Gait and motor functions in cerebral palsy after bi-anodal transcranial direct current stimulation combined with treadmill training: A feasibility clinical study

Hikmat Hadoush; Nedal AbuSalem; Nihad A. Almasri; Nasim Alnuman; Alham Al-Sharman

doi:10.12688/f1000research.170839.1

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Research Article

Gait and motor functions in cerebral palsy after bi-anodal transcranial direct current stimulation combined with treadmill training: A feasibility clinical study

[version 1; peer review: 1 approved with reservations]

Hikmat Hadoush ^1,2, Nedal AbuSalem¹, Nihad A. Almasri^3,4, Nasim Alnuman⁵, Alham Al-Sharman^1,2

Hikmat Hadoush ^1,2, Nedal AbuSalem¹, [...] Nihad A. Almasri^3,4, Nasim Alnuman⁵, Alham Al-Sharman^1,2

PUBLISHED 29 Apr 2026

Author details Author details

¹ Department of Physiotherapy, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
² Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
³ Department of Physiotherapy, Qatar University, Doha, Doha, Qatar
⁴ Department of Physiotherapy, University of Jordan, Amman, Jordan
⁵ Department Biomedical engineering, German Jordanian University, Amman, Jordan

Hikmat Hadoush
Roles: Conceptualization, Formal Analysis, Methodology, Project Administration, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

Nedal AbuSalem
Roles: Data Curation, Formal Analysis, Investigation, Validation, Visualization, Writing – Review & Editing

Nihad A. Almasri
Roles: Formal Analysis, Methodology, Validation, Visualization, Writing – Review & Editing

Nasim Alnuman
Roles: Formal Analysis, Software, Validation, Visualization, Writing – Review & Editing

Alham Al-Sharman
Roles: Validation, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Background

Children with cerebral palsy (CP) exhibit widespread alterations in cortical excitability and present with bilateral alterations in the bi-hemispheric sensorimotor functions, even when the initial brain lesion is unilateral.

Objective

This study evaluated the feasibility, safety, and preliminary efficacy of combining bilateral anodal transcranial direct current stimulation (tDCS) over the sensorimotor cortices with treadmill training in children with CP.

Method

A within-subjects case series was conducted with five children with CP. Participants received ten sessions of treadmill training (at 50% of their maximum over-ground speed) concurrently with bilateral anodal tDCS. Outcomes, assessed pre- and post-intervention, included postural alignment (medio-lateral and anterior-posterior), ankle dorsiflexion range of motion, gait variability, walking tolerance (6-minute walk test), motor function (GMFM-66), and hip/knee range of motion. Statistical analysis was performed using paired t-tests and effect sizes (Hedges’ g).

Results

The intervention was feasible and well-tolerated without any reported side effects. In addition, significant improvements with moderate to large effect sizes were observed in medio-lateral postural alignment (p = 0.003, g = 0.65) and left ankle passive dorsiflexion (p = 0.01, g = 1.42). Right ankle dorsiflexion showed a moderate, non-significant improvement (g = 0.77). No significant differences were found in anterior-posterior alignment, gait variability, walking tolerance, gross motor function, or other ranges of motion.

Conclusion

Bilateral anodal tDCS stimulation combined with treadmill training therapy is a feasible and safe intervention for children with CP. The preliminary efficacy results, showing significant improvements in specific postural and impairment measures, provide a necessary foundation for future large-scale randomized controlled trials.

Keywords

Cerebral palsy, transcranial direct current stimulation, treadmill gait training, accelerometer gait analysis, motor function, range of motion, walking tolerance

Corresponding author: Hikmat Hadoush

Competing interests: No competing interests were disclosed.

Grant information: This study is supported by the Jordan University of Science and Technology and the Erasmus+ program of the European Union project entitled (establishment of an interdisciplinary clinical rehabilitation sciences master program at Just-CRS) (project no: “573758-EPP-1-2016-1-JOEPPKA2-CBHE-JP”).
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright: © 2026 Hadoush H et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Hadoush H, AbuSalem N, A. Almasri N et al. Gait and motor functions in cerebral palsy after bi-anodal transcranial direct current stimulation combined with treadmill training: A feasibility clinical study [version 1; peer review: 1 approved with reservations]. F1000Research 2026, 15:637 (https://doi.org/10.12688/f1000research.170839.1) First published: 29 Apr 2026, 15:637 (https://doi.org/10.12688/f1000research.170839.1) Latest published: 29 Apr 2026, 15:637 (https://doi.org/10.12688/f1000research.170839.1)

Introduction

Motor control and coordination in pediatric cerebral palsy patients have been improved through various methods. Treadmill training demonstrates efficacy in enhancing gait velocity, balance, and functional independence. Furthermore, transcranial direct current stimulation (tDCS) presents a non-invasive and safe alternative to surgical or pharmacological treatments. Collectively, these interventions have proven effective in advancing gait performance and functional capabilities in this population.^1–3

The optimal protocol for administering tDCS to pediatric cerebral palsy patients has yet to be established. Contrary to earlier studies that utilized unilateral anodal stimulation targeting the contralateral motor cortex,^4–6 a hypothesis suggests that bilateral stimulation of both hemispheres could yield superior outcomes. This premise is supported by Nevalainen et al. (2015),⁷ who identified through magnetoencephalography (MEG) a widespread disruption in neural excitability within both sensory-motor cortices of children with CP. This bilateral impairment occurs even in cases of unilateral lesions and contributes to reduced activation in corticospinal pathways. Accordingly, subsequent research applying unilateral anodal tDCS to the ipsilateral motor cortex (non-lesioned hemisphere) demonstrated enhancements in motor functions such as reaching skills and movement duration.^8,9

As a feasibility study, this pilot research assessed the practicality and initial effects of administering bilateral anodal tDCS concurrently with treadmill training to enhance gait parameters, range of motion, and reduce spasticity in pediatric patients with diplegic CP.

Methods

Study design & participants

The study protocol received ethical approval based on the Declaration of Helsinki (JUST-420-2019). Besides, this study protocol and procedures were registered retrospectively in the National Clinical Trial Registry (https://clinicaltrials.gov/study/NCT07342660, Registration No.: NCT07342660). This is because the study originally registered within the Erasmus+ program database and the Jordan University of Science and Technology Deanship of Research system. However, internal registration would not be enabling the open access to the study protocol, Hereby, we proceeded with retrospective registration in a public registry and we clearly stated that in the registration database.

This study included five children (aged 4–12 years) with spastic diplegic CP. Inclusion criteria stipulated a Gross Motor Function Classification System (GMFCS) level of I-III, the ability to walk independently for at least 10 meters, and an IQ greater than 70. Key exclusion criteria included a history of orthopaedic surgery, neurolytic blocks, or Botox injections in the past six months, as well as the presence of concurrent orthopedic impairments, epilepsy, intracranial metal implants, or hearing aids. In addition, voluntary written informed consent was obtained from all participant children by their legal guardians before participation in the study.

Treadmill training & tDCS intervention

While prior research utilizing unilateral anodal tDCS in children with CP positioned a single anode over the C3 or C4 motor cortex and a cathode on the supra-orbital area according to the 10–20 EEG system,^5,7,8–11 the present study employed a bilateral montage. Using the 10–10 EEG system for more precise placement, two anodes were positioned over the left FC1 and right FC2 regions (encompassing motor and frontal areas), with two corresponding cathodes located over the bilateral supra-orbital areas ( Figure 1).¹² A low current intensity of 1 mA was applied.

Figure 1. The tDCS protocols.

A) shows the conventional tDCS precool done in previous literature, where the anodal stimulation only targeted the lesion side. Whereas B) shows the proposed tDCS stimulation in this study used bilateral anodal tDCS stimulation based on brain mapping data of a bilateral neuromotor deficit associated with reduced activation in bilateral corticospinal and sensorimotor pathways, even in cases of unilateral brain lesions.

The therapeutic protocol commenced with two treadmill familiarization sessions. This was followed by ten combined treatment sessions, each consisting of a 12-minute interval: a 1-minute warm-up, a 10-minute simultaneous treadmill training and tDCS therapy period, and a 1-minute cool-down. Treadmill speed was initiated at 50% of the child’s maximum ground speed from the 6-Minute Walk Test (6MWT) and was progressively increased based on individual tolerance. Tolerance was gauged by the absence of fatigue complaints, a heart rate not exceeding 70% of maximum, and the maintenance of proper gait without shuffling. Assistants were present to provide support and verbal feedback to promote correct movement patterns.

Outcome measures

Pre- and post-intervention data were collected, including body function measures like joint range of motion, activity measures such as walking endurance (6MWT), and motor function evaluation (GMFM-IS). Gait parameters in children walking on a 10-meter track were assessed using a tri-axial accelerometer measuring accelerations in x, y, and z axes ( Figure 2). Gait variability was determined using autocorrelation coefficients for each axis, indicating abnormality or normality. This method proved effective for studying gait function maturation in children by analysing deviations in each gait cycle relative to the mean value.^13–15

Figure 2. Gait kinematic analysis.

The upper panel (A) shows the location of the markers in the lower body gait model. The lower panel (B) shows the schematic of camera distribution and body model in our Nexus software/Vicon.

Data analysis

Due to the cautions reported in the previous study¹⁶ of using the paired t-test with extremely small sample sizes (n = 5), the mean ± standard deviation was calculated for all outcome measures, the intervention’s clinical effect size was determined using Hedges’ g, with values indicating small, moderate, or large effects, and gait outcomes were measured by having each child walk a 10 m track twice before and after the intervention. Data is available.¹⁷

Results

There were no side effects or stimulation intolerance reported by the children, parents, or caregivers. The study found that after 10 sessions of bilateral anodal tDCS and treadmill treatment, there was a significant improvement in medio-lateral alignment during gait, with a large clinical effect size. However, there were no significant changes in anterior-posterior alignment and gait variability. Additionally, walking tolerance or distance travelled, and motor function did not show significant improvement after the treatment sessions. The treatment did have a significant impact on left ankle dorsiflexion and right ankle dorsiflexion, with large clinical effect sizes. However, the treatment had minimal effects on the passive range of motion of the left and right hip and knee (See details in Table 1).

Table 1. Outcome measures.

Demographic data	Age (years)	Height weight	Walking ground speed (km/hr.)
Participants (n = 5)	6.40 (0.9)	114.0 (5.4) cm 21.8 (2.3) kg	1.80 (0.53)
Outcome measures		Mean (SD)	Effect size (Hedges’)
Distance traveled (6MWT)	Pre	182.3 (52.9)	0.22
Distance traveled (6MWT)	Post	195.3 (54.4)	0.22
Motor function (GMFM-IS)	Pre	66.4 (1.5)	0.23
Motor function (GMFM-IS)	Post	66.0 (1.5)	0.23
Gait Spatiotemporal
Medio-lateral alignment	Pre	56.02 (7.9)	0.65*
Medio-lateral alignment	Post	63.9 (7.8)	0.65*
Anterior-posterior alignment	Pre	34.59 (19.9)	0.06
Anterior-posterior alignment	Post	35.69 (14.0)	0.06
Gait variability	Pre	0.11 (0.1)	−0.19
Gait variability	Post	0.10 (0.1)	−0.19
Passive ROM
Right ankle DF (knee extended)	Pre	11.0 (4.0)	0.77
Right ankle DF (knee extended)	Post	15.5 (6.3)	0.77
Left ankle DF (knee extended)	Pre	13.8 (4.0)	1.49
Left ankle DF (knee extended)	Post	19.6 (3.2)	1.49
Right knee flexion	Pre	101.3 (39.7)	0.18
Right knee flexion	Post	86.3 (39.0)	0.18
Left knee flexion	Pre	99.2 (39.0)	0.05
Left knee flexion	Post	86.7 (40.2)	0.05
Right hip abduction (knee extended)	Pre	29.6 (6.6)	0.09
Right hip abduction (knee extended)	Post	27.8 (2.8)	0.09
Left hip abduction (knee extended)	Pre	30.2 (5.3)	0.13
Left hip abduction (knee extended)	Post	26.0 (8.9)	0.13
Right hip extension	Pre	18.4 (5.0)	0.40
Right hip extension	Post	12.2 (4.7)	0.40
Left hip extension	Pre	16.2 (6.8)	0.14
Left hip extension	Post	13.0 (5.8)	0.14

Discussion

Two studies investigated the efficacy of integrating unilateral anodal tDCS with treadmill training to improve gait alignment in pediatric populations with CP.^8,10 The first reported improvements in balance functions, and static anterior/posterior, medio/lateral swaying,⁸ and the second reported improvements in pelvic tilting and distance traveled (6MWT). Hereby, there However, this study applied bilateral anodal tDCS over prefrontal and motor areas influenced by previous brain imaging findings⁷ of global excitability alterations and reduction in children with CP. Hereby, this study’s approach is reported to be safe with no side effects, and we may assume that this approach would improve results by targeting both sides of the brain.

To start with, the spatiotemporal parameters of gait can be evaluated in three axes: anteroposterior, medio-lateral, and vertical. Tri-axial accelerometers are used to record these dimensions, providing a valid tool for analyzing gait parameters.¹⁸

The limited improvement in medio-lateral alignment, in this study, can only be explained by the findings of the previous study,¹⁴ where they reported that the major advantage of treadmill training over conventional ground training was in the lateral mechanical force the treadmill produced. In other words, the treadmill training will introduce mechanical lateral force to the body, and it was assumed that such mechanical lateral force generated by the treadmill would be behind the improvement in medio-lateral alignment in this study and previous studies.

On the other hand, in terms of gait variability, the gait pattern of children and adolescents with CP is often characterized by increased gait variability^15,16 and asymmetry¹⁹ compared with their healthy-developed peers. This manifests as stride-to-stride fluctuations. Normally, the fluctuations are relatively small in terms of the coefficient of variation in the gait speed and stride time.^20,21 Hereby, measuring gait variability is considered important because it serves as a sensitive and clinically relevant parameter in the evaluation of gait, mobility, fall risk, and the responses to therapeutic interventions.²¹ However, due to a lack of studies examining the changes in gait variability after the tDCS and treadmill treatments, this study’s results would be the first in this field and would add preliminary data that there are no significant improvements in gait variability post-tDCS treatment. Nevertheless, there is a crucial need for further studies in this regard.

Rehabilitation specialists use GMFM to measure motor function in children with CP for intervention effectiveness.²² This study finding comes from Grecco et al. (2015),¹⁰ who examined the effect of tDCS and treadmill gait training on 24 children with CP and found no significant changes in gross motor functions. This is because previous studies showed that significant improvements in gross motor function may require more time and intensive treatment, with one study reporting such improvement after 6 weeks¹⁸ and 12 weeks of intervention.²³ This highlights the importance of further research to understand the time and intensity required for interventions to have a significant impact on gross motor function in children with CP.

No research has explored how combining tDCS with treadmill training impacts passive ROM in children with spastic CP. The large effect improvement in ankle dorsiflexion in this study could be explained by the findings of previous research, which showed that treadmill training can reduce ankle joint stiffness and improve heel strike in children with CP.²⁴ Besides, Treadmill training has been linked to increased anterior tibialis muscle activity, leading to improved ankle dorsiflexion.²⁵ In addition, tDCS could temporarily reduce spasticity in children with CP.²⁶ Hereby, the combined effect of tDCS and treadmill training may lead to improved ankle dorsiflexion by reducing joint stiffness and muscle spasticity.

Conclusion

This pilot study successfully demonstrated that the application of bilateral anodal transcranial direct current stimulation (tDCS) concurrently with standard treadmill gait training is both a safe and feasible intervention for children diagnosed with diplegic CP. This study effectively fulfills the role of an essential pre-clinical or proof-of-concept study, as recommended by medical research councils before proceeding to a large-scale RCT, which is recommended and crucially needed.

Data availability

TDCS and Treadmill in CP is marked under a Creative Commons Attribution 4.0 International license (CC BY 4.0). To view a copy of this mark, visit: https://zenodo.org/records/18330054.¹⁷

References

1. Smania N, Bonetti P, Gandolfi M, et al.: Improved gait after repetitive locomotor training in children with cerebral palsy. Am J Phys Med Rehabil. 2011; 90(2): 137–149. PubMed Abstract | Publisher Full Text
2. Grecco LA, Tomita SM, Christovao TC, et al.: Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial. Braz J Phys Ther. 2013; 17(1): 17–23. Publisher Full Text
3. Hamilton A, Wakely L, Marquez J: Transcranial Direct-Current Stimulation on Motor Function in Pediatric Cerebral Palsy: A Systematic Review. Pediatr Phys Ther. 2018; 30(4): 291–301. PubMed Abstract | Publisher Full Text
4. Brunoni AR, Zanao TA, Vanderhasselt MA, et al.: Enhancement of affective processing induced by bifrontal transcranial direct current stimulation in patients with major depression. Neuromodulation. 2014; 17(2): 138–142. PubMed Abstract | Publisher Full Text
5. Grecco LA, Duarte NA, Zanon N, et al.: Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study. Braz J Phys Ther. 2014; 18(5): 419–427. Publisher Full Text
6. Lazzari RD, Politti F, Santos CA, et al.: Effect of a single session of transcranial direct-current stimulation combined with virtual reality training on the balance of children with cerebral palsy: a randomized, controlled, double-blind trial. J Phys Ther Sci. 2015; 27(3): 763–768. PubMed Abstract | Publisher Full Text | Free Full Text
7. Nevalainen P, Pihko E, Maenpaa H, et al.: Bilateral alterations in somatosensory cortical processing in hemiplegic cerebral palsy. Dev Med Child Neurol. 2012; 54(4): 361–367. PubMed Abstract | Publisher Full Text
8. Duarte NA, Grecco LA, Galli M, et al.: Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PLoS One. 2014; 9(8): e105777. Publisher Full Text
9. Al Jaouni SK, El-Fiky EA, Mourad SA, et al.: The effect of wet cupping on quality of life of adult patients with chronic medical conditions in King Abdulaziz University Hospital. Saudi Med J. 2017; 38(1): 53–62. Publisher Full Text
10. Grecco LA, de Almeida Carvalho Duarte N , Mendonca ME, et al.: Transcranial direct current stimulation during treadmill training in children with cerebral palsy: a randomized controlled double-blind clinical trial. Res Dev Disabil. 2014; 35(11): 2840–2848. Publisher Full Text
11. Ergin E, Savci S, Ozcan Kahraman B, et al.: Three-axis accelerometer system for comparison of gait parameters in children with cystic fibrosis and healthy peers. Gait Posture. 2020; 78: 60–64. PubMed Abstract | Publisher Full Text
12. Auvinet B, Berrut G, Touzard C, et al.: Reference data for normal subjects obtained with an accelerometric device. Gait Posture. 2002; 16(2): 124–134. PubMed Abstract | Publisher Full Text
13. Zijlstra W, Hof AL: Assessment of spatio-temporal gait parameters from trunk accelerations during human walking. Gait Posture. 2003; 18(2): 1–10. PubMed Abstract | Publisher Full Text
14. Zollinger M, Degache F, Currat G, et al.: External Mechanical Work and Pendular Energy Transduction of Overground and Treadmill Walking in Adolescents with Unilateral Cerebral Palsy. Front Physiol. 2016; 7: 121. Publisher Full Text
15. Bregou Bourgeois A, Mariani B, Aminian K, et al.: Spatio-temporal gait analysis in children with cerebral palsy using, foot-worn inertial sensors. Gait Posture. 2014; 39(1): 436–442. PubMed Abstract | Publisher Full Text
16. Prosser LA, Lauer RT, VanSant AF, et al.: Variability and symmetry of gait in early walkers with and without bilateral cerebral palsy. Gait Posture. 2010; 31(4): 522–526. PubMed Abstract | Publisher Full Text | Free Full Text
17. Hadoush H: tDCS and Treadmill in CP. OneDrive. Retrieved September 28, 202. Reference Source
18. Flores MB, Da Silva CP: Trunk control and gross motor outcomes after body weight supported treadmill training in young children with severe cerebral palsy: a non-experimental case series. Dev Neurorehabil. 2019; 22(7): 499–503. Publisher Full Text
19. Feng J, Pierce R, Do KP, et al.: Motion of the center of mass in children with spastic hemiplegia: balance, energy transfer, and work performed by the affected leg vs. the unaffected leg. Gait Posture. 2014; 39(1): 570–576. PubMed Abstract | Publisher Full Text
20. Terrier P, Schutz Y: Variability of gait patterns during unconstrained walking assessed by satellite positioning (GPS). Eur J Appl Physiol. 2003; 90(5–6): 554–561. PubMed Abstract | Publisher Full Text
21. Hausdorff JM: Gait variability: methods, modeling and meaning. J Neuroeng Rehabil. 2005; 2: 19. PubMed Abstract | Publisher Full Text | Free Full Text
22. Krach LE, Kriel RL, Gilmartin RC, et al.: GMFM 1 year after continuous intrathecal baclofen infusion. Pediatr Rehabil. 2005; 8(3): 207–213. PubMed Abstract | Publisher Full Text
23. Cherng RJ, Liu CF, Lau TW, et al.: Effect of treadmill training with body weight support on gait and gross motor function in children with spastic cerebral palsy. Am J Phys Med Rehabil. 2007; 86(7): 548–555. PubMed Abstract | Publisher Full Text
24. Willerslev-Olsen M, Lorentzen J, Nielsen JB: Gait training reduces ankle joint stiffness and facilitates heel strike in children with Cerebral Palsy. NeuroRehabilitation. 2014; 35(4): 643–655. Publisher Full Text
25. Bland DC, Prosser LA, Bellini LA, et al.: Tibialis anterior architecture, strength, and gait in individuals with cerebral palsy. Muscle Nerve. 2011; 44(4): 509–517. PubMed Abstract | Publisher Full Text | Free Full Text
26. Aree-uea B, Auvichayapat N, Janyacharoen T, et al.: Reduction of spasticity in cerebral palsy by anodal transcranial direct current stimulation. J Med Assoc Thai. 2014; 97(9): 954–962. PubMed Abstract

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Version 1

VERSION 1 PUBLISHED 29 Apr 2026

Author details Author details

¹ Department of Physiotherapy, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
² Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
³ Department of Physiotherapy, Qatar University, Doha, Doha, Qatar
⁴ Department of Physiotherapy, University of Jordan, Amman, Jordan
⁵ Department Biomedical engineering, German Jordanian University, Amman, Jordan

Hikmat Hadoush
Roles: Conceptualization, Formal Analysis, Methodology, Project Administration, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

Nedal AbuSalem
Roles: Data Curation, Formal Analysis, Investigation, Validation, Visualization, Writing – Review & Editing

Nihad A. Almasri
Roles: Formal Analysis, Methodology, Validation, Visualization, Writing – Review & Editing

Nasim Alnuman
Roles: Formal Analysis, Software, Validation, Visualization, Writing – Review & Editing

Alham Al-Sharman
Roles: Validation, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

This study is supported by the Jordan University of Science and Technology and the Erasmus+ program of the European Union project entitled (establishment of an interdisciplinary clinical rehabilitation sciences master program at Just-CRS) (project no: “573758-EPP-1-2016-1-JOEPPKA2-CBHE-JP”).
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Published: 29 Apr 2026, 15:637

https://doi.org/10.12688/f1000research.170839.1

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© 2026 Hadoush H et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Hadoush H, AbuSalem N, A. Almasri N et al. Gait and motor functions in cerebral palsy after bi-anodal transcranial direct current stimulation combined with treadmill training: A feasibility clinical study [version 1; peer review: 1 approved with reservations]. F1000Research 2026, 15:637 (https://doi.org/10.12688/f1000research.170839.1)

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VERSION 1

PUBLISHED 29 Apr 2026

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Reviewer Report 04 Jun 2026

Umair Ahmed, University of Lahore, Lahore, Pakistan

Romasa Sarwar, Physiotherapy, Link Medical Interface, Lahore, Punjab, Pakistan

Approved with Reservations

https://doi.org/10.5256/f1000research.188347.r485903

1. Is the work clearly and accurately presented and does it cite the current literature?
Partly
The manuscript is generally understandable and addresses a clinically relevant topic. The rationale for bilateral anodal tDCS is clearly introduced and is ... Continue reading

1. Is the work clearly and accurately presented and does it cite the current literature?
Partly
The manuscript is generally understandable and addresses a clinically relevant topic. The rationale for bilateral anodal tDCS is clearly introduced and is linked to prior evidence suggesting bilateral sensorimotor involvement in children with cerebral palsy. The topic is relevant, and most of the cited literature is appropriate to the intervention and population.
However, several presentation and citation issues require correction. The abstract reports the effect size for left ankle dorsiflexion as g = 1.42, whereas Table 1 reports g = 1.49 for the same outcome. One of these values appears to be incorrect and should be reconciled. In addition, p-values are reported for some outcomes in the abstract but are not consistently presented in Table 1, making it difficult to cross-reference the significance claims against the tabulated results.
There is also an unresolved sentence fragment in the Discussion: “Hereby, there However, this study applied bilateral anodal tDCS...”, which requires editorial correction. Reference 9, concerning wet cupping therapy in adults with chronic medical conditions, has no clear relevance to tDCS, treadmill training, gait, or cerebral palsy and appears to be misplaced. The Introduction also refers to Nevalainen et al. as a 2015 study, whereas the reference list appears to cite Nevalainen et al. as 2012. This citation inconsistency should be checked and corrected.

2. Is the study design appropriate and is the work technically sound?
Partly
The single-group feasibility case series design is acceptable for an early-stage investigation of safety, feasibility, and preliminary signal detection. The bilateral tDCS montage is rationally justified by prior neurophysiological evidence suggesting bilateral sensorimotor disruption in cerebral palsy. This is a technically interesting and potentially novel aspect of the study.
However, the technical reporting is incomplete. The tDCS protocol states the current intensity and electrode locations, but electrode size in cm² is not provided; therefore, current density cannot be calculated. Impedance monitoring, impedance thresholds, and ramp-up/ramp-down procedures are also not reported. These details are important for safety interpretation and technical reproducibility.
There is also inconsistency between the reported gait assessment method and Figure 2. The Methods section describes tri-axial accelerometry, whereas Figure 2 depicts a Vicon/Nexus motion-capture setup. It is unclear whether Vicon data were collected, whether they contributed to the reported outcomes, or whether the figure is unrelated to the data presented. This should be clarified.
The GMFM version is also inconsistently identified. The abstract refers to GMFM-66, whereas the Methods section and Table 1 refer to GMFM-IS. These are not interchangeable labels and may involve different scoring approaches. The correct instrument and scoring method should be confirmed and reported consistently.

3. Are sufficient details of methods and analysis provided to allow replication by others?
Partly
The manuscript provides some useful intervention details, including the number of treatment sessions, treadmill familiarisation sessions, treadmill speed basis, current intensity, and approximate electrode locations. However, several key details needed for replication are missing.

The tDCS electrode size, current density, impedance values or thresholds, and ramp-up/ramp-down procedures are not reported. Without these details, another research group could not fully reproduce the stimulation protocol.

Protocol Reporting

Electrode size (cm²) is not reported
Impedance monitoring during sessions is not mentioned
Ramp-up and ramp-down durations are not stated
It is not explicitly confirmed whether tDCS stimulation ran concurrently for the full 10-minute treadmill period
Recommendation: A dedicated tDCS parameter table following Peterchev et al. (2012) reporting standards should be added.

The statistical methods also require clarification. It is not clearly stated which outcomes were subjected to paired t-tests and which outcomes were interpreted using effect sizes only. This distinction should be explicitly stated in the Methods section or in a detailed table footnote.

Individual participant data are not presented in the manuscript. Given the very small sample size of five children, group means and standard deviations alone are insufficient to understand response variability, outliers, or consistency of response across participants.
Standard feasibility metrics are also incompletely reported. The number of children screened, number eligible, number declining participation, per-participant attendance, completion of all sessions, and treadmill speed progression are not clearly described. These details are especially important because the study is framed as a feasibility study and would inform the planning of a future trial.

4. If applicable, is the statistical analysis and its interpretation appropriate?
Partly
The statistical reporting requires substantial clarification before the preliminary efficacy claims can be interpreted reliably.

The Table 1 footnote reports t(9) = 3.97, p = 0.003 for medio-lateral alignment. However, the study included five participants in a single-group pre–post design. For a subject-level paired t-test with n = 5, the degrees of freedom should be n − 1 = 4, not 9. The reported df = 9 is therefore inconsistent with the stated sample size and paired design.

If df = 9 resulted from treating repeated walking trials as independent observations, this would raise a concern of pseudoreplication because repeated trials from the same child are not statistically independent. If trial-level data were analysed, the authors should use a method that accounts for clustering within participants, such as an appropriate repeated-measures or mixed-effects model.

Multiple outcomes appear to have been assessed for statistical significance, including walking tolerance, motor function, postural alignment, gait variability, and several passive range-of-motion outcomes. No correction for multiple comparisons is reported, and no clear primary efficacy outcome is identified. This increases the risk of Type I error, particularly in a sample of only five participants.

There are also internal reporting inconsistencies. The left ankle dorsiflexion effect size is reported as g = 1.42 in the abstract but g = 1.49 in Table 1. The abstract describes right ankle dorsiflexion as a moderate, non-significant improvement, whereas the Results section states that the treatment had a significant impact on both left and right ankle dorsiflexion. These inconsistencies should be corrected.

5. Are all the source data underlying the results available to ensure full reproducibility?
Partly
The manuscript provides a data availability statement and refers to a repository under a Creative Commons Attribution 4.0 license. Data is available on ZENODO. This is a positive aspect of the paper and supports transparency.
However, full reproducibility depends not only on the availability of the dataset but also on clarity of the analysis procedures. Because the manuscript does not clearly state which outcomes were analysed using paired t-tests, how repeated gait trials were handled, or how effect sizes were calculated, source data availability alone is not sufficient to ensure full reproducibility.

6. Are the conclusions drawn adequately supported by the results?
Partly
The conclusion that the intervention appears safe is supported by the reported absence of side effects or stimulation intolerance. However, the conclusion regarding feasibility should be more cautious because standard feasibility indicators, such as screening numbers, eligibility, recruitment flow, adherence, attendance, and protocol progression, are incompletely reported.

The conclusion that the intervention produced significant improvements in medio-lateral alignment and ankle dorsiflexion should also be interpreted cautiously. The reported degrees-of-freedom error, unclear handling of repeated gait trials, absence of correction for multiple outcome testing, and p-value reporting weaken confidence in the statistical significance claims.

The Discussion also appears to attribute observed changes to specific mechanisms, such as tDCS-related reduction in spasticity or treadmill-related lateral force effects. Because this was a combined-intervention, single-group case series without a control group, the study cannot separate the effects of tDCS, treadmill training, maturation, practice effects, or measurement variability. These mechanistic explanations should therefore be framed as speculative and hypothesis-generating rather than demonstrated findings.

The recommendation for future larger randomized controlled trials is appropriate and well aligned with the feasibility nature of the study. However, the manuscript should avoid overstating preliminary efficacy until the statistical and reporting issues are corrected.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

Partly
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

References

1. Peterchev A, Wagner T, Miranda P, Nitsche M, et al.: Fundamentals of transcranial electric and magnetic stimulation dose: Definition, selection, and reporting practices. Brain Stimulation. 2012; 5 (4): 435-453 Publisher Full Text

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Neurological physiotherapy and rehabilitation; stroke rehabilitation; gait, balance and fall prevention; pediatric and adult neurorehabilitation; digital health, AI-assisted rehabilitation, and predictive analytics in physiotherapy; clinical trials and evidence-based rehabilitation interventions.

We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above.

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Umair Ahmed, University of Lahore, Lahore, Pakistan

Romasa Sarwar, Link Medical Interface, Lahore, Pakistan

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Reviewer Report

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04 Jun 2026 | for Version 1

Umair Ahmed, University of Lahore, Lahore, Pakistan

Romasa Sarwar, Physiotherapy, Link Medical Interface, Lahore, Punjab, Pakistan

5 Views Cite this report Responses(0)

Approved With Reservations

1. Is the work clearly and accurately presented and does it cite the current literature?
Partly
The manuscript is generally understandable and addresses a clinically relevant topic. The rationale for bilateral anodal tDCS is clearly introduced and is linked to prior evidence suggesting bilateral sensorimotor involvement in children with cerebral palsy. The topic is relevant, and most of the cited literature is appropriate to the intervention and population.
However, several presentation and citation issues require correction. The abstract reports the effect size for left ankle dorsiflexion as g = 1.42, whereas Table 1 reports g = 1.49 for the same outcome. One of these values appears to be incorrect and should be reconciled. In addition, p-values are reported for some outcomes in the abstract but are not consistently presented in Table 1, making it difficult to cross-reference the significance claims against the tabulated results.
There is also an unresolved sentence fragment in the Discussion: “Hereby, there However, this study applied bilateral anodal tDCS...”, which requires editorial correction. Reference 9, concerning wet cupping therapy in adults with chronic medical conditions, has no clear relevance to tDCS, treadmill training, gait, or cerebral palsy and appears to be misplaced. The Introduction also refers to Nevalainen et al. as a 2015 study, whereas the reference list appears to cite Nevalainen et al. as 2012. This citation inconsistency should be checked and corrected.

2. Is the study design appropriate and is the work technically sound?
Partly
The single-group feasibility case series design is acceptable for an early-stage investigation of safety, feasibility, and preliminary signal detection. The bilateral tDCS montage is rationally justified by prior neurophysiological evidence suggesting bilateral sensorimotor disruption in cerebral palsy. This is a technically interesting and potentially novel aspect of the study.
However, the technical reporting is incomplete. The tDCS protocol states the current intensity and electrode locations, but electrode size in cm² is not provided; therefore, current density cannot be calculated. Impedance monitoring, impedance thresholds, and ramp-up/ramp-down procedures are also not reported. These details are important for safety interpretation and technical reproducibility.
There is also inconsistency between the reported gait assessment method and Figure 2. The Methods section describes tri-axial accelerometry, whereas Figure 2 depicts a Vicon/Nexus motion-capture setup. It is unclear whether Vicon data were collected, whether they contributed to the reported outcomes, or whether the figure is unrelated to the data presented. This should be clarified.
The GMFM version is also inconsistently identified. The abstract refers to GMFM-66, whereas the Methods section and Table 1 refer to GMFM-IS. These are not interchangeable labels and may involve different scoring approaches. The correct instrument and scoring method should be confirmed and reported consistently.

3. Are sufficient details of methods and analysis provided to allow replication by others?
Partly
The manuscript provides some useful intervention details, including the number of treatment sessions, treadmill familiarisation sessions, treadmill speed basis, current intensity, and approximate electrode locations. However, several key details needed for replication are missing.

The tDCS electrode size, current density, impedance values or thresholds, and ramp-up/ramp-down procedures are not reported. Without these details, another research group could not fully reproduce the stimulation protocol.

Protocol Reporting

Electrode size (cm²) is not reported
Impedance monitoring during sessions is not mentioned
Ramp-up and ramp-down durations are not stated
It is not explicitly confirmed whether tDCS stimulation ran concurrently for the full 10-minute treadmill period
Recommendation: A dedicated tDCS parameter table following Peterchev et al. (2012) reporting standards should be added.

The statistical methods also require clarification. It is not clearly stated which outcomes were subjected to paired t-tests and which outcomes were interpreted using effect sizes only. This distinction should be explicitly stated in the Methods section or in a detailed table footnote.

Individual participant data are not presented in the manuscript. Given the very small sample size of five children, group means and standard deviations alone are insufficient to understand response variability, outliers, or consistency of response across participants.
Standard feasibility metrics are also incompletely reported. The number of children screened, number eligible, number declining participation, per-participant attendance, completion of all sessions, and treadmill speed progression are not clearly described. These details are especially important because the study is framed as a feasibility study and would inform the planning of a future trial.

4. If applicable, is the statistical analysis and its interpretation appropriate?
Partly
The statistical reporting requires substantial clarification before the preliminary efficacy claims can be interpreted reliably.

The Table 1 footnote reports t(9) = 3.97, p = 0.003 for medio-lateral alignment. However, the study included five participants in a single-group pre–post design. For a subject-level paired t-test with n = 5, the degrees of freedom should be n − 1 = 4, not 9. The reported df = 9 is therefore inconsistent with the stated sample size and paired design.

If df = 9 resulted from treating repeated walking trials as independent observations, this would raise a concern of pseudoreplication because repeated trials from the same child are not statistically independent. If trial-level data were analysed, the authors should use a method that accounts for clustering within participants, such as an appropriate repeated-measures or mixed-effects model.

Multiple outcomes appear to have been assessed for statistical significance, including walking tolerance, motor function, postural alignment, gait variability, and several passive range-of-motion outcomes. No correction for multiple comparisons is reported, and no clear primary efficacy outcome is identified. This increases the risk of Type I error, particularly in a sample of only five participants.

There are also internal reporting inconsistencies. The left ankle dorsiflexion effect size is reported as g = 1.42 in the abstract but g = 1.49 in Table 1. The abstract describes right ankle dorsiflexion as a moderate, non-significant improvement, whereas the Results section states that the treatment had a significant impact on both left and right ankle dorsiflexion. These inconsistencies should be corrected.

5. Are all the source data underlying the results available to ensure full reproducibility?
Partly
The manuscript provides a data availability statement and refers to a repository under a Creative Commons Attribution 4.0 license. Data is available on ZENODO. This is a positive aspect of the paper and supports transparency.
However, full reproducibility depends not only on the availability of the dataset but also on clarity of the analysis procedures. Because the manuscript does not clearly state which outcomes were analysed using paired t-tests, how repeated gait trials were handled, or how effect sizes were calculated, source data availability alone is not sufficient to ensure full reproducibility.

6. Are the conclusions drawn adequately supported by the results?
Partly
The conclusion that the intervention appears safe is supported by the reported absence of side effects or stimulation intolerance. However, the conclusion regarding feasibility should be more cautious because standard feasibility indicators, such as screening numbers, eligibility, recruitment flow, adherence, attendance, and protocol progression, are incompletely reported.

The conclusion that the intervention produced significant improvements in medio-lateral alignment and ankle dorsiflexion should also be interpreted cautiously. The reported degrees-of-freedom error, unclear handling of repeated gait trials, absence of correction for multiple outcome testing, and p-value reporting weaken confidence in the statistical significance claims.

The Discussion also appears to attribute observed changes to specific mechanisms, such as tDCS-related reduction in spasticity or treadmill-related lateral force effects. Because this was a combined-intervention, single-group case series without a control group, the study cannot separate the effects of tDCS, treadmill training, maturation, practice effects, or measurement variability. These mechanistic explanations should therefore be framed as speculative and hypothesis-generating rather than demonstrated findings.

The recommendation for future larger randomized controlled trials is appropriate and well aligned with the feasibility nature of the study. However, the manuscript should avoid overstating preliminary efficacy until the statistical and reporting issues are corrected.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

Partly
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

References

1. Peterchev A, Wagner T, Miranda P, Nitsche M, et al.: Fundamentals of transcranial electric and magnetic stimulation dose: Definition, selection, and reporting practices. Brain Stimulation. 2012; 5 (4): 435-453 Publisher Full Text

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Neurological physiotherapy and rehabilitation; stroke rehabilitation; gait, balance and fall prevention; pediatric and adult neurorehabilitation; digital health, AI-assisted rehabilitation, and predictive analytics in physiotherapy; clinical trials and evidence-based rehabilitation interventions.

We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above.

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[1] 1. Smania N, Bonetti P, Gandolfi M, et al.: Improved gait after repetitive locomotor training in children with cerebral palsy. Am J Phys Med Rehabil. 2011; 90(2): 137–149. PubMed Abstract | Publisher Full Text

[2] 2. Grecco LA, Tomita SM, Christovao TC, et al.: Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial. Braz J Phys Ther. 2013; 17(1): 17–23. Publisher Full Text

[3] 3. Hamilton A, Wakely L, Marquez J: Transcranial Direct-Current Stimulation on Motor Function in Pediatric Cerebral Palsy: A Systematic Review. Pediatr Phys Ther. 2018; 30(4): 291–301. PubMed Abstract | Publisher Full Text

[4] 4. Brunoni AR, Zanao TA, Vanderhasselt MA, et al.: Enhancement of affective processing induced by bifrontal transcranial direct current stimulation in patients with major depression. Neuromodulation. 2014; 17(2): 138–142. PubMed Abstract | Publisher Full Text

[5] 5. Grecco LA, Duarte NA, Zanon N, et al.: Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study. Braz J Phys Ther. 2014; 18(5): 419–427. Publisher Full Text

[6] 6. Lazzari RD, Politti F, Santos CA, et al.: Effect of a single session of transcranial direct-current stimulation combined with virtual reality training on the balance of children with cerebral palsy: a randomized, controlled, double-blind trial. J Phys Ther Sci. 2015; 27(3): 763–768. PubMed Abstract | Publisher Full Text | Free Full Text

[7] 7. Nevalainen P, Pihko E, Maenpaa H, et al.: Bilateral alterations in somatosensory cortical processing in hemiplegic cerebral palsy. Dev Med Child Neurol. 2012; 54(4): 361–367. PubMed Abstract | Publisher Full Text

[8] 8. Duarte NA, Grecco LA, Galli M, et al.: Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PLoS One. 2014; 9(8): e105777. Publisher Full Text

[9] 9. Al Jaouni SK, El-Fiky EA, Mourad SA, et al.: The effect of wet cupping on quality of life of adult patients with chronic medical conditions in King Abdulaziz University Hospital. Saudi Med J. 2017; 38(1): 53–62. Publisher Full Text

[10] 10. Grecco LA, de Almeida Carvalho Duarte N , Mendonca ME, et al.: Transcranial direct current stimulation during treadmill training in children with cerebral palsy: a randomized controlled double-blind clinical trial. Res Dev Disabil. 2014; 35(11): 2840–2848. Publisher Full Text

[11] 11. Ergin E, Savci S, Ozcan Kahraman B, et al.: Three-axis accelerometer system for comparison of gait parameters in children with cystic fibrosis and healthy peers. Gait Posture. 2020; 78: 60–64. PubMed Abstract | Publisher Full Text

[12] 12. Auvinet B, Berrut G, Touzard C, et al.: Reference data for normal subjects obtained with an accelerometric device. Gait Posture. 2002; 16(2): 124–134. PubMed Abstract | Publisher Full Text

[13] 13. Zijlstra W, Hof AL: Assessment of spatio-temporal gait parameters from trunk accelerations during human walking. Gait Posture. 2003; 18(2): 1–10. PubMed Abstract | Publisher Full Text

[14] 14. Zollinger M, Degache F, Currat G, et al.: External Mechanical Work and Pendular Energy Transduction of Overground and Treadmill Walking in Adolescents with Unilateral Cerebral Palsy. Front Physiol. 2016; 7: 121. Publisher Full Text

[15] 15. Bregou Bourgeois A, Mariani B, Aminian K, et al.: Spatio-temporal gait analysis in children with cerebral palsy using, foot-worn inertial sensors. Gait Posture. 2014; 39(1): 436–442. PubMed Abstract | Publisher Full Text

[16] 16. Prosser LA, Lauer RT, VanSant AF, et al.: Variability and symmetry of gait in early walkers with and without bilateral cerebral palsy. Gait Posture. 2010; 31(4): 522–526. PubMed Abstract | Publisher Full Text | Free Full Text

[17] 17. Hadoush H: tDCS and Treadmill in CP. OneDrive. Retrieved September 28, 202. Reference Source

[18] 18. Flores MB, Da Silva CP: Trunk control and gross motor outcomes after body weight supported treadmill training in young children with severe cerebral palsy: a non-experimental case series. Dev Neurorehabil. 2019; 22(7): 499–503. Publisher Full Text

[19] 19. Feng J, Pierce R, Do KP, et al.: Motion of the center of mass in children with spastic hemiplegia: balance, energy transfer, and work performed by the affected leg vs. the unaffected leg. Gait Posture. 2014; 39(1): 570–576. PubMed Abstract | Publisher Full Text

[20] 20. Terrier P, Schutz Y: Variability of gait patterns during unconstrained walking assessed by satellite positioning (GPS). Eur J Appl Physiol. 2003; 90(5–6): 554–561. PubMed Abstract | Publisher Full Text

[21] 21. Hausdorff JM: Gait variability: methods, modeling and meaning. J Neuroeng Rehabil. 2005; 2: 19. PubMed Abstract | Publisher Full Text | Free Full Text

[22] 22. Krach LE, Kriel RL, Gilmartin RC, et al.: GMFM 1 year after continuous intrathecal baclofen infusion. Pediatr Rehabil. 2005; 8(3): 207–213. PubMed Abstract | Publisher Full Text

[23] 23. Cherng RJ, Liu CF, Lau TW, et al.: Effect of treadmill training with body weight support on gait and gross motor function in children with spastic cerebral palsy. Am J Phys Med Rehabil. 2007; 86(7): 548–555. PubMed Abstract | Publisher Full Text

[24] 24. Willerslev-Olsen M, Lorentzen J, Nielsen JB: Gait training reduces ankle joint stiffness and facilitates heel strike in children with Cerebral Palsy. NeuroRehabilitation. 2014; 35(4): 643–655. Publisher Full Text

[25] 25. Bland DC, Prosser LA, Bellini LA, et al.: Tibialis anterior architecture, strength, and gait in individuals with cerebral palsy. Muscle Nerve. 2011; 44(4): 509–517. PubMed Abstract | Publisher Full Text | Free Full Text

[26] 26. Aree-uea B, Auvichayapat N, Janyacharoen T, et al.: Reduction of spasticity in cerebral palsy by anodal transcranial direct current stimulation. J Med Assoc Thai. 2014; 97(9): 954–962. PubMed Abstract

Gait and motor functions in cerebral palsy after bi-anodal transcranial direct current stimulation combined with treadmill training: A feasibility clinical study

Abstract

Background

Objective

Method

Results

Conclusion

Keywords

Introduction

Methods

Study design & participants

Treadmill training & tDCS intervention

Figure 1. The tDCS protocols.

Outcome measures

Figure 2. Gait kinematic analysis.

Data analysis

Results

Table 1. Outcome measures.

Discussion

Conclusion

Data availability

References

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