Effects of transcranial direct current stimulation alone and in combination with rehabilitation therapies on gait and balance among individuals with Parkinson's disease: a systematic review and meta-analysis.
Thi Xuan Dieu Nguyen, Phuc Thi Mai, Ya-Ju Chang and 1 others
PMID 38373966WHAT IT FOUND
tDCS improved walking rhythm and reduced freezing of gait, but did not significantly change walking speed or stride length.
It also helped balance on the Timed Up and Go test. No single optimal protocol for dose or placement has been established.
Key findings
01tDCS significantly reduced cadence and improved scores on the freezing of gait questionnaire.
02tDCS significantly improved balance as measured by the Timed Up and Go test, but not on the Berg Balance Scale or Dynamic Gait Index.
03tDCS did not produce a statistically significant improvement in gait speed or stride length compared to sham treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Many included studies had small sample sizes and lacked rigorous blinding or allocation concealment. Half of the studies used crossover designs with short washout periods, raising the possibility of carry-over effects. Protocols varied widely in electrode placement, intensity, and duration, making it difficult to recommend a specific treatment plan. The analysis could not determine if tDCS works better at specific stages of Parkinson's disease due to insufficient data. Publication bias was detected for gait speed, with one outlier study influencing the results.
Declared interests
The study was funded by the National Science and Technology Council. No other conflicts of interest were declared.
The easy way to misread this
Do not assume tDCS will improve your patient's walking speed or stride length. The meta-analysis found these specific outcomes were not statistically significant compared to sham treatment, even though other gait parameters improved.