Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke

Objectives: This systematic review and meta-analysis aim to summarize and analyze the available evidence of non-invasive brain stimulation/spinal cord stimulation on gait, balance and/or lower limb motor recovery in stroke patients. Methods: The PubMed database was searched from its inception through to 31/03/2021 for randomized controlled trials investigating repetitive transcranial magnetic stimulation or transcranial/trans-spinal direct current/alternating current stimulation for improving gait, balance and/or lower limb motor function in stroke patients. Results: Overall, 25 appropriate studies (including 657 stroke subjects) were found. The data indicates that non-invasive brain stimulation/spinal cord stimulation is effective in supporting recovery. However, the effects are inhomogeneous across studies: (1) transcranial/trans-spinal direct current/alternating current stimulation induce greater effects than repetitive transcranial magnetic stimulation, and (2) bilateral application of non-invasive brain stimulation is superior to unilateral stimulation. Conclusions: The current evidence encourages further research and suggests that more individualized approaches are necessary for increasing effect sizes in stroke patients.

Automated summary

This systematic review and meta-analysis examined the effects of non-invasive brain stimulation/spinal cord stimulation on gait, balance, and lower limb motor recovery in stroke patients. The findings indicate that this stimulation is effective in supporting recovery, but the effects vary across studies.