimulation targeting the left dorsal lateral prefrontal cortex for 20 minutes, immediately prior to up to 10 of their PT visits.

Main Outcome Measures

Feasibility, safety, and functional outcomes were reported to inform the design of a larger and more definitive trial.

Results

Six fallers (88.8±5.0 y/o, 5F) completed the study and received 82.3% of the possible stimulation sessions, suggesting adding a 20-minute session of stimulation immediately prior to PT training sessions, along with pre- and post-assessments is feasible. The blinding strategy was successful and all reported side effects were expected and transient. While feasible and safe, the trial was met with numerous challenges, including selection bias, time and energy commitment, and large variation in functional performance, that must be considered when designing and implementing larger more definitive trials.