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Fallahiyan S, Sheikh M, Qeysari S F, Ghayour Najaf abadi M. The Combined Effect of Active Video Games and tDCS on Balance and Cognitive Flexibility in Children With ASD. BCN 2026; 17 (1) :113-122
URL: http://bcn.iums.ac.ir/article-1-3354-fa.html

Introduction: This study looked at the effects of combined transcranial direct current stimulation (tDCS) and exergaming therapy on the balance and cognitive flexibility in children with autism spectrum disorder (ASD). 
Methods: A quasi-experimental randomized controlled trial (RCTs) study was undertaken with 30 children aged 7-10 years, who were randomly allocated to either an experimental group (n=15) getting active tDCS (1.5 mA over the left DLPFC) + Kinect-based exergaming or a control group (n=15) receiving sham tDCS with exergaming. The 4-week intervention (3 sessions per week) was preceded and followed by extensive evaluations using the movement assessment battery for children-2 (MABC-2) and the Wisconsin card sorting test (WCST).
Results: Analysis of covariance (ANCOVA) showed significant between-group differences favoring the experimental group for static balance (F=9.537, P<0.001, ηp2=0.128) and dynamic balance (F=7.51, P<0.001, ηp2=0.158), with medium-to-large effect sizes. The results showed that the combined tDCS and exergame intervention had a stronger effect on improving cognitive flexibility than exergame alone. This improvement was associated with a significant increase in correct and conceptual responses and a decrease in repetitive errors in the combined group (P<0.001). 
Conclusion: The work fills a key gap in neurorehabilitation research by presenting empirical data for combined neuromodulation and digital-motor therapies in ASD. The findings encourage the creation of tailored protocols that target both cognitive and motor networks concurrently. Future studies should look at long-term maintenance effects and the brain processes that underpin these synergistic advantages. This integrated strategy holds promises for improving motor learning and functional results in children with neurodevelopmental problems.