Non-Invasive Brain Stimulation Effectiveness on Gait, Balance, and Motor Functions in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis.

Abstract

BackgroundStudies on non-invasive brain stimulation (NIBS) for children with cerebral palsy (CP) have yielded inconsistent findings regarding motor skills. This research will evaluate its efficacy through a systematic review.MethodA thorough search was conducted on the PubMed, Cochrane, and ScienceDirect databases, encompassing all trials that examined the impact of NIBS on balance, gait, and motor skills in children with CP. The analysis adhered to PRISMA guidelines.ResultsThe review included 17 trials, 13 assessing NIBS protocols, involving 385 children in the meta-analysis. Pooled analysis showed significant therapeutic effects on gait spatiotemporal outcomes in terms of walking speed (post-transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) multi-session treatment) and gait cadence (post-tDCS multi-session). In addition, tDCS multi-session showed significant therapeutic effects on standing abilities and mobility functions. However, no significant effect of tDCS on balance, step length, stride length, walking endurance, and GMFM-walking functions.ConclusionThis review highlighted the potential benefits of NIBS, particularly tDCS, in improving various motor functions in children with CP, such as walking speed, cadence, and mobility. However, its impact on balance and other gait factors remains inconclusive, indicating the need for further research to optimize NIBS protocols based on updated brain mapping findings.