Effect of Transcranial Direct Current Stimulation Combined With Physiotherapy on Hand Function and Quality of Life in Children With Hemiparetic Cerebral Palsy: a Randomized, Sham-controlled Trial
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Background: Cerebral palsy (CP) is a leading cause of childhood physical disability, and it frequently affects upper limb function in ways that limit independence, daily activity, and quality of life. Children with hemiparetic CP typically show reduced hand strength, impaired coordination, and limited bimanual performance, and many continue to have motor deficits even with conventional physiotherapy. Methods: In this randomized, double-blind (participant- and assessor-blinded), sham-controlled trial, 60 children aged 8–11 years with unilateral spastic cerebral palsy were allocated by sealed-envelope randomization to group A (Study group) receiving transcranial direct current stimulation (tDCS) with physiotherapy, and group B (control group) receiving physiotherapy with sham tDCS. Both groups trained five days a week for four weeks. Outcomes assessed at baseline and post-intervention were grip strength (hand-held dynamometer), spasticity (Modified Ashworth Scale), hand function (Jebsen–Taylor Hand Function Test), and quality of life (Pediatric Quality of Life Inventory, PedsQL™ 4.0). Between-group differences at post-treatment were evaluated using analysis of covariance (ANCOVA) with baseline score as a covariate. Results: Both groups demonstrated improvement following treatment; however, improvements were consistently greater in the active tDCS group. After adjusting for baseline values, the tDCS group showed significantly greater gains in grip strength (adjusted mean difference 1.79 kg, 95% CI 1.57–2.01, p<.001), greater reduction in spasticity (adjusted mean difference −0.30, 95% CI −0.48 to −0.12, p=.001), faster hand-function completion times (adjusted mean difference −10.50 s, 95% CI −12.30 to −8.70, p<.001), and higher scores across all PedsQL domains (adjusted mean differences 13.85–15.95 points, all p<.001). Conclusion: Adding tDCS to structured physiotherapy produced greater improvements in hand function and quality of life than physiotherapy with sham stimulation alone in children with hemiparetic cerebral palsy. These findings support tDCS as a promising adjunct in pediatric neurorehabilitation, though longer-term, multi-center trials are needed to confirm durability and generalizability.
Source: Acta Innovations
Language: English
Subfield: Neurology
Field: Neuroscience
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7225815591