TY - JOUR
T1 - Optimal timing and neural loci
T2 - a scoping review on the effect of non-invasive brain stimulation on post-stroke gait and balance recovery
AU - Parikh, Vyoma
AU - Medley, Ann
AU - Chung, Yu Chen
AU - Goh, Hui Ting
N1 - Funding Information:
No external funding was received for this project.
Publisher Copyright:
© 2021 Taylor & Francis Group, LLC.
PY - 2023
Y1 - 2023
N2 - Background: Little is known about the optimal timing and neural loci for applying noninvasive brain stimulation (NIBS) to promote gait and balance recovery after stroke. Objective: To identify the optimal timing and neural loci of NIBS for gait and balance recovery after stroke. Methods: We performed a PubMed search using keywords of stroke, transcranial magnetic stimulation, transcranial direct current stimulation, NIBS, balance, and gait. Interventional trials with various designs published in English were selected. Both flowcharts and tables were used for the result presentation. Results: The majority of selected 31 studies included individuals with chronic stroke and primary motor cortex (M1) stimulation. Studies’ quality ranged from 4 to 10 (max = 10) on the Pedro scale. NIBS led to improvements in gait and balance in individuals with chronic and subacute stroke, yet the evidence for the acute phase of stroke is limited. Further, stimulation over the ipsilesional M1 resulted in improvement in gait and balanced performance. Stimulation over non-motor regions such as the cerebellum has been limitedly explored. Conclusion: Current evidence supports the use of NIBS to the M1 in conjunction with behavioral training to improve gait and balance performance in individuals with subacute and chronic stroke. Future research is recommended to evaluate the effect of NIBS during acute stroke and over neural loci other than M1, and to implement a more rigorous method.
AB - Background: Little is known about the optimal timing and neural loci for applying noninvasive brain stimulation (NIBS) to promote gait and balance recovery after stroke. Objective: To identify the optimal timing and neural loci of NIBS for gait and balance recovery after stroke. Methods: We performed a PubMed search using keywords of stroke, transcranial magnetic stimulation, transcranial direct current stimulation, NIBS, balance, and gait. Interventional trials with various designs published in English were selected. Both flowcharts and tables were used for the result presentation. Results: The majority of selected 31 studies included individuals with chronic stroke and primary motor cortex (M1) stimulation. Studies’ quality ranged from 4 to 10 (max = 10) on the Pedro scale. NIBS led to improvements in gait and balance in individuals with chronic and subacute stroke, yet the evidence for the acute phase of stroke is limited. Further, stimulation over the ipsilesional M1 resulted in improvement in gait and balanced performance. Stimulation over non-motor regions such as the cerebellum has been limitedly explored. Conclusion: Current evidence supports the use of NIBS to the M1 in conjunction with behavioral training to improve gait and balance performance in individuals with subacute and chronic stroke. Future research is recommended to evaluate the effect of NIBS during acute stroke and over neural loci other than M1, and to implement a more rigorous method.
KW - cerebrovascular accident
KW - postural control
KW - transcranial direct current stimulation
KW - Transcranial magnetic stimulation
KW - walking
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U2 - 10.1080/10749357.2021.1990467
DO - 10.1080/10749357.2021.1990467
M3 - Review article
C2 - 34859744
AN - SCOPUS:85120967166
SN - 1074-9357
VL - 30
SP - 84
EP - 100
JO - Topics in Stroke Rehabilitation
JF - Topics in Stroke Rehabilitation
IS - 1
ER -