ABSTRACT
Background
Little is known about the optimal timing and neural loci for applying noninvasive brain stimulation (NIBS) to promote gait and balance recovery after stroke.
Objective
To identify the optimal timing and neural loci of NIBS for gait and balance recovery after stroke.
Methods
We performed a PubMed search using keywords of stroke, transcranial magnetic stimulation, transcranial direct current stimulation, NIBS, balance, and gait. Interventional trials with various designs published in English were selected. Both flowcharts and tables were used for the result presentation.
Results
The majority of selected 31 studies included individuals with chronic stroke and primary motor cortex (M1) stimulation. Studies’ quality ranged from 4 to 10 (max = 10) on the Pedro scale. NIBS led to improvements in gait and balance in individuals with chronic and subacute stroke, yet the evidence for the acute phase of stroke is limited. Further, stimulation over the ipsilesional M1 resulted in improvement in gait and balanced performance. Stimulation over non-motor regions such as the cerebellum has been limitedly explored.
Conclusion
Current evidence supports the use of NIBS to the M1 in conjunction with behavioral training to improve gait and balance performance in individuals with subacute and chronic stroke. Future research is recommended to evaluate the effect of NIBS during acute stroke and over neural loci other than M1, and to implement a more rigorous method.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Correction Statement
This article has been corrected with minor changes. These changes do not impact the academic content of the article.