Additive effect of transcranial direct current stimulation (tDCS) in combination with multicomponent training on elderly physical function capacity: a randomized, triple blind, controlled trial.

PURPOSE: To evaluate the additive effect of Transcranial Direct Current Stimulation (tDCS) associated with multi-component training (MT) on the functional capacity (FC) of older adults and to assess whether these effects remain after the end of training. The secondary objectives were to evaluate the locomotion capacity, balance, functional independence, and quality of life and correlate them with functional capacity. METHODOLOGY: Twenty-eight older adults were randomized into two groups: experimental (MT associated with active tDCS - a-tDCS) and control (MT associated with sham tDCS - s-tDCS). The FC was measured by the Glittre-ADL test, locomotion capacity by the 6-minute walk test, balance by the BESTest, functional independence by the FIM, and quality of life by the WHQOL. The assessments were performed pre-, post-intervention, and 30-day follow-up. RESULTS: There was a significant decrease in the time to the Glittre-ADL test when comparing the a-tDCS and s-tDCS groups after the interventions (139.77 ± 21.62, 205.10 ± 43.02, p < .001) and at the 30-day follow-up (142.74 ± 17.12, 219.55 ± 54.05, p < .001), respectively. There was a moderate correlation between FC and locomotion capacity and balance. CONCLUSIONS: The addition of tDCS potentiated the results of MT to impact FC, maintaining the positive results longer. Locomotion and balance influenced the improvement of functional capacity.

Perceptions of older adults living in long-term care institutions regarding recreational physiotherapy: a qualitative study.

Background: Long-term care institutions (LTCIs) present a limiting environment. Physiotherapy through recreational exercises can stimulate older adults.Objective: To explore LTCIs residents' perceptions regarding recreational physiotherapy.Method: This is a descriptive qualitative study. Participants included older adults living in two LTCIs, who took part in recreational physiotherapy and did not display severe communication problems or cognitive deficits. The activity was regularly offered in both LTCIs. Semi-structured interviews were audio-recorded to analyze the participants' perceptions of physiotherapy. We also observed video footage of the participants' behaviors during one session of the recreational activity. The audio recordings were transcribed, and content analysis was conducted with MAXQDA 12®.Results: Nine older adults participated, the majority women (n = 6), with a mean age of 83.8 ± 7.4 years. The interviews' average duration was about 30 minutes. The reports revealed three themes. In the "activity for myself" theme, participants discussed issues related to their own old age. In the "activity with others" theme, participants reported physiotherapy's value for providing sense of collectivity. In the "activity itself" theme, the components of physiotherapy and their benefits were evaluated. Observation of the video recording revealed that each resident engaged in the activity at their own pace and within their capabilities.Conclusions: The experience of older adults living in LTCIs showed that the regularly practicing physical exercises in recreational group, strengthens social bonds and provides physical and emotional well-being. When formulating and executing physiotherapy in the context of LTCIs, professionals should consider the residents' perceptions of the practice.

Effect of transcranial direct current stimulation and multicomponent training on functional capacity in older adults: protocol for a randomized, controlled, double-blind clinical trial.

INTRODUCTION: When physical activity contains training of at least three components such as balance, coordination and strength, among others, it is called multicomponent training. This type of training is recommended for improving the functional capacity in elderly individuals but has no lasting effects. The association of transcranial direct current stimulation (tDCS) with other types of therapy has been shown to facilitate the enhancement and prolongation of therapy outcomes. AIM: The objective of this study is to evaluate the effect of multicomponent training associated with active or sham tDCS on the performance of functional capacity in the elderly before treatment, after treatment and 30 days after the end of treatment. The secondary objective will be to correlate the performance of the primary outcome (functional capacity assessed by the Glittre Daily Life Activity Test) with walking capacity (by 6-min walk test), balance (with the mini-Balance Evaluation Systems Test), functional independence (by the Functional Independence Measure) and quality of life (with the World Health Organization Quality of Life Instrument). METHODS: Twenty-eight elderly people from the community will participate in the study, and will be randomized into two groups: 1) multicomponent training associated with active tDCS; and 2) multicomponent training associated with sham tDCS. The multicomponent training sessions will be held twice a week for 12 weeks, totaling 24 sessions. The tDCS will be administered over the dominant dorsolateral prefrontal cortex at the same time as multicomponent training, with an intensity of 2 mA, for 20 min. The evaluations will be made pretraining, after 24 training sessions and 30 days after the end of the training. DISCUSSION: We hypothesize that tDCS, when associated with multicomponent training, can potentiate and prolong the effects of this training on the functional capacity of the elderly. If this hypothesis is confirmed, this protocol may contribute to a longer-lasting physical rehabilitation of the elderly, encouraging them to maintain their independent daily activities for longer. TRIAL REGISTRATION: The study was registered in the Brazilian Clinical Trial Registry (RBR-2crd42) and received approval from the Human Research Ethics Committee of University Nove de Julho, São Paulo, Brazil (process number 3.077.953).