The use of transcranial direct current stimulation in children with cerebral palsy: a systematic review
DOI:
https://doi.org/10.33233/fb.v22i5.4773Keywords:
transcranial direct current stimulation; electric stimulation therapy; motor cortex, cerebral palsy; rehabilitationAbstract
Introduction: Transcranial direct current stimulation (ETCC) is a low-cost, non-invasive therapeutic resource for patients, based on altering the excitability of the motor cortex. Technique capable of influencing the autonomous mechanism of the CNS, increasing synaptic efficiency, and favoring motor learning. Objective: To systematize scientific evidence about ETCC as a therapeutic resource in the rehabilitation process of children with cerebral palsy. Methods: Systematic review following recommendations by PRISMA and the strategic search PICO before the indication of ETCC, as a therapeutic resource in the rehabilitation process of children with cerebral palsy. Included controlled and randomized clinical trials, published in the last 10 years, available in five relevant health databases in English, Spanish and Portuguese. Results: 604 studies were found, from which, after applying the eligibility criteria, four of them were selected. The results of such studies have proved positive results in the treatment of children with cerebral palsy, including those with more than 70% presence of spasticity. Conclusion: ETCC is a promising resource in the treatment of children with cerebral palsy, accepted by children as it is painless and presents mild reactions such as redness and tingling at the application site. The favorable effects highlighted were: improvement in functional and gait performance.
References
Morris C. Definition and classification of cerebral palsy: a historical perspective. Dev Med Child Neurol Suppl 2007;109:3-7. doi: 10.1111/j.1469-8749.2007.tb12609.x
Salazar AP, Pagnussat AS, Pereira GA, Scopel G, Lukrafka JL. Neuromuscular electrical stimulation to improve gross motor function in children with cerebral palsy: a meta-analysis. Braz J Phys Ther 2019;23(5):378-86. doi: 10.1016/j.bjpt.2019.01.006
Paz JA. Pediatria básica: Tomo II: Pediatria clínica geral. São Paulo: Savier; 2003.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Diretrizes de atenção à pessoa com paralisia cerebral. Departamento de Ações Programáticas Estratégicas. Brasília: Ministério da Saúde; 2013.
Leite JMRS, Prado GF. Paralisia cerebral aspectos fisioterapêuticos e clínicos. Rev Neurocienc 2004;12(1):41-5. doi: 10.4181/RNC.2004.12.41
Okano AH, Montenegro RA, Farinatti PTV, Li LM, Brunoni AR, Fontes EB. Estimulação cerebral na promoção da saúde e melhoria do desempenho físico. Rev Bras Educ Fís Esporte 2013;27(2):315-32. doi: 10.1590/S1807-55092013005000009
Rotta NT. Paralisia cerebral, novas perspectivas terapêuticas. J Pediatr 2002;78(Suppl.1):S48-S54. doi: 10.1590/S0021-75572002000700008
Rosa GKB, Marques I, Medina-Papst J, Gobbi LTB. Desenvolvimento motor de criança com paralisia cerebral: avaliação e intervenção. Rev Bras Educ Espec 2008;14(2):163-76. doi: 10.1590/S1413-65382008000200002
Dias ACB, Freitas JC, Formiga CKMR, Viana FP. Desempenho funcional de crianças com paralisia cerebral participantes de tratamento multidisciplinar. Fisioter Pesqui 2010;17(3):225-9. doi: 10.1590/S1809-29502010000300007
Fregni F, Pascual-Leone A. Technology insight: noninvasive brain stimulation in neurology-perspectives on the therapeutic potential of rTMS and tDCS. Nat Clin Pract Neurol 2007;3(7):383-93. doi: 10.1038/ncpneuro0530
Cargnin APM, Mazzitelli C. Proposta de tratamento fisioterapêutico para crianças portadoras de paralisia cerebral espástica, com ênfase nas alterações musculoesqueléticas. Rev Neurociências 2003;11(1):34-39. doi: 10.34024/rnc.2003.v11.8892
Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol 2000;527 Pt 3(Pt 3):633-9. doi: 10.1111/j.1469-7793.2000.t01-1-00633.x
Montenegro RA, Okano AH, Machado S, Porto F, Gurgel JL, Farinatti PTV. Estimulação transcraniana por corrente contínua: da aplicação clínica ao desempenho físico. Revista HUPE, Rio de Janeiro, 2013;12(4):27-37. doi: 110.12957/rhupe.2013.8710
Marques Junior NK. Neuromodulação através da estimulação transcraniana por corrente contínua: Prescrição da sessão que retarda a fadiga. RBPFEX [Internet]. 2016 [cited 2021 Oct 13];10(57):200-8. Available from: https://www.researchgate.net/publication/303114506
Moura RCF, Santos C, Collange Grecco L, Albertini G, Cimolin V, Galli M, Oliveira C. Effects of a single session of transcranial direct current stimulation on upper limb movements in children with cerebral palsy: A randomized, sham-controlled study. Dev Neurorehabil 2017;20(6):368-75. doi: 10.1080/17518423.2017.1282050
Ciechanski P, Kirton A. Transcranial Direct-current stimulation can enhace motor learning in children. Cereb Cortex 2017;27(5):2758-67. doi: 10.1093/cercor/bhw114
Santos CMC, Pimenta CAM, Nobre MRC. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Rev Latino-Am Enfermagem 2007;15(3):508-11. doi: 10.1590/S0104-11692007000300023
Marconi MA, Lakatos EM. Fundamentos de Metodologia Científica. São Paulo: Atlas; 2003.
Ferreira SB, Rezende F, Dumont AJL, Ferreira LAB, Lazzari RD, Oliveira CS. Effect of a single session of transcranial direct current stimulation combined with virtual reality training on functional mobility in children with cerebral palsy: A randomized, controlled, double-blind trial. J Phys Ther Sci 2015;27(3):763-8. doi: 10.1589/jpts.27.763
Shiwa SR, Costa LOP, Moses ADL, Aguiar IC, Oliveira LVF. PEDro; a base de dados de evidências em fisioterapia. Fisioter Mov 2011;24(3):523-33. doi: 10.1590/S0103-51502011000300017
Lazzari RD, Politti F, Santos CA, Dumont AJ, Rezende FL, Grecco LA, Braun Ferreira LA, Oliveira CS. Effect of a single session of transcranial direct-current stimulations combined with virtual reality training on functional mobility in children with cerebral palsy: a randomized, controlled, double-blind trial J Phys Ther Sci 2015;27(3):763-8. doi: 10.1589/jpts.27.763
Duarte NA, Grecco LA, Galli M, Fregni F, Oliveira CS. Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PLoS One 2014;9(8):e105777. doi: 10.1371/journal.pone.0105777
Grecco LAC, Duarte NAC, Zanon N, Galli M, Fregni F, Oliveira CS. 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. Braz J Phys Ther 2014;18(5):419-27. doi: 10.1590/bjpt-rbf.2014.0053
Grecco LA, Duarte NAC, Mendonça ME, Galli M, Fregni F, Oliveira CS. Effects of anodal transcranial direct current stimulation combined with virtual reality for improving gait in children with spastic diparetic cerebral palsy: a pilot, randomized, controlled, double-blind, clinical trial. Clin Rehabil 2015;29(12):1212-23. doi: 10.1177/0269215514566997
Lazzari RD, Politti F, Belina SF, Collange Grecco LA, Santos CA, et al. Effect of transcranial direct current stimulation combined with virtual reality training on balance in children with cerebral palsy: a randomized, controlled, double-blind, clinical trial. J Mot Behav 2017;49(3):329-36. doi: 10.1080/00222895.2016.1204266
Friel KM, Lee P, Soles LV, Smorenburg ARP, Kuo HC, Gupta D, Edwards DJ. Combined transcranial direct current stimulation and robotic upper limb therapy improves upper limb function in an adult with cerebral palsy. Neuro Rehabil 2017;41(1):41-50. doi: 10.3233/NRE-171455
Pavão SL, Lima CRG, Rocha NACF. Association between sensory processing and activity performance in children with cerebral palsy levels I-II on the gross motor function classification system. Braz J Phys Ther 2021;25(2):194-202. doi: 10.1016/j.bjpt.2020.05.007
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Copyright (c) 2021 Messias da Silva Paixão, Teresa Cristina Gioia Schimidt, Renata Calhes Franco de Moura
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