Transcranial direct current stimulation combined with an intensive training program for upper limb rehabilitation in children with unilateral cerebral palsy. A randomized controlled pilot study

BackgroundUnilateral cerebral palsy (UCP) presents a greater functional alteration of the upper limb. Among the recommended interventions are certain therapeutic tools, such as transcranial direct current stimulation (tDCS) that could increase the therapeutic window and enhance the effect of interve...

Descripción completa

Detalles Bibliográficos
Autores: Muñoz Marrón, Elena, Merino Andrés, Javier, Palomo Carrión, Rocío, Gómez Soriano, Julio, Fernández Pérez, Juan José, Serrano Muñoz, Diego, López Muñoz, Purificación
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad de Castilla-La Mancha
Repositorio:RUIdeRA. Repositorio Institucional de la UCLM
OAI Identifier:oai:ruidera.uclm.es:10578/43340
Acceso en línea:https://hdl.handle.net/10578/43340
Access Level:acceso abierto
Palabra clave:Bimanual therapy
Constraint-induced movement therapy
Transcranial direct current stimulation
Unilateral cerebral palsy
Descripción
Sumario:BackgroundUnilateral cerebral palsy (UCP) presents a greater functional alteration of the upper limb. Among the recommended interventions are certain therapeutic tools, such as transcranial direct current stimulation (tDCS) that could increase the therapeutic window and enhance the effect of interventions.AimsTo determine the effectiveness of a 3-weeks intervention of cathodal tDCS applied over the motor cortex of the less affected hemisphere combined with a manual function intensive training program in the upper limbs on quality of movement and the spontaneous use of upper limb in children with UCP. Secondarily, quality of life and user´s experience was also assessed.Methods and proceduresA pilot randomized triple-blind clinical trial was conducted. 18 children with UCP between 4 and 8 years were recruited and randomly allocated to one of the two experimental groups: 1) Active group: cathodal tDCS + intensive motor training; 2) Control group: Sham tDCS + intensive motor training. Assessments were performed before and after the intervention, and at three months follow-up.Outcomes and resultsOutcome measures: Shriners Hospital Upper Extremity Evaluation childrens manual experience questionnaire, Paediatric Quality of Life Questionnaire and the Childrens Manual Experience Questionnaire (miniCHEQ). Both groups improved in all variables but in the inter-group analysis only quality of life obtained significant results (p = 0.043).Conclusions and implicationsAdding cathodal tDCS to a program of intensive manual function therapy training did not produce a greater improvement on the spontaneous use, nor improving the experience of use in children with UCP. However, this technique has a short-term beneficial effect on quality of life.