Abstract
Postural stability is commonly decreased in individuals with chronic post-stroke hemiparesis due to multisystemic deficits. Transcranial direct current stimulation (tDCS) is a non-invasive method to modulate cortical excitability, inducing neuroplastic changes to the targeted cortical areas and has been suggested to potentially improve motor functions in individuals with neurological impairments. The purpose of this double-blinded, sham-controlled study was to examine the acute effects of anodal tDCS over the lesioned motor cortex leg area with concurrent limits of stability training on postural control in individuals with chronic post-stroke hemiparesis. Ten individuals with chronic post-stroke hemiparesis received either anodal or sham tDCS stimulation over the lesioned leg region of the motor cortex while undergoing 20 min of postural training. The type of stimulation to receive during the first session was pseudorandomized, and the two sessions were separated by 14 days. Before and immediately after 20 min of tDCS, the 10 m walk test, the Berg Balance Scale, and dynamic posturography assessments were performed. After a single session of anodal tDCS with concurrent postural training, we observed no changes in clinical measures of balance and walking, assessed using the Berg Balance Scale and 10 m walk test. For dynamic posturography assessments, participants demonstrated improvements in adaptation responses to toes-up and toes-down perturbations, regardless of the type of tDCS received. Additionally, improved performance in the shifting center of gravity was observed during anodal tDCS. Taken together, these preliminary findings suggest that tDCS can potentially be used as a feasible approach be incorporated into the rehabilitation of chronic post-stroke individuals with issues related to postural control and fear of falling, and that multiple sessions of tDCS stimulation may be needed to improve functional measures of postural control and walking.
Highlights
Individuals with post-stroke hemiparesis are at higher risks for falls, which can be debilitating, negatively impacts the quality of life, and poses a significant burden on health care costs (Sattin, 1992)
For the Berg Balance Scale, the two-way ANOVA revealed no significant interaction between stimulation and time [F(1, 9) = 0.053, p = 0.823]
No significant differences were found for the main effects of stimulation [F(1, Transcranial direct current stimulation (tDCS) on Post-stroke Postural Control
Summary
Individuals with post-stroke hemiparesis are at higher risks for falls, which can be debilitating, negatively impacts the quality of life, and poses a significant burden on health care costs (Sattin, 1992). Falls can involve multiple factors, includingindividual related intrinsic factors, environment-related extrinsic factors, and activity-related behavioral factors (Tinetti et al, 1988; Nevitt et al, 1989). Postural instability has been identified as a major intrinsic risk factor for falls (Tinetti et al, 1988; Shumway-Cook et al, 1997). Previous evidence demonstrated the involvement of the leg motor area in postural tasks, static standing, responding to perturbations greater than postural sway during static standing, and locomotion (Beck et al, 2007; Tokuno et al, 2009). After lesions to the cortex, such as in a stroke, postural stability is commonly decreased as a result of deficits in the sensory, musculoskeletal, perceptual, and cognitive systems (Duncan, 1994)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
