Effect of transcranial direct current stimulation on balance and risk of fall in patients with stroke

Abstract Background. Balance refers to the ability to achieve and maintain a state of equilibrium where all acting forces neutralize one another and equal zero. It plays a crucial role in community ambulation and gait performance after a stroke. Post-stroke balance impairment predisposes individuals to falls, leading to negative consequences such as fall-induced injuries (including fractures), an increased fear of falling, depression, social isolation, and even death. Purpose. To investigate the effect of transcranial direct current stimulation (tDCS) on balance and risk of falls in stroke patients. Subjects & Methods: Thirty chronic stroke patients, both male and female, aged 45–60 years, participated in this study. Participants were randomly allocated into two equal groups: the study group and the control group. The study group (GI) received active tDCS in combination with selected physical therapy exercises, while the control group (GII) received sham tDCS and the same physical therapy exercises. Balance was assessed using the Biodex Balance System (Biodex-BS) and the Berg Balance Scale (BBS), while the risk of falls was assessed using the Timed Up and Go Test (TUG) and the Fall Efficacy Scale (FES). All outcome measures were evaluated for each patient before and after a four-week program, consisting of three sessions per week. Results. There was a significant improvement in all measured variables (overall stability index, overall dynamic limit of stability, BBS, TUG, and FES) in the study group compared to the control group (p < 0.05). Conclusion. tDCS effectively enhances balance and reduces the risk of falls in individuals post-stroke. Key words balance, risk of falls, tDCS, stroke