Postural Balance Clinical Trial
Official title:
Additive Effect of Transcranial Direct Current Stimulation on Physiotherapeutic Treatment of Children With Balance Deficit: a Randomized, Controlled, Double-blind Clinical Trial
Neural control of posture depends on interaction of sensory and motor information from multiple structures, including the primary motor cortex (M1). Transcranial direct current stimulation (TDCS) improves postural control in children and adults with and without neurological disorders, however, additive effects to physical therapy treatment are still unknown, specifically balance exercises for children with balance deficit. The aim of this study is to identify the effects of adding anodic TDCS over M1 to exercises on postural control of children with balance deficit. This is a randomized, double-blind, controlled clinical trial.
Maintaining body position and orientation is a complex and multifactorial task. Balance is
defined as the ability to control and maintain the center of gravity or center of mass over
the area of the support base. Postural control system aims (1) to maintain balance and
postural orientation (2) to perform voluntary movement in static or dynamic circumstances and
(3) to react to internal and external disturbances. Neural control of posture will be
efficient when there is an interaction of sensory and motor information from multiple
structures, and it will vary according to the age of the individuals, maturation of the
structures involved, motor repertoire, neuromuscular synergies and musculoskeletal
components, among others. The primary motor cortex (M1) has been persistently studied due to
its complexity, numerous connections and direct involvement with motor control. Studies
suggest that the main neural activity of M1 is to command muscle activity and optimize the
effector system´s operation, producing a more uniform, efficient and coordinated motor
response, including postural responses to mechanical disturbances.
When one of the organs involved in this function is compromised, regardless of the age of the
individuals, whether due to injury or a change in functioning or integration, body
oscillations happen. Historically, balance deficit (and consequent falls) are considered
normal and acceptable in childhood, however, it is necessary to be careful with falls and
their consequences in children with mobility or behavioral diseases. Physical therapy is
essential in the rehabilitation of children and adults with balance deficit, with or without
injury in nervous system. Currently, there is an increasing number of studies that have
pointed Transcranial direct current stimulation (TDCS) as an efficient and safe device to
modulate motor performance. To our knowledge, despite this growing number of studies, little
is known about how much TDCS could add to an balance exercise protocol for children without
structural damage in nervous system with balance deficit. Therefore, it is relevant to carry
out studies in order to investigate and possibly elucidate the effects of TDCS on postural
control and balance in children. Thus, the aim of this study is to identify the effects of
adding anodic TDCS over M1 to exercises on postural control of children with balance deficit.
This is a randomized, double-blind, controlled clinical trial.
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