Investigating the feasibility of cerebellar transcranial direct current stimulation to facilitate post-stroke overground gait performance in chronic stroke: a partial least-squares regression approach.
Dhaval Solanki, Zeynab Rezaee, Anirban Dutta and 1 others
PMID 33509192WHAT IT FOUND
A single session of cerebellar brain stimulation was tolerated by ten men with chronic stroke.
It did not improve clinical walking speed or balance. However, it changed specific timing patterns in gait, with one stimulation setup speeding up steps on the affected side while slowing stance on the unaffected side.
Key findings
01Ten participants completed the study after two dropped out due to discomfort with the cap; none reported adverse effects like burning, nausea, or headache.
02Clinical measures of walking speed (TMWT), mobility (TUG), and balance (BBS) showed only small improvements that did not reach the minimum clinically important difference.
03Quantitative gait analysis showed significant differences between the two stimulation montages for step time on the affected leg and stance time on the unaffected leg.
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
The study was not adequately powered and lacked a sham control group, making it impossible to determine if the observed changes were due to the stimulation or natural variability/practice effects. The sample consisted only of male participants with intact cerebellums, limiting generalizability to women or patients with cerebellar lesions. The electric field modeling used age-matched healthy templates rather than individual patient MRI scans, which may not accurately reflect the current flow in stroke-damaged brains. The carry-over effects of stimulation were not evaluated despite the short washout period.
Declared interests
The authors declared no competing interests. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not interpret the significant changes in quantitative gait timing (step time and stance time) as evidence that cerebellar tDCS improves walking ability. These changes did not result in clinically meaningful improvements in speed, balance, or mobility, and the study lacked a sham control to rule out placebo or practice effects.