Gait and motor functions in cerebral palsy after bi-anodal transcranial direct current stimulation combined with treadmill training: A feasibility clinical study

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Abstract

Background: Children with cerebral palsy (CP) exhibit widespread alterations in cortical excitability and present with bilateral alterations in the bi-hemispheric sensorimotor functions, even when the initial brain lesion is unilateral. Objective This study evaluated the feasibility, safety, and preliminary efficacy of combining bilateral anodal transcranial direct current stimulation (tDCS) over the sensorimotor cortices with treadmill training in children with CP. Method A within-subjects case series was conducted with five children with CP. Participants received ten sessions of treadmill training (at 50% of their maximum over-ground speed) concurrently with bilateral anodal tDCS. Outcomes, assessed pre- and post-intervention, included postural alignment (medio-lateral and anterior-posterior), ankle dorsiflexion range of motion, gait variability, walking tolerance (6-minute walk test), motor function (GMFM-66), and hip/knee range of motion. Statistical analysis was performed using paired t-tests and effect sizes (Hedges’ g). Results The intervention was feasible and well-tolerated without any reported side effects. In addition, significant improvements with moderate to large effect sizes were observed in medio-lateral postural alignment (p = 0.003, g = 0.65) and left ankle passive dorsiflexion (p = 0.01, g = 1.42). Right ankle dorsiflexion showed a moderate, non-significant improvement (g = 0.77). No significant differences were found in anterior-posterior alignment, gait variability, walking tolerance, gross motor function, or other ranges of motion. Conclusion Bilateral anodal tDCS stimulation combined with treadmill training therapy is a feasible and safe intervention for children with CP. The preliminary efficacy results, showing significant improvements in specific postural and impairment measures, provide a necessary foundation for future large-scale randomized controlled trials.
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Almasri" }, { "@type": "Person", "name": "Nasim Alnuman" }, { "@type": "Person", "name": "Alham Al-Sharman" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Children with cerebral palsy (CP) exhibit widespread alterations in cortical excitability and present with bilateral alterations in the bi-hemispheric sensorimotor functions, even when the initial brain lesion is unilateral. Objective This study evaluated the feasibility, safety, and preliminary efficacy of combining bilateral anodal transcranial direct current stimulation (tDCS) over the sensorimotor cortices with treadmill training in children with CP. Method A within-subjects case series was conducted with five children with CP. Participants received ten sessions of treadmill training (at 50% of their maximum over-ground speed) concurrently with bilateral anodal tDCS. Outcomes, assessed pre- and post-intervention, included postural alignment (medio-lateral and anterior-posterior), ankle dorsiflexion range of motion, gait variability, walking tolerance (6-minute walk test), motor function (GMFM-66), and hip/knee range of motion. Statistical analysis was performed using paired t-tests and effect sizes (Hedges’ g). Results The intervention was feasible and well-tolerated without any reported side effects. In addition, significant improvements with moderate to large effect sizes were observed in medio-lateral postural alignment (p = 0.003, g = 0.65) and left ankle passive dorsiflexion (p = 0.01, g = 1.42). Right ankle dorsiflexion showed a moderate, non-significant improvement (g = 0.77). No significant differences were found in anterior-posterior alignment, gait variability, walking tolerance, gross motor function, or other ranges of motion. Conclusion Bilateral anodal tDCS stimulation combined with treadmill training therapy is a feasible and safe intervention for children with CP. The preliminary efficacy results, showing significant improvements in specific postural and impairment measures, provide a necessary foundation for future large-scale randomized controlled trials. 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F1000Research 2026, 15 :637 ( https://doi.org/10.12688/f1000research.170839.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Gait and motor functions in cerebral palsy after bi-anodal transcranial direct current stimulation combined with treadmill training: A feasibility clinical study [version 1; peer review: awaiting peer review] Hikmat Hadoush https://orcid.org/0000-0001-9493-424X 1,2 , Nedal AbuSalem 1 , Nihad A. Almasri https://orcid.org/0000-0002-3079-7327 3,4 , Nasim Alnuman 5 , Alham Al-Sharman 1,2 Hikmat Hadoush https://orcid.org/0000-0001-9493-424X 1,2 , Nedal AbuSalem 1 , [...] Nihad A. Almasri https://orcid.org/0000-0002-3079-7327 3,4 , Nasim Alnuman 5 , Alham Al-Sharman 1,2 PUBLISHED 29 Apr 2026 Author details Author details 1 Department of Physiotherapy, University of Sharjah, Sharjah, Sharjah, United Arab Emirates 2 Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan 3 Department of Physiotherapy, Qatar University, Doha, Doha, Qatar 4 Department of Physiotherapy, University of Jordan, Amman, Jordan 5 Department Biomedical engineering, German Jordanian University, Amman, Jordan Hikmat Hadoush Roles: Conceptualization, Formal Analysis, Methodology, Project Administration, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Nedal AbuSalem Roles: Data Curation, Formal Analysis, Investigation, Validation, Visualization, Writing – Review & Editing Nihad A. Almasri Roles: Formal Analysis, Methodology, Validation, Visualization, Writing – Review & Editing Nasim Alnuman Roles: Formal Analysis, Software, Validation, Visualization, Writing – Review & Editing Alham Al-Sharman Roles: Validation, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW Abstract Background Children with cerebral palsy (CP) exhibit widespread alterations in cortical excitability and present with bilateral alterations in the bi-hemispheric sensorimotor functions, even when the initial brain lesion is unilateral. Objective This study evaluated the feasibility, safety, and preliminary efficacy of combining bilateral anodal transcranial direct current stimulation (tDCS) over the sensorimotor cortices with treadmill training in children with CP. Method A within-subjects case series was conducted with five children with CP. Participants received ten sessions of treadmill training (at 50% of their maximum over-ground speed) concurrently with bilateral anodal tDCS. Outcomes, assessed pre- and post-intervention, included postural alignment (medio-lateral and anterior-posterior), ankle dorsiflexion range of motion, gait variability, walking tolerance (6-minute walk test), motor function (GMFM-66), and hip/knee range of motion. Statistical analysis was performed using paired t-tests and effect sizes (Hedges’ g). Results The intervention was feasible and well-tolerated without any reported side effects. In addition, significant improvements with moderate to large effect sizes were observed in medio-lateral postural alignment (p = 0.003, g = 0.65) and left ankle passive dorsiflexion (p = 0.01, g = 1.42). Right ankle dorsiflexion showed a moderate, non-significant improvement (g = 0.77). No significant differences were found in anterior-posterior alignment, gait variability, walking tolerance, gross motor function, or other ranges of motion. Conclusion Bilateral anodal tDCS stimulation combined with treadmill training therapy is a feasible and safe intervention for children with CP. The preliminary efficacy results, showing significant improvements in specific postural and impairment measures, provide a necessary foundation for future large-scale randomized controlled trials. READ ALL READ LESS Keywords Cerebral palsy, transcranial direct current stimulation, treadmill gait training, accelerometer gait analysis, motor function, range of motion, walking tolerance Corresponding Author(s) Hikmat Hadoush ( [email protected] ) Close Corresponding author: Hikmat Hadoush Competing interests: No competing interests were disclosed. Grant information: This study is supported by the Jordan University of Science and Technology and the Erasmus+ program of the European Union project entitled (establishment of an interdisciplinary clinical rehabilitation sciences master program at Just-CRS) (project no: “573758-EPP-1-2016-1-JOEPPKA2-CBHE-JP”). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2026 Hadoush H et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Hadoush H, AbuSalem N, A. Almasri N et al. Gait and motor functions in cerebral palsy after bi-anodal transcranial direct current stimulation combined with treadmill training: A feasibility clinical study [version 1; peer review: awaiting peer review] . F1000Research 2026, 15 :637 ( https://doi.org/10.12688/f1000research.170839.1 ) First published: 29 Apr 2026, 15 :637 ( https://doi.org/10.12688/f1000research.170839.1 ) Latest published: 29 Apr 2026, 15 :637 ( https://doi.org/10.12688/f1000research.170839.1 ) Introduction Motor control and coordination in pediatric cerebral palsy patients have been improved through various methods. Treadmill training demonstrates efficacy in enhancing gait velocity, balance, and functional independence. Furthermore, transcranial direct current stimulation (tDCS) presents a non-invasive and safe alternative to surgical or pharmacological treatments. Collectively, these interventions have proven effective in advancing gait performance and functional capabilities in this population. 1 – 3 The optimal protocol for administering tDCS to pediatric cerebral palsy patients has yet to be established. Contrary to earlier studies that utilized unilateral anodal stimulation targeting the contralateral motor cortex, 4 – 6 a hypothesis suggests that bilateral stimulation of both hemispheres could yield superior outcomes. This premise is supported by Nevalainen et al. (2015), 7 who identified through magnetoencephalography (MEG) a widespread disruption in neural excitability within both sensory-motor cortices of children with CP. This bilateral impairment occurs even in cases of unilateral lesions and contributes to reduced activation in corticospinal pathways. Accordingly, subsequent research applying unilateral anodal tDCS to the ipsilateral motor cortex (non-lesioned hemisphere) demonstrated enhancements in motor functions such as reaching skills and movement duration. 8 , 9 As a feasibility study, this pilot research assessed the practicality and initial effects of administering bilateral anodal tDCS concurrently with treadmill training to enhance gait parameters, range of motion, and reduce spasticity in pediatric patients with diplegic CP. Methods Study design & participants The study protocol received ethical approval based on the Declaration of Helsinki (JUST-420-2019). Besides, this study protocol and procedures were registered retrospectively in the National Clinical Trial Registry ( https://clinicaltrials.gov/study/NCT07342660 , Registration No.: NCT07342660 ). This is because the study originally registered within the Erasmus+ program database and the Jordan University of Science and Technology Deanship of Research system. However, internal registration would not be enabling the open access to the study protocol, Hereby, we proceeded with retrospective registration in a public registry and we clearly stated that in the registration database. This study included five children (aged 4–12 years) with spastic diplegic CP. Inclusion criteria stipulated a Gross Motor Function Classification System (GMFCS) level of I-III, the ability to walk independently for at least 10 meters, and an IQ greater than 70. Key exclusion criteria included a history of orthopaedic surgery, neurolytic blocks, or Botox injections in the past six months, as well as the presence of concurrent orthopedic impairments, epilepsy, intracranial metal implants, or hearing aids. In addition, voluntary written informed consent was obtained from all participant children by their legal guardians before participation in the study. Treadmill training & tDCS intervention While prior research utilizing unilateral anodal tDCS in children with CP positioned a single anode over the C3 or C4 motor cortex and a cathode on the supra-orbital area according to the 10–20 EEG system, 5 , 7 , 8 – 11 the present study employed a bilateral montage. Using the 10–10 EEG system for more precise placement, two anodes were positioned over the left FC1 and right FC2 regions (encompassing motor and frontal areas), with two corresponding cathodes located over the bilateral supra-orbital areas ( Figure 1 ). 12 A low current intensity of 1 mA was applied. Figure 1. The tDCS protocols. A) shows the conventional tDCS precool done in previous literature, where the anodal stimulation only targeted the lesion side. Whereas B) shows the proposed tDCS stimulation in this study used bilateral anodal tDCS stimulation based on brain mapping data of a bilateral neuromotor deficit associated with reduced activation in bilateral corticospinal and sensorimotor pathways, even in cases of unilateral brain lesions. The therapeutic protocol commenced with two treadmill familiarization sessions. This was followed by ten combined treatment sessions, each consisting of a 12-minute interval: a 1-minute warm-up, a 10-minute simultaneous treadmill training and tDCS therapy period, and a 1-minute cool-down. Treadmill speed was initiated at 50% of the child’s maximum ground speed from the 6-Minute Walk Test (6MWT) and was progressively increased based on individual tolerance. Tolerance was gauged by the absence of fatigue complaints, a heart rate not exceeding 70% of maximum, and the maintenance of proper gait without shuffling. Assistants were present to provide support and verbal feedback to promote correct movement patterns. Outcome measures Pre- and post-intervention data were collected, including body function measures like joint range of motion, activity measures such as walking endurance (6MWT), and motor function evaluation (GMFM-IS). Gait parameters in children walking on a 10-meter track were assessed using a tri-axial accelerometer measuring accelerations in x, y, and z axes ( Figure 2 ). Gait variability was determined using autocorrelation coefficients for each axis, indicating abnormality or normality. This method proved effective for studying gait function maturation in children by analysing deviations in each gait cycle relative to the mean value. 13 – 15 Figure 2. Gait kinematic analysis. The upper panel (A) shows the location of the markers in the lower body gait model. The lower panel (B) shows the schematic of camera distribution and body model in our Nexus software/Vicon. Data analysis Due to the cautions reported in the previous study 16 of using the paired t-test with extremely small sample sizes (n = 5), the mean ± standard deviation was calculated for all outcome measures, the intervention’s clinical effect size was determined using Hedges’ g, with values indicating small, moderate, or large effects, and gait outcomes were measured by having each child walk a 10 m track twice before and after the intervention. Data is available. 17 Results There were no side effects or stimulation intolerance reported by the children, parents, or caregivers. The study found that after 10 sessions of bilateral anodal tDCS and treadmill treatment, there was a significant improvement in medio-lateral alignment during gait, with a large clinical effect size. However, there were no significant changes in anterior-posterior alignment and gait variability. Additionally, walking tolerance or distance travelled, and motor function did not show significant improvement after the treatment sessions. The treatment did have a significant impact on left ankle dorsiflexion and right ankle dorsiflexion, with large clinical effect sizes. However, the treatment had minimal effects on the passive range of motion of the left and right hip and knee (See details in Table 1 ). Table 1. Outcome measures. Demographic data Age (years) Height weight Walking ground speed (km/hr.) Participants (n = 5) 6.40 (0.9) 114.0 (5.4) cm 21.8 (2.3) kg 1.80 (0.53) Outcome measures Mean (SD) Effect size (Hedges’) Distance traveled (6MWT) Pre 182.3 (52.9) 0.22 Post 195.3 (54.4) Motor function (GMFM-IS) Pre 66.4 (1.5) 0.23 Post 66.0 (1.5) Gait Spatiotemporal Medio-lateral alignment Pre 56.02 (7.9) 0.65* Post 63.9 (7.8) Anterior-posterior alignment Pre 34.59 (19.9) 0.06 Post 35.69 (14.0) Gait variability Pre 0.11 (0.1) −0.19 Post 0.10 (0.1) Passive ROM Right ankle DF (knee extended) Pre 11.0 (4.0) 0.77 Post 15.5 (6.3) Left ankle DF (knee extended) Pre 13.8 (4.0) 1.49 Post 19.6 (3.2) Right knee flexion Pre 101.3 (39.7) 0.18 Post 86.3 (39.0) Left knee flexion Pre 99.2 (39.0) 0.05 Post 86.7 (40.2) Right hip abduction (knee extended) Pre 29.6 (6.6) 0.09 Post 27.8 (2.8) Left hip abduction (knee extended) Pre 30.2 (5.3) 0.13 Post 26.0 (8.9) Right hip extension Pre 18.4 (5.0) 0.40 Post 12.2 (4.7) Left hip extension Pre 16.2 (6.8) 0.14 Post 13.0 (5.8) Discussion Two studies investigated the efficacy of integrating unilateral anodal tDCS with treadmill training to improve gait alignment in pediatric populations with CP. 8 , 10 The first reported improvements in balance functions, and static anterior/posterior, medio/lateral swaying, 8 and the second reported improvements in pelvic tilting and distance traveled (6MWT). Hereby, there However, this study applied bilateral anodal tDCS over prefrontal and motor areas influenced by previous brain imaging findings 7 of global excitability alterations and reduction in children with CP. Hereby, this study’s approach is reported to be safe with no side effects, and we may assume that this approach would improve results by targeting both sides of the brain. To start with, the spatiotemporal parameters of gait can be evaluated in three axes: anteroposterior, medio-lateral, and vertical. Tri-axial accelerometers are used to record these dimensions, providing a valid tool for analyzing gait parameters. 18 The limited improvement in medio-lateral alignment, in this study, can only be explained by the findings of the previous study, 14 where they reported that the major advantage of treadmill training over conventional ground training was in the lateral mechanical force the treadmill produced. In other words, the treadmill training will introduce mechanical lateral force to the body, and it was assumed that such mechanical lateral force generated by the treadmill would be behind the improvement in medio-lateral alignment in this study and previous studies. On the other hand, in terms of gait variability, the gait pattern of children and adolescents with CP is often characterized by increased gait variability 15 , 16 and asymmetry 19 compared with their healthy-developed peers. This manifests as stride-to-stride fluctuations. Normally, the fluctuations are relatively small in terms of the coefficient of variation in the gait speed and stride time. 20 , 21 Hereby, measuring gait variability is considered important because it serves as a sensitive and clinically relevant parameter in the evaluation of gait, mobility, fall risk, and the responses to therapeutic interventions. 21 However, due to a lack of studies examining the changes in gait variability after the tDCS and treadmill treatments, this study’s results would be the first in this field and would add preliminary data that there are no significant improvements in gait variability post-tDCS treatment. Nevertheless, there is a crucial need for further studies in this regard. Rehabilitation specialists use GMFM to measure motor function in children with CP for intervention effectiveness. 22 This study finding comes from Grecco et al. (2015), 10 who examined the effect of tDCS and treadmill gait training on 24 children with CP and found no significant changes in gross motor functions. This is because previous studies showed that significant improvements in gross motor function may require more time and intensive treatment, with one study reporting such improvement after 6 weeks 18 and 12 weeks of intervention. 23 This highlights the importance of further research to understand the time and intensity required for interventions to have a significant impact on gross motor function in children with CP. No research has explored how combining tDCS with treadmill training impacts passive ROM in children with spastic CP. The large effect improvement in ankle dorsiflexion in this study could be explained by the findings of previous research, which showed that treadmill training can reduce ankle joint stiffness and improve heel strike in children with CP. 24 Besides, Treadmill training has been linked to increased anterior tibialis muscle activity, leading to improved ankle dorsiflexion. 25 In addition, tDCS could temporarily reduce spasticity in children with CP. 26 Hereby, the combined effect of tDCS and treadmill training may lead to improved ankle dorsiflexion by reducing joint stiffness and muscle spasticity. Conclusion This pilot study successfully demonstrated that the application of bilateral anodal transcranial direct current stimulation (tDCS) concurrently with standard treadmill gait training is both a safe and feasible intervention for children diagnosed with diplegic CP. This study effectively fulfills the role of an essential pre-clinical or proof-of-concept study, as recommended by medical research councils before proceeding to a large-scale RCT, which is recommended and crucially needed. Data availability TDCS and Treadmill in CP is marked under a Creative Commons Attribution 4.0 International license (CC BY 4.0) . To view a copy of this mark, visit: https://zenodo.org/records/18330054 . 17 References 1. Smania N, Bonetti P, Gandolfi M, et al. : Improved gait after repetitive locomotor training in children with cerebral palsy. Am J Phys Med Rehabil. 2011; 90 (2): 137–149. PubMed Abstract | Publisher Full Text 2. Grecco LA, Tomita SM, Christovao TC, et al. : Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial. Braz J Phys Ther. 2013; 17 (1): 17–23. Publisher Full Text 3. Hamilton A, Wakely L, Marquez J: Transcranial Direct-Current Stimulation on Motor Function in Pediatric Cerebral Palsy: A Systematic Review. Pediatr Phys Ther. 2018; 30 (4): 291–301. PubMed Abstract | Publisher Full Text 4. Brunoni AR, Zanao TA, Vanderhasselt MA, et al. : Enhancement of affective processing induced by bifrontal transcranial direct current stimulation in patients with major depression. Neuromodulation. 2014; 17 (2): 138–142. PubMed Abstract | Publisher Full Text 5. Grecco LA, Duarte NA, Zanon N, et al. : Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study. Braz J Phys Ther. 2014; 18 (5): 419–427. Publisher Full Text 6. Lazzari RD, Politti F, Santos CA, et al. : Effect of a single session of transcranial direct-current stimulation combined with virtual reality training on the balance of children with cerebral palsy: a randomized, controlled, double-blind trial. J Phys Ther Sci. 2015; 27 (3): 763–768. PubMed Abstract | Publisher Full Text | Free Full Text 7. Nevalainen P, Pihko E, Maenpaa H, et al. : Bilateral alterations in somatosensory cortical processing in hemiplegic cerebral palsy. Dev Med Child Neurol. 2012; 54 (4): 361–367. PubMed Abstract | Publisher Full Text 8. Duarte NA, Grecco LA, Galli M, et al. : Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PLoS One. 2014; 9 (8): e105777. Publisher Full Text 9. Al Jaouni SK, El-Fiky EA, Mourad SA, et al. : The effect of wet cupping on quality of life of adult patients with chronic medical conditions in King Abdulaziz University Hospital. Saudi Med J. 2017; 38 (1): 53–62. Publisher Full Text 10. Grecco LA, de Almeida Carvalho Duarte N , Mendonca ME, et al. : Transcranial direct current stimulation during treadmill training in children with cerebral palsy: a randomized controlled double-blind clinical trial. Res Dev Disabil. 2014; 35 (11): 2840–2848. Publisher Full Text 11. Ergin E, Savci S, Ozcan Kahraman B, et al. : Three-axis accelerometer system for comparison of gait parameters in children with cystic fibrosis and healthy peers. Gait Posture. 2020; 78 : 60–64. PubMed Abstract | Publisher Full Text 12. Auvinet B, Berrut G, Touzard C, et al. : Reference data for normal subjects obtained with an accelerometric device. Gait Posture. 2002; 16 (2): 124–134. PubMed Abstract | Publisher Full Text 13. Zijlstra W, Hof AL: Assessment of spatio-temporal gait parameters from trunk accelerations during human walking. Gait Posture. 2003; 18 (2): 1–10. PubMed Abstract | Publisher Full Text 14. Zollinger M, Degache F, Currat G, et al. : External Mechanical Work and Pendular Energy Transduction of Overground and Treadmill Walking in Adolescents with Unilateral Cerebral Palsy. Front Physiol. 2016; 7 : 121. Publisher Full Text 15. Bregou Bourgeois A, Mariani B, Aminian K, et al. : Spatio-temporal gait analysis in children with cerebral palsy using, foot-worn inertial sensors. Gait Posture. 2014; 39 (1): 436–442. PubMed Abstract | Publisher Full Text 16. Prosser LA, Lauer RT, VanSant AF, et al. : Variability and symmetry of gait in early walkers with and without bilateral cerebral palsy. Gait Posture. 2010; 31 (4): 522–526. PubMed Abstract | Publisher Full Text | Free Full Text 17. Hadoush H: tDCS and Treadmill in CP. OneDrive. Retrieved September 28, 202. Reference Source 18. Flores MB, Da Silva CP: Trunk control and gross motor outcomes after body weight supported treadmill training in young children with severe cerebral palsy: a non-experimental case series. Dev Neurorehabil. 2019; 22 (7): 499–503. Publisher Full Text 19. Feng J, Pierce R, Do KP, et al. : Motion of the center of mass in children with spastic hemiplegia: balance, energy transfer, and work performed by the affected leg vs. the unaffected leg. Gait Posture. 2014; 39 (1): 570–576. PubMed Abstract | Publisher Full Text 20. Terrier P, Schutz Y: Variability of gait patterns during unconstrained walking assessed by satellite positioning (GPS). Eur J Appl Physiol. 2003; 90 (5–6): 554–561. PubMed Abstract | Publisher Full Text 21. Hausdorff JM: Gait variability: methods, modeling and meaning. J Neuroeng Rehabil. 2005; 2 : 19. PubMed Abstract | Publisher Full Text | Free Full Text 22. Krach LE, Kriel RL, Gilmartin RC, et al. : GMFM 1 year after continuous intrathecal baclofen infusion. 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PubMed Abstract Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 29 Apr 2026 ADD YOUR COMMENT Comment Author details Author details 1 Department of Physiotherapy, University of Sharjah, Sharjah, Sharjah, United Arab Emirates 2 Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan 3 Department of Physiotherapy, Qatar University, Doha, Doha, Qatar 4 Department of Physiotherapy, University of Jordan, Amman, Jordan 5 Department Biomedical engineering, German Jordanian University, Amman, Jordan Hikmat Hadoush Roles: Conceptualization, Formal Analysis, Methodology, Project Administration, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Nedal AbuSalem Roles: Data Curation, Formal Analysis, Investigation, Validation, Visualization, Writing – Review & Editing Nihad A. Almasri Roles: Formal Analysis, Methodology, Validation, Visualization, Writing – Review & Editing Nasim Alnuman Roles: Formal Analysis, Software, Validation, Visualization, Writing – Review & Editing Alham Al-Sharman Roles: Validation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information This study is supported by the Jordan University of Science and Technology and the Erasmus+ program of the European Union project entitled (establishment of an interdisciplinary clinical rehabilitation sciences master program at Just-CRS) (project no: “573758-EPP-1-2016-1-JOEPPKA2-CBHE-JP”). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (1) version 1 Published: 29 Apr 2026, 15:637 https://doi.org/10.12688/f1000research.170839.1 Copyright © 2026 Hadoush H et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Hadoush H, AbuSalem N, A. Almasri N et al. Gait and motor functions in cerebral palsy after bi-anodal transcranial direct current stimulation combined with treadmill training: A feasibility clinical study [version 1; peer review: awaiting peer review] . 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Ask this paper AI returns verbatim quotes from the full text · source: preprint-html

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europepmc
last seen: 2026-05-20T01:45:00.602351+00:00
unpaywall
last seen: 2026-05-26T02:00:01.498150+00:00
License: CC-BY-4.0