Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study methods
Aim. Evidence-backed execution summary for Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study methods from Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study.
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human
Subject model for the experiment.
- Use
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Method
reagent used in the protocol.
- Use
- tDCS is the application of a low-intensity direct current on the scalp using two electrodes (anode and cathode). A sufficient amount of current penetrates the overlying tissues and reaches the structures of the motor cortex, modifying the neuronal membrane potential. Anodal stimulation enhances cortex excitability....
Introduction
There has been an increase in the number of studies stating that tDCS applied to the motor cortex can be used for the treatment of neurological disorders in children, such as cerebral palsy (CP). CP results in diminished activation of the central nervous system during the execution of movements. A reduction in mot...
- Use
- There has been an increase in the number of studies stating that tDCS applied to the motor cortex can be used for the treatment of neurological disorders in children, such as cerebral palsy (CP). CP results in diminished activation of the central nervous system during the execution of movements. A reduction in mot...
Evaluation procedures
Static balance was evaluated with the use of a force plate (Kistler model 9286BA), which allows stabilometric analysis through readings of oscillations of the CoP. The acquisition frequency was 50 Hz, captured by four piezoelectric sensors positioned at the extremities of the platform, which measured 40 × 60 cm...
- Use
- Static balance was evaluated with the use of a force plate (Kistler model 9286BA), which allows stabilometric analysis through readings of oscillations of the CoP. The acquisition frequency was 50 Hz, captured by four piezoelectric sensors positioned at the extremities of the platform, which measured 40 × 60 cm...
Method
tDCS is the application of a low-intensity direct current on the scalp using two electrodes (anode and cathode). A sufficient amount of current penetrates the overlying tissues and reaches the structures of the motor cortex, modifying the neuronal membrane potential. Anodal stimulation enhances cortex excitability....
- Use
- tDCS is the application of a low-intensity direct current on the scalp using two electrodes (anode and cathode). A sufficient amount of current penetrates the overlying tissues and reaches the structures of the motor cortex, modifying the neuronal membrane potential. Anodal stimulation enhances cortex excitability....
Evaluation procedures
The evaluation of spatiotemporal gait variables (gait velocity, cadence, step length, stride length and step width) was performed using the SMART-D 140 (r) system (BTS Engineering, Italy) with eight infrared cameras, the SMART-D INTEGRATED WORKSTATION (r) with 32 analog channels and a synchronized video system. Afte...
- Use
- The evaluation of spatiotemporal gait variables (gait velocity, cadence, step length, stride length and step width) was performed using the SMART-D 140 (r) system (BTS Engineering, Italy) with eight infrared cameras, the SMART-D INTEGRATED WORKSTATION (r) with 32 analog channels and a synchronized video system. Afte...
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Method:
A randomized controlled trial with a blinded evaluator was conducted involving 20 children with CP between six and ten years of age. Gait and balance were evaluated three times: Evaluation 1 (before the stimulation), Evaluation 2 (immediately after stimulation), and Evaluation 3 (20 minutes after the stimulation). The protocol consisted of a 20-minute session of tDCS applied to the primary motor cortex at an intensity of 1 mA. The participants were randomly allocated to two groups: experimental group - anodal stimulation of the primary motor cortex; and control group - placebo transcranial stimulation.
Evaluation procedures
Static balance was evaluated with the use of a force plate (Kistler model 9286BA), which allows stabilometric analysis through readings of oscillations of the CoP. The acquisition frequency was 50 Hz, captured by four piezoelectric sensors positioned at the extremities of the platform, which measured 40 × 60 cm. The data were recorded and interpreted using the SWAY software program (BTS Engineering) integrated to and synchronized with the SMART-D 140 (r). The child was instructed to remain in a quiet standing position on the platform, barefoot, arms alongside the body, gaze fixed on a point marked at a distance of one meter at the height of the glabellum, with heels aligned and an unrestricted foot base. The children classified at level III of the GMFCS, used their usual gait assistance device, which was positioned off the force plate. The platform used has dimensions (600X400X...
Method
The procedures were carried out in a single day. Following Evaluation 1 (pretreatment evaluation/ before stimulation), the children received 20 minutes of either active (experimental group) or sham (control group) tDCS. The children received tDCS at rest and seated comfortably. A responsible therapist accompanied the stimulation session. Evaluation 2 (post-treatment evaluation/after stimulation) was performed immediately following tDCS and Evaluation 3 (twenty minutes after stimulation) was performed after 20 minutes of rest. Three researchers carried out the procedures - two performed the evaluations and one performed the tDCS. The evaluations and tDCS were carried out in separate rooms to ensure the blinding of the examiners. Only the researcher in charge of the application of the tDCS was aware of the allocation of the children to the experimental and control groups.
Method
tDCS is the application of a low-intensity direct current on the scalp using two electrodes (anode and cathode). A sufficient amount of current penetrates the overlying tissues and reaches the structures of the motor cortex, modifying the neuronal membrane potential. Anodal stimulation enhances cortex excitability. The tDCS device (Soterix Medical Inc., USA) included two non-metallic sponge surface electrodes measuring 5 × 5 cm 2 and moistened with saline solution. The children in the experimental group received anodal stimulation of the primary motor cortex and those in the control group received placebo transcranial stimulation. The anode was positioned over the primary motor cortex of the dominant hemisphere following the 10-20 international system of electrode placement for electroencephalography and the cathode was positioned in the supra-orbital region contralateral to the...
Evaluation procedures
Readings of displacement from the CoP on the X (anteroposterior) and Y (mediolateral) axes were performed under two conditions: eyes open and eyes closed. Three acquisitions of 30 seconds were obtained for each condition and the average of the acquisitions was used in the statistical analysis. The outputs of the force platform allowed us to compute the CoP time series in the anteroposterior direction and the mediolateral direction. The output of the platform was processed to compute quantitative parameters in the time domain. The anteroposterior and mediolateral coordinates of the CoP trajectory underwent post-acquisition filtering using a low-pass filter with a cut-off frequency of 10 Hz. In the analysis, we identified and computed the range of CoP displacement in the anteroposterior direction (RANGEAP index) and the mediolateral direction (RANGEML index), expressed in mm.
Measurement outputs
What raw and processed outputs should exist?
Static balance was evaluated with the use of a force plate (Kistler model 9286BA), which allows stabilometric analysis through readings of oscillations of the CoP. The acquisiti...
- Raw artifact
- Per-run gait capture with paw placement, timing, and stride features for each animal
- Processed artifact
- Cleaned gait metrics table and recovery trend summary across timepoints
- Reported as
- Group comparisons of gait indices, stride metrics, or recovery curves
The evaluation of spatiotemporal gait variables (gait velocity, cadence, step length, stride length and step width) was performed using the SMART-D 140 (r) system (BTS Engineeri...
- Raw artifact
- Per-run gait capture with paw placement, timing, and stride features for each animal
- Processed artifact
- Cleaned gait metrics table and recovery trend summary across timepoints
- Reported as
- Group comparisons of gait indices, stride metrics, or recovery curves
Mean and standard deviation values of gait velocity, cadence, step length, stride length, and step width were used for the statistical analysis.
- Raw artifact
- Per-run gait capture with paw placement, timing, and stride features for each animal
- Processed artifact
- Cleaned gait metrics table and recovery trend summary across timepoints
- Reported as
- Group comparisons of gait indices, stride metrics, or recovery curves
Readings of displacement from the CoP on the X (anteroposterior) and Y (mediolateral) axes were performed under two conditions: eyes open and eyes closed. Three acquisitions of...
- Raw artifact
- Per-run gait capture with paw placement, timing, and stride features for each animal
- Processed artifact
- Cleaned gait metrics table and recovery trend summary across timepoints
- Reported as
- Group comparisons of gait indices, stride metrics, or recovery curves
Analysis plan
How should the outputs become interpretable results?
Acquisition
Collect raw experimental outputs with enough metadata to preserve sample identity, condition, and timing.
inferred from protocolPreprocessing / cleaning
Mean and standard deviation values of gait velocity, cadence, step length, stride length, and step width were used for the statistical analysis.
from paperScoring or quantification
Quantify the primary readouts for this experiment: Static balance was evaluated with the use of a force plate (Kistler model 9286BA), which allows stabilometric analysis through readings of oscillations of the CoP. The acquisiti...; The evaluation of spatiotemporal gait variables (gait velocity, cadence, step length, stride length and step width) was performed using the SMART-D 140 (r) system (BTS Engineeri...; Mean and standard deviation values of gait velocity, cadence, step length, stride length, and step width were used for the statistical analysis.; Readings of displacement from the CoP on the X (anteroposterior) and Y (mediolateral) axes were performed under two conditions: eyes open and eyes closed. Three acquisitions of....
from paperStatistical comparison
Mean and standard deviation values of gait velocity, cadence, step length, stride length, and step width were used for the statistical analysis.; Readings of displacement from the CoP on the X (anteroposterior) and Y (mediolateral) axes were performed under two conditions: eyes open and eyes closed. Three acquisitions of...; Three-dimensional gait analysis, and stabilometry, are considered fundamental assessment tools for the adequate quantification of the effects of interventions aimed at improve...
from paperReporting output
Report representative outputs alongside summary comparisons for Static balance was evaluated with the use of a force plate (Kistler model 9286BA), which allows stabilometric analysis through readings of oscillations of the CoP. The acquisiti..., The evaluation of spatiotemporal gait variables (gait velocity, cadence, step length, stride length and step width) was performed using the SMART-D 140 (r) system (BTS Engineeri..., Mean and standard deviation values of gait velocity, cadence, step length, stride length, and step width were used for the statistical analysis., Readings of displacement from the CoP on the X (anteroposterior) and Y (mediolateral) axes were performed under two conditions: eyes open and eyes closed. Three acquisitions of....
inferred from protocolStructured statistical methods
Mean and standard deviation values of gait velocity, cadence, step length, stride length, and step width were used for the statistical analysis.; Readings of displacement from the CoP on the X (anteroposterior) and Y (mediolateral) axes were performed under two conditions: eyes open and eyes closed. Three acquisitions of...; Three-dimensional gait analysis, and stabilometry, are considered fundamental assessment tools for the adequate quantification of the effects of interventions aimed at improve...
source structuredSource and audit
What supports the facts on this page?
Evidence quotes (5)
A randomized controlled trial with a blinded evaluator was conducted involving 20 children with CP between six and ten years of age. Gait and balance were evaluated three times: Evaluation 1 (before the stimulation), Evaluation 2 (immediately after stimulation), and Evaluation 3 (20 minutes after the stimulation). The protocol consisted of a 20-minute session of tDCS applied to the primary motor cortex at an intensity of 1 mA. The participants were randomly allocated to two groups: experimental group - anodal stimulation of the primary motor cortex; and control group - placebo transcranial stimulation.
Static balance was evaluated with the use of a force plate (Kistler model 9286BA), which allows stabilometric analysis through readings of oscillations of the CoP. The acquisition frequency was 50 Hz, captured by four piezoelectric sensors positioned at the extremities of the platform, which measured 40 × 60 cm. The data were recorded and interpreted using the SWAY software program (BTS Engineering) integrated to and synchronized with the SMART-D 140 (r). The child was instructed to remain in a quiet standing position on the platform, barefoot, arms alongside the body, gaze fixed on a point marked at a distance of one meter at the height of the glabellum, with heels aligned and an unrestricted foot base. The children classified at level III of the GMFCS, used their usual gait assistance device, which was positioned off the force plate. The platform used has dimensions (600X400X35mm) that do not require the child to make great postural adjustments to position the gait assistance device off the platform. The children were instructed to keep the assistance device off the platform. The positioning of the device should allow a comfortable posture. The exact location of the dev...
The procedures were carried out in a single day. Following Evaluation 1 (pretreatment evaluation/ before stimulation), the children received 20 minutes of either active (experimental group) or sham (control group) tDCS. The children received tDCS at rest and seated comfortably. A responsible therapist accompanied the stimulation session. Evaluation 2 (post-treatment evaluation/after stimulation) was performed immediately following tDCS and Evaluation 3 (twenty minutes after stimulation) was performed after 20 minutes of rest. Three researchers carried out the procedures - two performed the evaluations and one performed the tDCS. The evaluations and tDCS were carried out in separate rooms to ensure the blinding of the examiners. Only the researcher in charge of the application of the tDCS was aware of the allocation of the children to the experimental and control groups.
tDCS is the application of a low-intensity direct current on the scalp using two electrodes (anode and cathode). A sufficient amount of current penetrates the overlying tissues and reaches the structures of the motor cortex, modifying the neuronal membrane potential. Anodal stimulation enhances cortex excitability. The tDCS device (Soterix Medical Inc., USA) included two non-metallic sponge surface electrodes measuring 5 × 5 cm 2 and moistened with saline solution. The children in the experimental group received anodal stimulation of the primary motor cortex and those in the control group received placebo transcranial stimulation. The anode was positioned over the primary motor cortex of the dominant hemisphere following the 10-20 international system of electrode placement for electroencephalography and the cathode was positioned in the supra-orbital region contralateral to the anode. The current was applied to the primary motor cortex for 20 minutes, during which the children remained seated. The tDCS device has a button that allows the operator to control the intensity of the current. Stimulation was gradually increased until reaching 1 mA and gradually reduced in the fi...
Readings of displacement from the CoP on the X (anteroposterior) and Y (mediolateral) axes were performed under two conditions: eyes open and eyes closed. Three acquisitions of 30 seconds were obtained for each condition and the average of the acquisitions was used in the statistical analysis. The outputs of the force platform allowed us to compute the CoP time series in the anteroposterior direction and the mediolateral direction. The output of the platform was processed to compute quantitative parameters in the time domain. The anteroposterior and mediolateral coordinates of the CoP trajectory underwent post-acquisition filtering using a low-pass filter with a cut-off frequency of 10 Hz. In the analysis, we identified and computed the range of CoP displacement in the anteroposterior direction (RANGEAP index) and the mediolateral direction (RANGEML index), expressed in mm.
Machine-readable layer
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