The Effect of Motor Imaginary Combined with Transcranial Direct Current Stimulation (tDCS) on Balance in Middle-Aged Women with High Fall Risk: A Double-Blind Randomized Controlled Trial

Abstract

Introduction. The risk of falling and its subsequent injuries increases with aging. Impaired balance and gait are important contributing factors to the increased risk of falling. A wide range of methods was examined to improve balance, but these interventions might produce small effects or be inapplicable for this population. The current study aimed at investigating the effect of motor imaginary (MI) training combined with transcranial direct current stimulation (tDCS) over the cerebellum on balance in middle-aged women with high fall risk. Methods. Thirty subjects aged 40-65 years old were divided into two groups including intervention ( $n=15$ ) and sham control ( $n=15$ ). The participants completed a 4-week program 3 times per week. The intervention group performed MI training combined with tDCS over the cerebellum, and the control group performed MI training combined with sham tDCS over the cerebellum. Static and dynamic balance were measured at baseline and after completing the 4-week program using balance error scoring system (BESS) and Y balance testing, respectively. Result. A one-way analysis of covariance and paired $t$ -tests were used to analyze the data. Significant improvement was observed in both balance tests in the intervention group after the implementation of the 4-week intervention program compared to the control group. The within-group analysis showed that both static and dynamic balance improved significantly from the baseline values only in the intervention group ( $p<0.05$ ) and not in the control group ( $p>0.05$ ). Conclusion. The results of the study indicate that MI training combined with tDCS over the cerebellum can lead to balance improvement in middle-aged women with high fall risk.