The Possibility of Improvement in Balance and Function Following Conjunct Effects of Transcranial Direct Current Stimulation and Whole-Body Vibration Therapy in Spastic Cerebral Palsy Patients: A Hypothesis Study

Abstract

Cerebral palsy (CP) results from developmental brain injury, affecting posture and muscular coordination. Traditional treatments offer varying effectiveness, among them the most recent therapies are whole-body vibration therapy (WBVT) and transcranial direct current stimulation (tDCS). WBV enhances proprioceptive function, muscle mass, bone density, and joint stability by stimulating muscle spindle fibers and activating dormant motor units. It also modulates spastic reflexes through mechanoreceptors, proving more effective than traditional physiotherapy. tDCS, a non-invasive neuromodulation, reshapes cortical excitability and modulates synaptic plasticity by altering neuronal activity. It affects long-term potentiation and depression, crucial in learning and adaptive functions. tDCS's interaction with neurotransmitters, especially dopamine and GABA, and its effect on NMDA and dopaminergic receptors make it promising for CP rehabilitation. Both therapies offer novel insights into CP rehabilitation through their influence on central and peripheral neural system. This hypothesis study tends to explore the conjunct effects of transcranial direct current stimulation (tDCS) and whole-body vibration therapy (WBVT) on improving balance and function in children with spastic cerebral palsy. The hypothesis suggests that WBVT's vibratory input, alongside tDCS's central stimulation, enhances function by modulating neuronal excitability and sensory information. The tonic vibration reflex (TVR) from WBV is believed to amplify muscle strength and modulate spinal excitability. When integrated with tDCS, it might accelerate excitability in the motor cortex, essential for brain-injured patient rehabilitation. Despite evidence of individual benefits from both therapies, conjunct effects remain under-researched. Preliminary results show improvements in balance, gait velocity, and motor functions. Validating this combined approach could revolutionize treatment for children with spastic cerebral palsy.