Effects Of tDCS With Physical Therapy On Rehabilitation In Parkinson's Disease
Condition: Parkinson Disease
MeSH terms: Parkinson Disease
Study type: Interventional
Phase: Phase 2

Summary: 
      The present study aims to investigate the effect of transcranial direct current stimulation
      (tDCS) associated with physiotherapy in parkinson´s rehabilitation. Previous studies showed
      that tDCS could reduce the bradykinesia, one of the symptom of Parkinson disease. In this
      way, this study will combine tDCS with physiotherapy in order to enhance the motor
      rehabilitation and the quality of life.
    

Detailed description: 
      12 patients were participated of this study.After screening to check the eligibility criteria
      and giving informed consent, they were randomized in two groups. All patients were submitted
      to a 10 therapeutic sessions that occurred 3 times per week.

      Before, immediately after and 1 month after the last session patients were submitted to an
      evaluation with the follow tests: Unified Parkinson´s Disease Rating Scale(UPDRS), Jebsen
      Taylor Test (JTT) and Parkinson's Disease Quality of Life (PDQL). Furthermore, before and
      after each session the patients were submitted to transcranial magnetic stimulation (TMS) to
      evaluate cortical excitability through motor threshold and motor evoked potential.

      In experimental sessions, the subjects always received physiotherapy with conventional
      techniques, the protocol followed the clinical practice guideline for physical therapy in
      Parkinson disease with the Royal Dutch Society Therapy. During tDCS protocol the patients
      seated in a comfortable chair with head and arm rests. Continuous current was applied using a
      pair of saline-soaked surface sponge electrodes (surface 35 cm2), the anode electrode was
      placed over the primary motor cortex and cathode above contralateral orbit. tDCS was applied
      of twice stimulation of 13 minutes with 20 minutes of interval between them and a current
      strength of 1mA. Sham tDCS was applied by current flow of 30s.
    

Intervention name(s): tDCS; Physiotherapy
Intervention type(s): Device; Behavioral
Intervention description(s): tDCS involves application of very low amplitude direct current via surface scalp electrodes. The applied current modifies the transmembrane neuronal potential and thus influences the level of excitability. Depending on the polarity of active electrodes tDCS can increase or decrease the cortical excitability. The anodal tDCS increase the excitability.; Physiotherapy protocol followed the guidelines outlined in clinical practice guideline for physical therapy in Parkinson disease of the Royal Dutch society for physical therapy (Keus, 2007). This guideline proposes some objectives for motor rehabilitation in patients with PD, such as: flexibility, strength, coordination, balance, posture and gait. The difficulty of exercises ranged according with Hoehn and Yahr (HY) staging scale. In this way, each stage of HY had a specific physical therapy protocol following the guideline.
Other intervention name(s): non invasive brain stimulation
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Parkinson, rehabilitation, tDCS