Background: One of the most disabling problems in Parkinson disease (PD) is gait impairment. Noninvasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS), have been introduced as a therapeutic alternative for coping with PD motor problems. However, the effects of tDCS on gait performance in PD have not yet been fully established. Therefore, the main objective of this study was to evaluate whether a single session of tDCS modifies gait kinematics in individuals with PD. Methods: Twenty-one individuals with PD were included in this randomized, double-blinded, sham-controlled design study. They were randomly allocated in one real (N = 8) or sham (N = 9) tDCS group. Real tDCS comprises a 2-mA anodic current applied over 15 minutes in the supplementary motor area and medial areas of the primary motor cortices through a bipolar electrode montage. Gait kinematics and the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) were assessed before and immediately after a single stimulation session. Pre- minus poststimulation (Δ) values were computed and compared through a Mann-Whitney test. Data are shown as the median (lower, upper quartile). Results: There was a significant group difference with a large effect size for Δ values of gait cadence (P = .014, d = 0.87), indicating its reduction after anodic stimulation in the real (−0.28 [−1.16, 0.01] steps/s) compared with sham tDCS group (0.17 [0.00, 0.40] steps/s). No other significant effect was found. Conclusion: The findings of this study suggest that anodic tDCS administered in a single session improves gait cadence in PD individuals.

In this study we investigate to what extent the effects of motor imagery on postural sway are constrained by movement features and the subject's imagery ability. Twenty-three subjects were asked to imagine three movements using the kinesthetic modality: rising on tiptoes, whole-body forward reaching, and whole-body lateral reaching. After each task, subjects reported the level of imagery vividness and were subsequently grouped into a HIGH group (scores ≥3, “moderately intense” imagery) or a LOW group (scores ≤2, “mildly intense” imagery). An eyes closed trial was used as a control task. Center of gravity (COG) coordinates were collected, along with surface EMG of the deltoid (medial and anterior portion) and lateral gastrocnemius muscles. COG variability was quantified as the amount of fluctuations in position and velocity in the forward-backward and lateral directions. Changes in COG variability during motor imagery were observed only for the HIGH group. COG variability in the forward-backward direction was increased during the rising on tiptoes imagery, compared with the control task (p = 0.01) and the lateral reaching imagery (p = 0.02). Conversely, COG variability in the lateral direction was higher in rising on tiptoes and lateral reaching imagery than during the control task (p < 0.01); in addition, COG variability was higher during the lateral reaching imagery than in the forward reaching imagery (p = 0.02). EMG analysis revealed no effects of group (p > 0.08) or task (p > 0.46) for any of the tested muscles. In summary, motor imagery influences body sway dynamics in a task-dependent manner, and relies on the subject' imagery ability.

Background and Purpose The motor impairments related to gait and balance have a huge impact on the life of individuals with spinocerebellar ataxia (SCA). Here, the aim was to assess the possibility of retraining gait, improving cardiopulmonary capacity, and challenging balance during gait in SCA using a partial body weight support (BWS) and a treadmill. Also, the effects of this training over functionality and quality of life were investigated. Methods Eight SCA patients were engaged in the first stage of the study that focused on gait training and cardiovascular conditioning. From those, five took part in a second stage of the study centered on dynamic balance training during gait. The first and second stages lasted 8 and 10 weeks, respectively, both comprising sessions of 50 min (2 times per week). Results The results showed that gait training using partial BWS significantly increased gait performance, treadmill inclination, duration of exercise, and cardiopulmonary capacity in individuals with SCA. After the second stage, balance improvements were also found. Conclusion Combining gait training and challenging tasks to the postural control system in SCA individuals is viable, well tolerated by patients with SCA, and resulted in changes in capacity for walking and balance.