Effect of Combined Therapy of Virtual Reality and Transcranial Direct Current Stimulation in Children and Adolescents With Cerebral Palsy: A Study Protocol for a Triple-Blinded Randomized Controlled Crossover Trial

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da Silva, Talita Dias ; Fontes, Anne Michelli Gomes Goncalves ; de Oliveira-Furlan, Barbara Soares ; Roque, Tatiane Tedeschi ; Lima, Ana Izabel Izidorio ; de Souza, Bruna Mayara Magalhaes ; Alberissi, Camila Aparecida de Oliveira ; Silveira, Ana Clara ; de Moraes, Ibis Ariana Pena ; Collett, Johnny ; Silva, Roger Pereira ; Airoldi, Marina Junqueira ; Ribeiro-Papa, Denise Cardoso ; Dawes, Helen ; Monteiro, Carlos Bandeira de Mello

• Tipo de documento: Artigo Científico
• Fonte: FRONTIERS IN NEUROLOGY; v. 11, p. 14-pg., 2020-09-02.

Resumo

Background: Transcranial direct current stimulation (tDCS) and therapy-based virtual reality (VR) have been investigated separately. They have shown promise as efficient and engaging new tools in the neurological rehabilitation of individuals with cerebral palsy (CP). However, the recent literature encourages investigation of the combination of therapy tools in order to potentiate clinic effects and its mechanisms. Methods: A triple-blinded randomised sham-controlled crossover trial will be performed. Thirty-six individuals with gross motor function of levels I to IV (aged 4-14 years old) will be recruited. Individuals will be randomly assigned to Group A (active first) or S (sham first): Group A will start with ten sessions of active tDSC combined with VR tasks. After a 1-month washout, this group will be reallocated to another ten sessions with sham tDCS combined with VR tasks. In contrast, Group S will carry out the opposite protocol, starting with sham tDCS. For the active tDCS the protocol will use low frequency tDCS [intensity of 1 milliampere (mA)] over the primary cortex (M1) area on the dominant side of the brain. Clinical evaluations (reaction times and coincident timing through VR, functional scales: Abilhand-Kids, ACTIVLIM-CP, Paediatric Evaluation of Disability Inventory-PEDI- and heart rate variability-HRV) will be performed at baseline, during, and after active and sham tDCS. Conclusion: tDCS has produced positive results in treating individuals with CP; thus, its combination with new technologies shows promise as a potential mechanism for improving neurological functioning. The results of this study may provide new insights into motor rehabilitation, thereby contributing to the better use of combined tDCS and VR in people with CP. (AU)

• Processo FAPESP: 17/24991-7 - Transferência de desempenho motor entre ambientes virtuais e reais em pessoas com Distrofia Muscular de Duchenne
• Beneficiário: Carlos Bandeira de Mello Monteiro
• Modalidade de apoio: Bolsas no Exterior - Pesquisa
• Processo FAPESP: 16/08358-0 - Análise de viabilidade de jogos digitais adaptáveis ao perfil de pessoas com deficiência como instrumento de apoio à reabilitação
• Beneficiário: Talita Dias da Silva Magalhães
• Modalidade de apoio: Auxílio à Pesquisa - Pesquisa Inovativa em Pequenas Empresas - PIPE