Effects of a single session of transcranial direct current stimulation on static balance in a patient with hemiparesis: a case study

[Purpose] Cerebrovascular accident (stroke) is characterized by an abrupt onset of focal or global neurological signs and symptoms. Asymmetry of the limbs is common following a stroke due to hemiplegia or hemiparesis. [Subject and Methods] A male patient having suffered an ischemic stroke was initia...

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Published inJournal of Physical Therapy Science Vol. 27; no. 3; pp. 955 - 958
Main Authors Ferreira, Luiz Alfredo Braun, Galli, Manuela, Oliveira, Claudia Santos, Lazzari, Roberta Delasta, Dumont, Arislander Jonathan Lopes, Santos, Cibele Almedia, Carvalho, Debora Bachin, Renata Calhes Franco de Moura, Araujo, Maria Carolina
Format Journal Article
LanguageEnglish
Published Japan The Society of Physical Therapy Science 01.03.2015
Subjects
Balance
Case Study
Hemiparesis
Transcranial direct current stimulation
Hemiparesis
Balance
Transcranial direct current stimulation
Online AccessGet full text
ISSN0915-5287
2187-5626
2187-5626
DOI10.1589/jpts.27.955

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Abstract [Purpose] Cerebrovascular accident (stroke) is characterized by an abrupt onset of focal or global neurological signs and symptoms. Asymmetry of the limbs is common following a stroke due to hemiplegia or hemiparesis. [Subject and Methods] A male patient having suffered an ischemic stroke was initially evaluated using the Timed Up-and-Go Test and the Six-Minute Walk Test. Static balance was evaluated using a force plate (Kistler model 9286BA) for the stabilometry analysis of center of pressure (COP) sway. The data were interpreted using the SWAY software program (BTS Engineering) synchronized with the SMART-D 140® system. Anodal transcranial direct current stimulation (tDCS; 2 mA) was applied over the primary motor cortex for 20 minutes during gait training on a treadmill. [Results] Under the condition of eyes open, reductions were found in anteroposterior sway (6.18%), trace length (3.3%) and sway velocity (3.3%) immediately following tDCS. [Conclusion] A single session of anodal tDCS combined with treadmill training had a positive effect on the static balance of a subject with chronic hemiparesis stemming from a stroke.
AbstractList [Purpose] Cerebrovascular accident (stroke) is characterized by an abrupt onset of focal or global neurological signs and symptoms. Asymmetry of the limbs is common following a stroke due to hemiplegia or hemiparesis. [Subject and Methods] A male patient having suffered an ischemic stroke was initially evaluated using the Timed Up-and-Go Test and the Six-Minute Walk Test. Static balance was evaluated using a force plate (Kistler model 9286BA) for the stabilometry analysis of center of pressure (COP) sway. The data were interpreted using the SWAY software program (BTS Engineering) synchronized with the SMART-D 140® system. Anodal transcranial direct current stimulation (tDCS; 2 mA) was applied over the primary motor cortex for 20 minutes during gait training on a treadmill. [Results] Under the condition of eyes open, reductions were found in anteroposterior sway (6.18%), trace length (3.3%) and sway velocity (3.3%) immediately following tDCS. [Conclusion] A single session of anodal tDCS combined with treadmill training had a positive effect on the static balance of a subject with chronic hemiparesis stemming from a stroke.
[Purpose] Cerebrovascular accident (stroke) is characterized by an abrupt onset of focal or global neurological signs and symptoms. Asymmetry of the limbs is common following a stroke due to hemiplegia or hemiparesis. [Subject and Methods] A male patient having suffered an ischemic stroke was initially evaluated using the Timed Up-and-Go Test and the Six-Minute Walk Test. Static balance was evaluated using a force plate (Kistler model 9286BA) for the stabilometry analysis of center of pressure (COP) sway. The data were interpreted using the SWAY software program (BTS Engineering) synchronized with the SMART-D 140(®) system. Anodal transcranial direct current stimulation (tDCS; 2 mA) was applied over the primary motor cortex for 20 minutes during gait training on a treadmill. [Results] Under the condition of eyes open, reductions were found in anteroposterior sway (6.18%), trace length (3.3%) and sway velocity (3.3%) immediately following tDCS. [Conclusion] A single session of anodal tDCS combined with treadmill training had a positive effect on the static balance of a subject with chronic hemiparesis stemming from a stroke.
[Purpose] Cerebrovascular accident (stroke) is characterized by an abrupt onset of focal or global neurological signs and symptoms. Asymmetry of the limbs is common following a stroke due to hemiplegia or hemiparesis. [Subject and Methods] A male patient having suffered an ischemic stroke was initially evaluated using the Timed Up-and-Go Test and the Six-Minute Walk Test. Static balance was evaluated using a force plate (Kistler model 9286BA) for the stabilometry analysis of center of pressure (COP) sway. The data were interpreted using the SWAY software program (BTS Engineering) synchronized with the SMART-D 140® system. Anodal transcranial direct current stimulation (tDCS; 2 mA) was applied over the primary motor cortex for 20 minutes during gait training on a treadmill. [Results] Under the condition of eyes open, reductions were found in anteroposterior sway (6.18%), trace length (3.3%) and sway velocity (3.3%) immediately following tDCS. [Conclusion] A single session of anodal tDCS combined with treadmill training had a positive effect on the static balance of a subject with chronic hemiparesis stemming from a stroke.
Author Renata Calhes Franco de Moura
Santos, Cibele Almedia
Galli, Manuela
Ferreira, Luiz Alfredo Braun
Lazzari, Roberta Delasta
Araujo, Maria Carolina
Oliveira, Claudia Santos
Carvalho, Debora Bachin
Dumont, Arislander Jonathan Lopes
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  fullname: Ferreira, Luiz Alfredo Braun
  organization: Guairacá College, Student Doctoral Program in Rehabilitation Sciences, University Nove, Brazil
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  fullname: Galli, Manuela
  organization: Dipartimento di Bioingegneria, Politecnico di Milano, Italy
– sequence: 1
  fullname: Oliveira, Claudia Santos
  organization: Master’s and Doctoral Programs in Rehabilitation Sciences, University Nove Julho, Brazil
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  fullname: Lazzari, Roberta Delasta
  organization: Master’s Program in Rehabilitation Sciences, University Nove de Julho, Brazil
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  fullname: Dumont, Arislander Jonathan Lopes
  organization: Master’s Program in Rehabilitation Sciences, University Nove de Julho, Brazil
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  fullname: Santos, Cibele Almedia
  organization: Master’s Program in Rehabilitation Sciences, University Nove de Julho, Brazil
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  fullname: Carvalho, Debora Bachin
  organization: Department of Physiotherapy, University Nove de Julho, Brazil
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  organization: Doctoral Program in Rehabilitation Sciences, University Nove de Julho, Brazil
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  fullname: Araujo, Maria Carolina
  organization: Master’s Program in Rehabilitation Sciences, University Nove de Julho, Brazil
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Cites_doi 10.1590/S1413-35552011005000030
10.1093/brain/awh369
10.1177/1545968311402091
10.1016/j.clinph.2006.04.009
10.1016/j.neuroimage.2007.01.027
10.1186/1471-2431-13-168
10.3233/RNN-140393
10.1111/j.1532-5415.1991.tb01616.x
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10.1017/S0012162205001027
10.1016/0013-4694(87)90206-9
10.5535/arm.2013.37.6.759
10.1589/jpts.26.899
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Issue 3
Keywords Hemiparesis
Balance
Transcranial direct current stimulation
Language English
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References 9) Miranda PC, Lomarev M, Hallett M: Modeling the current distribution during transcranial direct current stimulation. Clin Neurophysiol, 2006, 117: 1623–1629.
11) Hummel F, Celnik P, Giraux P, et al.: Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain, 2005, 128: 490–499.
15) Maher CA, Williams MT, Olds TS: The six-minute walk test for children with cerebral palsy. Int J Rehabil Res, 2008, 31: 185–188.
18) Grecco LA, Duarte NA, de Mendonça ME, et al.: Effect of transcranial direct current stimulation combined with gait and mobility training on functionality in children with cerebral palsy: study protocol for a double-blind randomized controlled clinical trial. BMC Pediatr, 2013, 13: 168.
21) Tanaka S, Takeda K, Otaka Y, et al.: Single session of transcranial direct current stimulation transiently increases knee extensor force in patients with hemiparetic stroke. Neurorehabil Neural Repair, 2011, 25: 565–569.
1) Iwabe C, da Rocha Diz MA, Barudy DP: Análise cinemática da marcha em indivíduos com Acidente Vascular Encefálico. Rev Neurocienc, 2008, 16: 292–296.
5) Chen CC, Hong WH, Wang CM, et al.: Kinematic features of rear-foot motion using anterior and posterior ankle-foot orthoses in stroke patients with hemiplegic gait. Arch Phys Med Rehabil, 2010, 91: 1862–1868.
19) Tahtis V, Kaski D, Seemungal BM: The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in sub-acute stroke: a pilot study. Restor Neurol Neurosci, 2014, 32: 527–532.
3) Contran RS, Kumar V, Robbins SL: Patologia Estrutural e Funcional. 5ª edição, Editora Guarabara Koogan, Rio de Janeiro, 1996.
20) Duarte NA, Grecco LA, Galli M, et al.: Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PLoS ONE, 2014, 9: e105777.
10) Wagner T, Fregni F, Fecteau S, et al.: Transcranial direct current stimulation: a computer-based human model study. Neuroimage, 2007, 35: 1113–1124.
2) Smith L, Weiss E, Lehmkuhl D: Cinesiologia Clínica de Brunnstrom. 5ª edição. Editora Manole, São Paulo, 1997.
12) Williams EN, Carroll SG, Reddihough DS, et al.: Investigation of the timed ‘up & go’ test in children. Dev Med Child Neurol, 2005, 47: 518–524.
14) ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories: ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med, 2002, 166: 111–117.
16) Homan RW, Herman J, Purdy P: Cerebral location of international 10-20 system electrode placement. Electroencephalogr Clin Neurophysiol, 1987, 66: 376–382.
13) Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc, 1991, 39: 142–148.
17) Park SW, Lee KJ, Shin DC, et al.: The effect of underwater gait training on balance ability of stroke patients. J Phys Ther Sci, 2014, 26: 899–903.
4) Thijssen DH, Paulus R, van Uden CJ, et al.: Decreased energy cost and improved gait pattern using a new orthosis in persons with long-term stroke. Arch Phys Med Rehabil, 2007, 88: 181–186.
8) Stagg CJ, Bachtiar V, O’Shea J, et al.: Cortical activation changes underlying stimulation-induced behavioural gains in chronic stroke. Brain, 2012, 135: 276–284.
7) Sohn MK, Jee SJ, Kim YW: Effect of transcranial direct current stimulation on postural stability and lower extremity strength in hemiplegic stroke patients. Ann Rehabil Med, 2013, 37: 759–765.
6) Prado-Medeiros CL, Sousa CO, Souza AS, et al.: Effects of the addition of functional electrical stimulation to ground level gait training with body weight support after chronic stroke. Rev Bras Fisioter, 2011, 15: 436–444.
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16762592 - Clin Neurophysiol. 2006 Jul;117(7):1623-9
21436391 - Neurorehabil Neural Repair. 2011 Jul-Aug;25(6):565-9
21112427 - Arch Phys Med Rehabil. 2010 Dec;91(12 ):1862-8
24112817 - BMC Pediatr. 2013 Oct 11;13:168
24906374 - Restor Neurol Neurosci. 2014;32(4):527-32
17270515 - Arch Phys Med Rehabil. 2007 Feb;88(2):181-6
22155982 - Brain. 2012 Jan;135(Pt 1):276-84
24466510 - Ann Rehabil Med. 2013 Dec;37(6):759-65
1991946 - J Am Geriatr Soc. 1991 Feb;39(2):142-8
25013292 - J Phys Ther Sci. 2014 Jun;26(6):899-903
25171216 - PLoS One. 2014 Aug 29;9(8):e105777
12091180 - Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
18467936 - Int J Rehabil Res. 2008 Jun;31(2):185-8
15634731 - Brain. 2005 Mar;128(Pt 3):490-9
2435517 - Electroencephalogr Clin Neurophysiol. 1987 Apr;66(4):376-82
22031271 - Rev Bras Fisioter. 2011 Nov-Dec;15(6):436-44
16108451 - Dev Med Child Neurol. 2005 Aug;47(8):518-24
17337213 - Neuroimage. 2007 Apr 15;35(3):1113-24
References_xml – reference: 12) Williams EN, Carroll SG, Reddihough DS, et al.: Investigation of the timed ‘up & go’ test in children. Dev Med Child Neurol, 2005, 47: 518–524.
– reference: 14) ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories: ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med, 2002, 166: 111–117.
– reference: 17) Park SW, Lee KJ, Shin DC, et al.: The effect of underwater gait training on balance ability of stroke patients. J Phys Ther Sci, 2014, 26: 899–903.
– reference: 15) Maher CA, Williams MT, Olds TS: The six-minute walk test for children with cerebral palsy. Int J Rehabil Res, 2008, 31: 185–188.
– reference: 20) Duarte NA, Grecco LA, Galli M, et al.: Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PLoS ONE, 2014, 9: e105777.
– reference: 11) Hummel F, Celnik P, Giraux P, et al.: Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain, 2005, 128: 490–499.
– reference: 5) Chen CC, Hong WH, Wang CM, et al.: Kinematic features of rear-foot motion using anterior and posterior ankle-foot orthoses in stroke patients with hemiplegic gait. Arch Phys Med Rehabil, 2010, 91: 1862–1868.
– reference: 16) Homan RW, Herman J, Purdy P: Cerebral location of international 10-20 system electrode placement. Electroencephalogr Clin Neurophysiol, 1987, 66: 376–382.
– reference: 21) Tanaka S, Takeda K, Otaka Y, et al.: Single session of transcranial direct current stimulation transiently increases knee extensor force in patients with hemiparetic stroke. Neurorehabil Neural Repair, 2011, 25: 565–569.
– reference: 1) Iwabe C, da Rocha Diz MA, Barudy DP: Análise cinemática da marcha em indivíduos com Acidente Vascular Encefálico. Rev Neurocienc, 2008, 16: 292–296.
– reference: 3) Contran RS, Kumar V, Robbins SL: Patologia Estrutural e Funcional. 5ª edição, Editora Guarabara Koogan, Rio de Janeiro, 1996.
– reference: 2) Smith L, Weiss E, Lehmkuhl D: Cinesiologia Clínica de Brunnstrom. 5ª edição. Editora Manole, São Paulo, 1997.
– reference: 10) Wagner T, Fregni F, Fecteau S, et al.: Transcranial direct current stimulation: a computer-based human model study. Neuroimage, 2007, 35: 1113–1124.
– reference: 7) Sohn MK, Jee SJ, Kim YW: Effect of transcranial direct current stimulation on postural stability and lower extremity strength in hemiplegic stroke patients. Ann Rehabil Med, 2013, 37: 759–765.
– reference: 13) Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc, 1991, 39: 142–148.
– reference: 18) Grecco LA, Duarte NA, de Mendonça ME, et al.: Effect of transcranial direct current stimulation combined with gait and mobility training on functionality in children with cerebral palsy: study protocol for a double-blind randomized controlled clinical trial. BMC Pediatr, 2013, 13: 168.
– reference: 8) Stagg CJ, Bachtiar V, O’Shea J, et al.: Cortical activation changes underlying stimulation-induced behavioural gains in chronic stroke. Brain, 2012, 135: 276–284.
– reference: 19) Tahtis V, Kaski D, Seemungal BM: The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in sub-acute stroke: a pilot study. Restor Neurol Neurosci, 2014, 32: 527–532.
– reference: 4) Thijssen DH, Paulus R, van Uden CJ, et al.: Decreased energy cost and improved gait pattern using a new orthosis in persons with long-term stroke. Arch Phys Med Rehabil, 2007, 88: 181–186.
– reference: 6) Prado-Medeiros CL, Sousa CO, Souza AS, et al.: Effects of the addition of functional electrical stimulation to ground level gait training with body weight support after chronic stroke. Rev Bras Fisioter, 2011, 15: 436–444.
– reference: 9) Miranda PC, Lomarev M, Hallett M: Modeling the current distribution during transcranial direct current stimulation. Clin Neurophysiol, 2006, 117: 1623–1629.
– ident: 2
– ident: 6
  doi: 10.1590/S1413-35552011005000030
– ident: 11
  doi: 10.1093/brain/awh369
– ident: 3
– ident: 21
  doi: 10.1177/1545968311402091
– ident: 9
  doi: 10.1016/j.clinph.2006.04.009
– ident: 10
  doi: 10.1016/j.neuroimage.2007.01.027
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  doi: 10.1186/1471-2431-13-168
– ident: 19
  doi: 10.3233/RNN-140393
– ident: 13
  doi: 10.1111/j.1532-5415.1991.tb01616.x
– ident: 15
  doi: 10.1097/MRR.0b013e32830150f9
– ident: 14
  doi: 10.1164/ajrccm.166.1.at1102
– ident: 5
  doi: 10.1016/j.apmr.2010.09.013
– ident: 1
  doi: 10.34024/rnc.2008.v16.8618
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  doi: 10.1371/journal.pone.0105777
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  doi: 10.1093/brain/awr313
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  doi: 10.1016/j.apmr.2006.11.014
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  doi: 10.1016/0013-4694(87)90206-9
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– ident: 17
  doi: 10.1589/jpts.26.899
– reference: 18467936 - Int J Rehabil Res. 2008 Jun;31(2):185-8
– reference: 25013292 - J Phys Ther Sci. 2014 Jun;26(6):899-903
– reference: 24112817 - BMC Pediatr. 2013 Oct 11;13:168
– reference: 22155982 - Brain. 2012 Jan;135(Pt 1):276-84
– reference: 16108451 - Dev Med Child Neurol. 2005 Aug;47(8):518-24
– reference: 21436391 - Neurorehabil Neural Repair. 2011 Jul-Aug;25(6):565-9
– reference: 1991946 - J Am Geriatr Soc. 1991 Feb;39(2):142-8
– reference: 24466510 - Ann Rehabil Med. 2013 Dec;37(6):759-65
– reference: 12091180 - Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
– reference: 25171216 - PLoS One. 2014 Aug 29;9(8):e105777
– reference: 15634731 - Brain. 2005 Mar;128(Pt 3):490-9
– reference: 16762592 - Clin Neurophysiol. 2006 Jul;117(7):1623-9
– reference: 17337213 - Neuroimage. 2007 Apr 15;35(3):1113-24
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Snippet [Purpose] Cerebrovascular accident (stroke) is characterized by an abrupt onset of focal or global neurological signs and symptoms. Asymmetry of the limbs is...
[Purpose] Cerebrovascular accident (stroke) is characterized by an abrupt onset of focal or global neurological signs and symptoms. Asymmetry of the limbs is...
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SubjectTerms Balance
Case Study
Hemiparesis
Transcranial direct current stimulation
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Title Effects of a single session of transcranial direct current stimulation on static balance in a patient with hemiparesis: a case study
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