The Effect of Bilateral Anodal Transcranial Direct Current Stimulation versus Treadmill Training on Brain Activities, Gait Functions, Level of Participation and Enjoyment of Children with Cerebral Palsy: A Randomized Controlled Trial Protocol.

Background: Cerebral palsy (CP) possesses bilateral sensory-motor cortical excitability alterations. In past studies, researchers have applied unilateral anodal transcranial direct stimulation (tDCS) with inconsistent findings.Objective: Examining the effects of treadmill training with either unilateral or bilateral anodal tDCS stimulation on brain activities, gait, and body functions of children with CP.Design: Randomized-clinical-trial.Participants: Eighty children with CP will be allocated into: treadmill/bilateral-tDCS, treadmill/unilateral-tDCS, treadmill/sham-tDCS, and treadmill groups. Additional 20 neurotypical children will be recruited for comparison.Intervention: Planned intervention will implement ten-sessions of treadmill training (50% of maximum-ground speed) either with unilateral-tDCS over left sensory-motor, or bilateral-tDCS over left/right sensory-motor areas. Brain activities, gait, body functions, and participation will be assessed at pre-intervention, post-intervention, and at one-month follow-up.Result and Discussion: This study would contribute to extant findings on the use of tDCS stimulation in children with CP and to our understanding of the appropriateness of the planned outcome measures.