Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review

• Published in: Disability and rehabilitation: Assistive technology 2017-08, Vol.12 (6), p.551-559
• Main Authors: Massetti, Thais, Crocetta, Tânia Brusque, Silva, Talita Dias da, Trevizan, Isabela Lopes, Arab, Claudia, Caromano, Fátima Aparecida, Monteiro, Carlos Bandeira de Mello
• Format: Article
• Language: English
• Subjects: Application; Clinical assessment; Clinical trials; Exposure therapy virtual reality; Gait; Humans; Intervention; Nervous System Diseases - rehabilitation; Nervous System Diseases - therapy; Randomized Controlled Trials as Topic; Recovery of Function; Rehabilitation; Research subjects; Stimulation; Stroke; Systematic review; Transcranial direct current stimulation; Transcranial Direct Current Stimulation - methods; transcranial stimulation current continues; Virtual Reality; Virtual Reality Exposure Therapy - methods
• ISSN: 1748-3107; 1748-3115
• DOI: 10.1080/17483107.2016.1230152

Purpose: To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials. Method: A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies. Results: Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions. Conclusions: The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR. Implications for Rehabilitation tDCS with VR intervention can be an alternative to traditional rehabilitation programs. tDCS with VR is a promising type of intervention with a variety of positive effects. Application of tDCS with VR is appropriated to both healthy and impaired patients. There is no consensus of tDCS with VR application.