Efficacy of transcranial direct current stimulation and mirror therapy for rehabilitation of spastic quadriplegic cerebral palsy-a pilot study

Background: Advancements in medical science, including Transcranial Direct Current Stimulation (tDCS) and Mirror Therapy (MT), are being utilized to treat Cerebral Palsy (CP), a non-progressive condition that impacts neuromuscular development. Objective: To compare the effects of tDCS and MT for rehabilitation of spastic quadriplegic CP Methods: A Double-Blind Randomized Clinical Trial(IRCT20231227060542N1) was conducted at the Department of Physical Therapy, Ghurki Hospital, Lahore, Pakistan. Thirty CP patients were randomly assigned by sealed envelopes to three equal groups: Group A (tDCS, MT), and routine Physical Therapy (RPT)), Group B (tDCS and RPT), and Group C (MT and RPT). Participants underwent tDCS with MT for 30 minutes per session, five times weekly for two weeks. RPT was also provided for 20 minutes per session, five times weekly for 10 weeks^. Motor development (MD) was assessed using the Shoaib Sensorimotor Development Tool (SMDT), motor control (MC) by Fugl-Meyer Assessment (UE, LE), and Muscle Performance(MP) by isokinetic dynamometer at baseline, after two weeks, and after ten weeks of follow-up. Results: Group A demonstrated a more significant impact on rehabilitation in terms of motor development, motor control, and muscle performance compared to Groups B and C, based on mean comparisons after two and ten weeks. There was a statistically significant difference between the groups in MD (P = 0.01), MC (P = 0.02), and MP (P = 0.04). Conclusion: Transcranial direct current stimulation, either alone or in combination, has a more consistent impact on the rehabilitation of spastic quadriplegic cerebral palsy patients. (author)