Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Aug 3;19(1):84.
doi: 10.1186/s12984-022-01062-y.

Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke

Jitka Veldema  1   2 , Alireza Gharabaghi  3
Affiliations
Meta-Analysis

Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke

Jitka Veldema et al. J Neuroeng Rehabil. .

Abstract

Objectives: This systematic review and meta-analysis aim to summarize and analyze the available evidence of non-invasive brain stimulation/spinal cord stimulation on gait, balance and/or lower limb motor recovery in stroke patients.

Methods: The PubMed database was searched from its inception through to 31/03/2021 for randomized controlled trials investigating repetitive transcranial magnetic stimulation or transcranial/trans-spinal direct current/alternating current stimulation for improving gait, balance and/or lower limb motor function in stroke patients.

Results: Overall, 25 appropriate studies (including 657 stroke subjects) were found. The data indicates that non-invasive brain stimulation/spinal cord stimulation is effective in supporting recovery. However, the effects are inhomogeneous across studies: (1) transcranial/trans-spinal direct current/alternating current stimulation induce greater effects than repetitive transcranial magnetic stimulation, and (2) bilateral application of non-invasive brain stimulation is superior to unilateral stimulation.

Conclusions: The current evidence encourages further research and suggests that more individualized approaches are necessary for increasing effect sizes in stroke patients.

Keywords: Balance; Gait; Lower limb function; Stroke; rTMS; tACS; tDCS; tsDCS.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

.

.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
Postinterventional overview of effect sizes, 95% confidence intervals and homogeneity for studies comparing non-invasive brain stimulation/spinal cord stimulation with sham stimulation for improving gait, balance and/or lower limb recovery in stroke patients. black   repetitive transcranial magnetic stimulation, white   transcranial/trans-spinal direct current/alternating current stimulation, patterned   non-invasive brain stimulation overall, CL   contralesional, FR   frontal, Hz   hertz, IL   ipsilesional, I2   inconsistency test, iTBS   intermittent theta burst stimulation, mA   milliampere, PA   parietal, rTMS   repetitive transcranial magnetic stimulation, SP   spinal, tACS   transcranial alternating current stimulation, tDCS   transcranial direct current stimulation, tsDCS   trans-spinal direct current stimulation
Fig. 3
Fig. 3
Follow-up overview of effect sizes, 95% confidence intervals and homogeneity for studies comparing non-invasive brain stimulation/spinal cord stimulation with placebo stimulation in supporting gait, balance and/or lower limb recovery in stroke patients. black   repetitive transcranial magnetic stimulation, white   transcranial/trans-spinal direct current/alternating current stimulation, patterned   non-invasive brain stimulation overall, CL   contralesional, Hz   hertz, IL   ipsilesional, I2   inconsistency test, iTBS   intermittent theta burst stimulation, mA   milliampere, rTMS   repetitive transcranial magnetic stimulation, SP   spinal, tACS   transcranial alternating current stimulation, tDCS   transcranial direct current stimulation, tsDCS   trans-spinal direct current stimulation
Fig. 4
Fig. 4
Postinterventional overview of effect sizes, 95% confidence intervals and homogeneity for studies comparing different non-invasive brain stimulation protocols in supporting gait, balance and/or lower limb recovery in stroke patients. white   transcranial/trans-spinal direct current stimulation, CL   contralesional, IL   ipsilesional, I2   inconsistency test, mA   milliampere, tDCS   transcranial direct current stimulation, tsDCS   trans-spinal direct current stimulation
Fig. 5
Fig. 5
Follow-up overview of effect sizes, 95% confidence intervals and homogeneity for studies comparing different non-invasive brain stimulation protocols in supporting gait, balance and/or lower limb recovery in stroke patients. white   transcranial/trans-spinal direct current stimulation, CL   contralesional, IL   ipsilesional, I2   inconsistency test, mA   milliampere, tDCS   transcranial direct current stimulation, tsDCS   trans-spinal direct current stimulation
See this image and copyright information in PMC

References

    1. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2020 update: a report from the American Heart Association. American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2020;141:e139–e596. - PubMed
    1. Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS. Recovery of walking function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil. 1995;76:27–32. doi: 10.1016/S0003-9993(95)80038-7. - DOI - PubMed
    1. Grau-Pellicer M, Chamarro-Lusar A, Medina-Casanovas J, Serdà Ferrer BC. Walking speed as a predictor of community mobility and quality of life after stroke. Top Stroke Rehabil. 2019;26:349–358. doi: 10.1080/10749357.2019.1605751. - DOI - PubMed
    1. Minet LR, Peterson E, von Koch L, Ytterberg C. Occurrence and predictors of falls in people with stroke: six-year prospective study. Stroke. 2015;46:2688–2690. doi: 10.1161/STROKEAHA.115.010496. - DOI - PubMed
    1. Bohannon RW, Andrews AW, Smith MB. Rehabilitation goals of patients with hemiplegia. Int J Rehabil Res. 1988;11:181–183. doi: 10.1097/00004356-198806000-00012. - DOI

Publication types