Integrating Transcranial Direct Current Stimulation into an Existing Inpatient Physiotherapy Program to Enhance Motor Learning in an Adolescent with Traumatic Brain Injury: A Case Report.

Autor:	Ryan JL; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.; Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada., Beal DS; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.; Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada., Levac DE; School of Rehabilitation, University of Montreal, Montreal, Canada., Fehlings DL; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.; Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada., Wright FV; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.; Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.; Department of Physical Therapy, University of Toronto, Toronto, Canada.
Jazyk:	angličtina
Zdroj:	Physical & occupational therapy in pediatrics [Phys Occup Ther Pediatr] 2023; Vol. 43 (4), pp. 463-481. Date of Electronic Publication: 2023 Jan 09.
DOI:	10.1080/01942638.2022.2163214
Abstrakt:	Purpose: Describe how transcranial direct current stimulation (tDCS) was incorporated into an inpatient physiotherapy program for an adolescent with severe traumatic brain injury (TBI), detail the motor learning focus of the physiotherapy sessions, and summarize gross motor progress. Method: This case report describes an adolescent who received 20 minutes of anodal tDCS immediately prior to 16 physiotherapy sessions over four weeks. Potential side effects were tracked pre/post tDCS. Gross motor outcomes were measured pre-intervention, post-intervention, and three months post-intervention. Physiotherapy session content was analyzed using therapist documentation and the Motor Learning Strategies Rating Instrument. Results: The youth tolerated tDCS well. The primary side effect was itchiness under the electrodes during tDCS sessions. His mobility progressed from wheelchair use pre- 'tDCS + physiotherapy' to ambulation with a walker post-intervention. His Gross Motor Function Measure score increased 33.1% points pre/post intervention. Session tasks often had several foci (e.g., skill acquisition, strength, and balance) with task focus changing as the youth progressed. Various motor learning strategies were layered within tasks to support performance and learning. Conclusions: tDCS was successfully integrated into an existing inpatient physiotherapy program for an adolescent with TBI. This protocol provides a structure for implementing, monitoring, and measuring tDCS + physiotherapy in pediatric rehabilitation.
Databáze:	MEDLINE
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