Dados do Trabalho

Título

Does non-invasive brain stimulation improve functional locomotion in people with multiple sclerosis? A systematic review and meta-analysis

Resumo

Introduction: Multiple sclerosis (MS) is a neurodegenerative disease that is the leading cause of progressive functional impairments in working-age people. MS symptoms can vary from sensorimotor to cognitive dysfunction, affecting activities of daily living and affecting the ambulation. Treating the walking disabilities associated with MS can delay its dysfunction throughout the disease course. Objective: This review aimed to analyze the effects of non-invasive brain stimulation (NIBS) on functional locomotion in people with multiple sclerosis (PwMS). Methods: The search strategy was based on the PICO process (transcranial direct current stimulation; any control group: gait, walking, or ambulation). Online databases such as PubMed, CINAHL, Web of Science, Embase, PsycINFO, and Lilacs were searched up to January 2022. Two review authors independently assessed the risk of bias in the included studies, and we used the Grading of Recommendations Assessment, Development, and Evaluation methodology to rate the certainty of the evidence for each included study. A meta-analysis was performed by pooling the appropriate data using RevMan version 5.3. Results: One study included a qualitative synthesis and three a meta-analysis. In the meta-analysis, an improvement in the stride length (mean of differences: 0.19; 95% CI: 0.07 to 0.31; I² 77%; p = 0.002) was found in the experimental group. Conclusions: Transcranial direct current stimulation as a NIBS associated with aerobic and resistance exercise can improve stride length in PwMS.