Efficacy of transcranial direct current stimulation combined with physical exercise in postural control with dual task in people with Parkinson's disease

• Grant number: 23/02950-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): May 01, 2023
• Effective date (End): December 31, 2024
• Field of knowledge: Health Sciences - Physical Education
• Principal Investigator: José Angelo Barela
• Grantee: Pedro Paulo Gutierrez
• Host Institution: Instituto de Biociências (IB). Universidade Estadual Paulista (UNESP). Campus de Rio Claro. Rio Claro , SP, Brazil

Abstract

Introduction: Postural changes are common impairments in Parkinson's disease (PD). Although pharmacological treatment is the most used for rehabilitation in people with PD, impairments in postural control are unresponsive to this treatment. Therefore, complementary therapies have been targeted in rehabilitation research for people with PD. Evidence suggests that physical exercise and transcranial direct current stimulation (tDCS) may be effective in the treatment of PD motor symptoms. However, the results are still inconclusive, especially in relation to the combination of tDCS and exercise. Objective: To analyze the effectiveness of tDCS (2mA, for 20min, applied to the prefrontal cortex (PFC) and primary motor cortex (M1), separately) combined with physical exercise in postural control with dual task in people with PD. Materials and Methods: Twenty-four participants with PD will be recruited to participate in this study in four days, at least 1 week apart. On the first day, participants will carry out clinical and cognitive assessments, and treadmill familiarization, in the other sessions, participants will carry out postural control assessments before and after the intervention. tDCS, applied in the PFC, M1, or sham, will be combined, at the same time, with physical exercise on a treadmill. For postural control assessment, the participant will be instructed to remain standing still on a force plate. Six trials will be performed, lasting 30 seconds each, being three in a single task and three in a dual task condition. Two-way ANOVAs, with stimulation factor (PFC x M1 x sham) and time (pre x post-tDCS), will be used for statistical analysis.