Effect of Transcranial Direct Current Stimulation on Lower Extremity Muscle Strength, Quality of Life, and Functional Recovery in Individuals With Incomplete Spinal Cord Injury: A Randomized Controlled Study

Cureus, 2024 · DOI: 10.7759/cureus.51989 · Published: January 10, 2024

Neurology Neurorehabilitation Rehabilitation

Simple Explanation

This study investigated whether transcranial direct current stimulation (tDCS) could improve lower limb strength and function in people with incomplete spinal cord injury (iSCI). tDCS is a non-invasive brain stimulation technique. Participants were divided into two groups: one receiving real tDCS and the other a sham (placebo) tDCS, along with conventional rehabilitation. The study measured lower extremity motor scores, spinal cord independence, and quality of life. The results showed that while both groups improved, there was no significant difference between the real tDCS and sham tDCS groups, suggesting tDCS was not effective in improving outcomes in this short-term study.

Study Duration

2 weeks

Participants

32 iSCI participants (28 males and four females)

Evidence Level

Level 1: Randomized single-blinded sham control parallel-group study

Key Findings

1
Anodal tDCS was not more effective than sham tDCS for improving LEMS, QoL, and function in persons with iSCI.
2
Within-group analysis of the anodal group showed significant improvement in LEMS, WHO QoL Bref domain two, and SCIM III after the intervention.
3
No adverse events related to the application of tDCS were demonstrated in either the anodal or sham tDCS groups.

Research Summary

This study evaluated the effect of anodal tDCS on lower limb muscle strength, quality of life (QoL), and function in individuals with incomplete spinal cord injury (iSCI). The study found no significant difference between the anodal tDCS group and the sham tDCS group in terms of LEMS, SCIM III, and WHO QoL Bref scores after one and two weeks of intervention. The researchers concluded that anodal tDCS, as administered in this study, is not more effective than sham tDCS for improving motor and functional capabilities and QoL in individuals with iSCI.

Practical Implications

Refinement of tDCS Protocols

The study results contribute to the design of better tDCS protocols for the rehabilitation of individuals with iSCI.

Combination Therapies

Future studies should explore the combined effect of tDCS with other non-invasive electrical stimulation therapies or patterned electrical stimulation in SCI management.

Further Research

Further research with larger, more homogenous populations is needed to verify the potential clinical impact of non-invasive brain stimulation in iSCI patients.

Study Limitations

1
The study was single-blinded, which may introduce bias.
2
The participant recruitment was from a single rehabilitation facility, which could lead to potential bias in selection.
3
The study sample was heterogeneous in terms of etiology, the severity of SCI, time since injury, and neurologic level of injury.

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