Evaluating Transcranial Direct Current Stimulation as an Adjunct to In-Patient Physiotherapy in Paediatric Acquired Brain Injury: A Randomized Feasibility Trial.

Purpose: Evaluate the feasibility of transcranial direct current stimulation (tDCS) as an adjunct to in-patient physiotherapy for children and youth with acquired brain injury (ABI). Method: This randomized feasibility trial allocated children (5-18 years of age with moderate to severe ABI) to receive either active or sham anodal tDCS immediately prior to 16 of their existing in-patient physiotherapy sessions. Participants, physiotherapists, assessors, and primary investigators were blinded to treatment allocation. Eligibility, recruitment, retention, tolerance, and preliminary treatment outcomes were evaluated against a priori feasibility targets. Results: Of 232 children admitted over 21 months, 6 were eligible (2.6%) and 4 were recruited (66.7%). One participant completed the entire study protocol, two were withdrawn for unrelated changes in medical stability, and one could not commence the study due to COVID-19 restrictions. Participants completed all tDCS sessions that were started with the primary transient side effect being sub-electrode itchiness. Conclusions: While the study was infeasible from eligibility and retention perspectives, study procedures (e.g., assessment, treatment, side effect tracking, physiotherapy documentation) were viable and should be applied to future paediatric tDCS studies.