Feasibility and Safety of Sequential Transcranial Direct Current Stimulation and Physical Therapy in Older Adults at Risk of Falling: A Randomized Pilot Study.
On-Yee Lo, Sarah Charest, Heather Margulis and 2 others
PMID 38163031WHAT IT FOUND
Six older fall-risk participants completed 20-minute tDCS or sham sessions before usual PT, and no unanticipated side effects or adverse effects were reported.
Functional changes were inconsistent, and the study was too small to show whether tDCS helped.
Key findings
01Six of ten enrolled participants completed the final assessment after receiving combined stimulation plus PT, and no unanticipated side effects or adverse effects were reported.
02After adding either real or sham stimulation to usual PT, all but one participant improved on the Berg Balance Scale by 2 to 7 points; other functional and cognitive outcomes were inconsistent and showed no clear between-group pattern.
03Satisfaction averaged 7.8 on a 1 to 10 scale, but only 1 of 6 participants said they would be willing to participate again or for a longer period, and 4 of 6 reported gel application as their main concern.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 10 people were enrolled, and 4 withdrew before any intervention, so the functional comparisons rested on 6 participants. The groups were very small and unequal, with 2 participants receiving tDCS and 4 receiving sham. The paper states the sample was too small and heterogeneous to estimate the effect of tDCS plus PT compared with sham plus PT. Recruitment was stopped after 5 months because of the COVID-19 pandemic. Participants were very old and frail, with 9 of 10 over 80 years. Only one participant said they would be willing to participate again or for a longer period.
Declared interests
The supplied text does not report funding sources or author conflict-of-interest declarations. It lists Neuroelectrics Starstim 32 as the tDCS device and software supplier and APDM Wearable Technologies as the wearable sensor supplier.
The easy way to misread this
Do not conclude that tDCS improves gait, balance, or fall risk. Only six participants completed the pilot, two received tDCS and four received sham, and the paper says the sample was too small to estimate the effect of tDCS plus PT compared with sham plus PT. The Berg Balance Scale improvements occurred after adding either real or sham stimulation to usual PT, so they cannot be attributed to tDCS.