Effect of Non-Invasive Brain Stimulation (tDCS) Combined with Physiotherapy on Postural Control, Balance, and Fall Risk in Older Adults with Alzheimer's Disease

Abstract

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that not only impairs cognitive function but also disrupts postural control and balance, leading to a higher risk of falls in older adults. Conventional physiotherapy has shown limited success in mitigating these deficits due to the underlying cortical dysfunction associated with AD. Recent advances suggest that transcranial direct current stimulation (tDCS), a non-invasive neuromodulatory technique, may enhance cortical excitability and promote neuroplasticity when combined with physiotherapy. Objective: This study aimed to evaluate the effect of tDCS combined with physiotherapy on postural control, balance, and fall risk in older adults with mild to moderate Alzheimer’s disease. Methods: Forty participants aged 65–85 years were randomly assigned to two groups: experimental (tDCS + physiotherapy) and control (physiotherapy only). The intervention was conducted over six weeks, with tDCS applied at 2 mA for 20 minutes to the motor cortex before physiotherapy sessions. Balance and mobility were assessed using the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Fall Risk Assessment Scale (FRAS) at baseline, post-intervention, and three-month follow-up. Results: The experimental group showed significant improvement in BBS and TUG scores and a marked reduction in FRAS values compared with controls (p < 0.01), indicating enhanced postural stability and reduced fall risk. Conclusion: The combination of tDCS and physiotherapy produces superior outcomes in balance and fall prevention among older adults with Alzheimer’s disease, highlighting its potential as an effective neurorehabilitation strategy.