Effects of transcranial direct current stimulation and sensorimotor training in anterior cruciate ligament patients: a sham-controlled pilot study

Sven Reuter; Christophe Lambert; Maja Schadt; Andreas B. Imhoff; Christoph Centner; Elmar Herbst; Fabian Stöcker; Philipp Forkel

doi:10.1055/a-2285-7159

Sportverletzung · Sportschaden, Table of Contents

Sportverletz Sportschaden 2024; 38(02): 73-78
DOI: 10.1055/a-2285-7159

Original Article

Effects of transcranial direct current stimulation and sensorimotor training in anterior cruciate ligament patients: a sham-controlled pilot study

Auswirkungen von transkranieller Gleichstromstimulation und sensomotorischem Training bei Patienten mit vorderer Kreuzbandruptur – eine Sham-kontrollierte Pilotstudie

Sven Reuter

¹SRH University of Applied Sciences Heidelberg: SRH Hochschule Heidelberg, Gera, GERMANY (Ringgold ID: RIN120298)

,

Christophe Lambert

²Deparment of Trauma and Orthopedic Surgery, University of Witten/Herdecke: Universitat Witten/Herdecke, Cologne, GERMANY (Ringgold ID: RIN12263)

,

Maja Schadt

³Department of Biomechanics in Sports, Technical University Munich: Technische Universitat Munchen, München, GERMANY (Ringgold ID: RIN9184)

,

Andreas B. Imhoff

⁴Department for Orthopaedic Sports Medicine, Munich University of Technology: Technische Universitat Munchen, München, GERMANY (Ringgold ID: RIN9184)

,

Christoph Centner

⁵University of Freiburg im Breisgau: Albert-Ludwigs-Universitat Freiburg, Freiburg, GERMANY (Ringgold ID: RIN9174)

,

Elmar Herbst

⁶Department for Orthopaedic Sports Medicine, Technische Universität München: Technische Universitat Munchen, München, GERMANY (Ringgold ID: RIN9184)

,

Fabian Stöcker

⁷Department of Biomechanics in Sports, Technische Universität München: Technische Universitat Munchen, München, GERMANY (Ringgold ID: RIN9184)

,

Philipp Forkel

⁶Department for Orthopaedic Sports Medicine, Technische Universität München: Technische Universitat Munchen, München, GERMANY (Ringgold ID: RIN9184)

› Author Affiliations

Abstract

Background Studies showed changes in the central nervous system in patients who sustained an anterior cruciate ligament tear. There is a lack of evidence regarding the effectiveness of transcranial direct-current stimulation in such patients.

Methods A sham-controlled randomised study. One group of patients (n = 6) underwent 6 weeks of sensorimotor training after an anterior cruciate ligament tear during transcranial direct-current stimulation. The stimulation consisted of 20 minutes (3 sessions/week; 2 weeks) of 2 mA anodal transcranial direct-current stimulation over the primary motor and premotor cortex. The second group (n = 6) received sham stimulation with 6 weeks of sensorimotor training. Centre of pressure deviations in the medio-lateral and anterior-posterior direction and centre of pressure velocity were measured.

Results The results demonstrated a significant effect of sensorimotor training on the centre of pressure in medio-lateral and anterior-posterior direction (p=0.025) (p=0.03) in the leg in which an anterior cruciate ligament tear occurred. The type of training did not affect the results. Post-hoc tests showed no significant effect of training in the subgroups (p≥0.115).

Conclusion Sensorimotor training led to a decrease in sway of the centre of pressure in patients who sustained an anterior cruciate ligament tear, but the addition of anodal transcranial direct-current stimulation placed over the primary motor cortex did not potentiate the adaptive responses of the sensorimotor training.

Zusammenfassung

Hintergrund Studien haben Veränderungen im zentralen Nervensystem bei Patienten nach einer Ruptur des vorderen Kreuzbandes gezeigt. Für die Wirksamkeit von transkranieller Gleichstromstimulation bei Patienten nach einer vorderen Kreuzbandruptur gibt es keine ausreichenden Belege.

Methoden Eine Gruppe von Patienten (n=6) unterzog sich nach vorderer Kreuzbandruptur einem 6-wöchigen sensomotorischen Training während der transkraniellen Gleichstromstimulation. Die Stimulation bestand aus 20 Minuten (3 Sitzungen/Woche; 2 Wochen) über den primären motorischen und prämotorischen Kortex. Die zweite Gruppe (n=6) erhielt eine Scheinstimulation mit 6 Wochen sensomotorischem Training nach vorderer Kreuzbandruptur. Die Abweichungen des Druckzentrums in mediolateraler und anterior-posteriorer Richtung sowie die Geschwindigkeit wurden gemessen.

Ergebnisse Die Ergebnisse zeigten einen signifikanten Effekt des sensomotorischen Trainings auf die Abweichungen des Druckzentrums in mediolateraler und anterior-posteriorer Richtung (p=0,025; p=0,03) im Bein mit vorderer Kreuzbandruptur. Die Art des Trainings hatte keinen Einfluss auf die Ergebnisse. Post-hoc-Tests zeigten keinen signifikanten Effekt des Trainings in den Untergruppen (p≥0,115).

Schlussfolgerung Sensomotorisches Training führte zu einer Verringerung des Schwankens des Druckzentrums bei Patienten nach vorderer Kreuzbandruptur, aber der Zusatz von transkranieller Gleichstromstimulation, die über dem primären motorischen Kortex platziert wurde, potenziert die adaptiven Reaktionen des sensomotorischen Trainings nicht.

Keywords

Anterior Cruciate Ligament - Transcranial Direct Current Stimulation - Sensorimotor Training

Schlüsselwörter

vorderes Kreuzband - transkranielle Gleichstromstimulation - sensomotorisches Training

Full Text

References

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