Cerebellar Transcranial Direct Current Stimulation for Motor Learning in People With Chronic Stroke: A Pilot Randomised Controlled Trial

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aut.relation.articlenumber982en_NZ
aut.relation.issue12en_NZ
aut.relation.journalBrain Sciencesen_NZ
aut.relation.volume10en_NZ
aut.researcherRashid, Usman
dc.contributor.authorKumari, Nen_NZ
dc.contributor.authorTaylor, Den_NZ
dc.contributor.authorOlsen, Sen_NZ
dc.contributor.authorRashid, Uen_NZ
dc.contributor.authorSignal, Nen_NZ
dc.date.accessioned2021-03-11T21:38:22Z
dc.date.available2021-03-11T21:38:22Z
dc.date.copyright2020en_NZ
dc.date.issued2020en_NZ
dc.description.abstractCerebellar transcranial direct current stimulation (ctDCS) is a non-invasive brain stimulation technique that alters neural plasticity through weak, continuous, direct currents delivered to the cerebellum. This study aimed to evaluate the feasibility of conducting a randomized controlled trial (RCT) delivering three consecutive days of ctDCS during split-belt treadmill training (SBTT) in people with chronic stroke. Using a double-blinded, parallel-group RCT design, eligible participants were randomly allocated to receive either active anodal ctDCS or sham ctDCS combined with SBTT on three consecutive days. Outcomes were assessed at one-week follow-up, using step length symmetry as a measure of motor learning and comfortable over-ground walking speed as a measure of walking capacity. The feasibility of the RCT protocol was evaluated based on recruitment, retention, protocol deviations and data completeness. The feasibility of the intervention was assessed based on safety, adherence and intervention fidelity. Of the 26 potential participants identified over four months, only four were enrolled in the study (active anodal ctDCS n = 1, sham ctDCS n = 3). Both the inclusion criteria and the fidelity of the SBTT relied upon the accurate estimation of step length asymmetry. The method used to determine the side of the step length asymmetry was unreliable and led to deviations in the protocol. The ctDCS intervention was well adhered to, safe, and delivered as per the planned protocol. Motor learning outcomes for individual participants revealed that treadmill step length symmetry remained unchanged for three participants but improved for one participant (sham ctDCS). Comfortable over-ground walking speed improved for two participants (sham ctDCS). The feasibility of the planned protocol and intervention was limited by intra-individual variability in the magnitude and side of the step length asymmetry. This limited the sample and compromised the fidelity of the SBTT intervention. To feasibly conduct a full RCT investigating the effect of ctDCS on locomotor adaptation, a reliable method of identifying and defining step length asymmetry in people with stroke is required. Future ctDCS research should either optimize the methods for SBTT delivery or utilize an alternative motor adaptation task.
dc.identifier.citationBrain Sciences, 10(12), 982. doi:10.3390/brainsci10120982
dc.identifier.doi10.3390/brainsci10120982en_NZ
dc.identifier.issn2076-3425en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/14044
dc.publisherMDPI AGen_NZ
dc.relation.urihttps://www.mdpi.com/2076-3425/10/12/982
dc.rights© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectTranscranial direct current stimulation; Cerebellum; Motor learning; Locomotor adaptation; Split-belt treadmill; Chronic stroke
dc.titleCerebellar Transcranial Direct Current Stimulation for Motor Learning in People With Chronic Stroke: A Pilot Randomised Controlled Trialen_NZ
dc.typeJournal Article
pubs.elements-id385472
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Faculty of Design & Creative Technologies
pubs.organisational-data/AUT/Faculty of Design & Creative Technologies/School of Engineering, Computer & Mathematical Sciences
pubs.organisational-data/AUT/Faculty of Design & Creative Technologies/School of Engineering, Computer & Mathematical Sciences/BioDesign Lab
pubs.organisational-data/AUT/Faculty of Health & Environmental Science
pubs.organisational-data/AUT/Faculty of Health & Environmental Science/School of Clinical Sciences
pubs.organisational-data/AUT/Faculty of Health & Environmental Science/School of Clinical Sciences/Physiotherapy Department
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HH Clinical Sciences 2018 PBRF
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