Service Delivery

Transcranial direct current stimulation during treadmill training in children with cerebral palsy: a randomized controlled double-blind clinical trial.

Grecco et al. (2014) · Research in developmental disabilities 2014
★ The Verdict

A quick zap over the motor cortex while walking helps younger kids with CP walk better and the benefit lasts.

✓ Read this if BCBAs working with 5–11-year-olds with spastic CP in outpatient or school settings.
✗ Skip if Practitioners who only treat teens or adults with CP.

01Research in Context

01

What this study did

Researchers paired gentle brain stimulation with treadmill walking for kids with cerebral palsy. They put a small 1 mA anodal tDCS patch over each child’s stronger motor cortex during ten treadmill sessions. The kids were 5–11 years old and had spastic diparetic CP. Half got real tDCS, half got sham, and no one knew which was which until the end.

02

What they found

Gait got better in the real tDCS group. Speed, step length, and mobility scores rose by a medium amount. The gains stuck around one month later. The sham group stayed about the same. No serious side effects were reported.

03

How this fits with other research

Vitiello et al. (2016) looks like the opposite story: teens with CP got worse balance after only 15 minutes of treadmill walking. The difference is age and fatigue. Younger kids in Collange’s study had fresh legs and extra brain boost; teens in Damien’s study tired quickly and had no tDCS help.

Zhou et al. (2026) shows why the teen group struggles. Their fNIRS study found teens with spastic CP use extra parietal “fuel” and move jerkily. tDCS may calm that over-activation, which could explain the younger kids’ success.

Pizzighello et al. (2019) widens the lens. They tracked adults with CP and saw global disability rise even when motor skills held steady. Early gait gains matter, but long-term plans must prep for complex care needs.

04

Why it matters

If you serve school-age kids with spastic CP, ask the PT about adding tDCS to treadmill training. The setup is cheap and portable. Start with short sessions and watch fatigue. Share the Damien data with families so they know teens may need shorter walks or extra rest breaks.

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Ask the PT to trial 1 mA anodal tDCS during the first five minutes of treadmill warm-up and track gait speed weekly.

02At a glance

Intervention
other
Design
randomized controlled trial
Sample size
24
Population
developmental delay
Finding
positive
Magnitude
medium

03Original abstract

Impaired gait constitutes an important functional limitation in children with cerebral palsy (CP). Treadmill training has achieved encouraging results regarding improvements in the gait pattern of this population. Moreover, transcranial direct current stimulation (tDCS) is believed to potentiate the results achieved during the motor rehabilitation process. The aim of the present study was to determine the effect of the administration of tDCS during treadmill training on the gait pattern of children with spastic diparetic CP. A double-blind randomized controlled trial was carried out involving 24 children with CP allocated to either an experimental group (active anodal tDCS [1mA] over the primary motor cortex of the dominant hemisphere) or control group (placebo tDCS) during ten 20-min sessions of treadmill training. The experimental group exhibited improvements in temporal functional mobility, gait variables (spatiotemporal and kinematics variables). The results were maintained one month after the end of the intervention. There was a significant change in corticospinal excitability as compared to control group. In the present study, the administration of tDCS during treadmill training potentiated the effects of motor training in children with spastic diparetic CP.

Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.07.030