Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke

• Published in: Journal of neuroengineering and rehabilitation Vol. 19; no. 1; pp. 84 - 24
• Main Authors: Veldema, Jitka, Gharabaghi, Alireza
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03.08.2022; BioMed Central; BMC
• Subjects: Achievement tests; Alternating current; Asymmetry; Balance; Brain; Brain - physiology; Care and treatment; Clinical trials; Diagnosis; Direct current; Disability; Gait; Human motion; Humans; Intervention; Lower Extremity; Magnetic brain stimulation; Magnetic fields; Medical imaging; Meta-analysis; Methods; Motor ability; Neuroimaging; Recovery; Rehabilitation; Review; Risk factors; rTMS; Spinal cord; Stroke; Stroke (Disease); Stroke - therapy; Stroke Rehabilitation; tACS; tDCS; Tomography; Transcranial Direct Current Stimulation; Transcranial magnetic stimulation; Transcranial Magnetic Stimulation - methods; tsDCS; Walking; Germany; Lower limb function; Stroke; tsDCS; Gait; tDCS; tACS; Balance; rTMS
• ISSN: 1743-0003; 1743-0003
• DOI: 10.1186/s12984-022-01062-y

This systematic review and meta-analysis aim to summarize and analyze the available evidence of non-invasive brain stimulation/spinal cord stimulation on gait, balance and/or lower limb motor recovery in stroke patients. The PubMed database was searched from its inception through to 31/03/2021 for randomized controlled trials investigating repetitive transcranial magnetic stimulation or transcranial/trans-spinal direct current/alternating current stimulation for improving gait, balance and/or lower limb motor function in stroke patients. Overall, 25 appropriate studies (including 657 stroke subjects) were found. The data indicates that non-invasive brain stimulation/spinal cord stimulation is effective in supporting recovery. However, the effects are inhomogeneous across studies: (1) transcranial/trans-spinal direct current/alternating current stimulation induce greater effects than repetitive transcranial magnetic stimulation, and (2) bilateral application of non-invasive brain stimulation is superior to unilateral stimulation. The current evidence encourages further research and suggests that more individualized approaches are necessary for increasing effect sizes in stroke patients.