Efeitos da estimulação transcraniana por corrente contínua (ETCC) na função manual de indivíduos com paralisia cerebral: revisão de escopo

Abstract

Cerebral palsy (CP) is an early, non-degenerative neurodevelopmental condition that results in activity limitations due to abnormal development of movement and posture. Limitations in hand function are common in CP and arise from disorders of muscle tone, range of motion, grip strength, and motor control. Transcranial direct current stimulation (tDCS) has emerged as a promising therapeutic tool, standing out due to its ease of application and safe pressure. Considering the importance of hand function in promoting autonomy and participation in daily activities, as well as the potential therapeutic effects of tDCS in motor rehabilitation, we aim to synthesize the available evidence in the literature on the effects of tDCS on hand function in individuals with CP. To achieve this objective, this review aims to: 1) Explain the effects of tDCS on hand function in individuals with CP; 2) Identify treatments and interventions associated with tDCS sessions; 3) Map tDCS application protocols; 4) present data on safety, tolerability, and adverse effects; and 5) identify gaps and limitations in specific articles. This study is a scoping review, guided by the methodology proposed by the Joanna Briggs Institute (JBI) and the PRISMA-ScR recommendations. Data were searched in the Scopus, Web of Science, Cochrane, and PubMed databases using the following descriptors: transcranial stimulation; transcranial direct current stimulation; cerebral palsy; unimanual training; bimanual; upper limb. Eighty-two studies were identified, but after screening, only eight scientific articles were found. The stages of the studies indicated that tDCS combined with motor rehabilitation has specific effects on hand function in children, adolescents, and young adults with CP, although some of the results are inconclusive. The application is safe and feasible for various age groups, but there is little evidence available in the literature regarding its effects on pediatrics, and further studies are needed to elucidate the short-, medium-, and long-term effects.