The effects of transcranial direct current stimulation (tDCS) combined with group exercise treatment in subjects with chronic low back pain: a pilot randomized control trial

Straudi, Sofía; Buja, Sergio; Baroni, A.; Pavarelli, Claudia; Pranovi, Giulia; Fregni, Felipe; Basaglia, Nino

doi:10.1177/0269215518777881

Cited by 42 publications

(72 citation statements)

References 39 publications

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“…Figure 1 shows reasons for exclusion. One placebo-controlled crossover randomized (Schabrun et al, 2014) trial was excluded as it was unclear that the included participants had CLBP according to our definition (Chang et al, 2017;da Graca-Tarrago et al, 2019;Hazime et al, 2017;Luedtke et al, 2015;Mendonca et al, 2016;Riberto et al, 2011;Sakrajai et al, 2014;Schabrun et al, 2014;Straudi et al, 2018). Table 1 summarizes the final list of eight selected studies for the analysis.…”

Section: Resultsmentioning

confidence: 99%

The Analgesic Effect of Transcranial Direct Current Stimulation (tDCS) combined with Physical Therapy on Common Musculoskeletal Conditions: A Systematic Review and Meta-Analysis

Teixeira

Alawdah

Alhassan

et al. 2020

ppcrj

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Background: The analgesic effects of transcranial Direct Current Stimulation (tDCS) combined with physical therapy remain unclear. Objective: To systematically review available evidence comparing tDCS with any physical therapy modality (PTM) to PTM alone or PTM with sham tDCS on pain relief on common musculoskeletal (MSK) conditions, namely knee osteoarthritis (KOA), chronic low back pain (CLBP), myofascial pain syndrome (MPS) and fibromyalgia. Methods: EMBASE and MEDLINE were searched from inception to April 2019 for randomized controlled trials. Reviewers independently assessed the studies quality and extracted data according to the PRISMA protocol. The GRADE approach was used to asses quality of evidence and a "Summary of Findings" table was created. The analyses used random-effects model. The primary outcome was pain reduction after treatment. Results: Eight articles were included. Only one study had low risk of bias. Quality of evidence was considered low or very low. Significant reduction in pain scores were found for fibromyalgia and KOA (Standardized mean difference (SMD) =-1.94 [95% CI:-3.37 to-0.49; I2=76.4%] and SMD =-2.35 [95% CI:-3.63 to-1.06; I2=69.7%] respectively). Subgroup analysis considering the type of PTM despite MSK condition revealed significant reduction in pain scores for exercise, SMD =-1.20 [95% CI:-1.683 to-0.717; I2=10.8%]. Conclusions: Large heterogeneity and low quality of evidence and limited number of studies were found. Results suggest a potential analgesic effect of tDCS in combination with a PTM for fibromyalgia and KOA. Subgroup analysis suggests a stronger effect of tDCS when combined with an exercise based PTM.

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Section: Resultsmentioning

confidence: 99%

The Analgesic Effect of Transcranial Direct Current Stimulation (tDCS) combined with Physical Therapy on Common Musculoskeletal Conditions: A Systematic Review and Meta-Analysis

Teixeira

Alawdah

Alhassan

et al. 2020

ppcrj

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“…A recent study suggested that patients with LBP do not respond to tDCS M1 stimulation. 96 However, associating this approach with PES 43 or exercises 107 has been shown to be effective, but the exact mechanisms by which this additive effect happens are not known.…”

Section: Discussionmentioning

confidence: 99%

Latin American and Caribbean consensus on noninvasive central nervous system neuromodulation for chronic pain management (LAC2-NIN-CP)

Baptista

Fernandes

Sá

et al. 2019

PR9

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“…Movement dysfunction such as unnecessary protective behavior may justify our findings, when patients received a stimulus perceived as threatening. The primary motor cortex has already been target of brain stimulation treatment, with a positive impact on pain relief (Fregni et al, 2006;Straudi et al, 2018). Abnormal function of motor and prefrontal cortex during stimulus perception may be due to neuroplastic changes that occur in the human brain subjected to long-lasting pain.…”

Section: Discussionmentioning

confidence: 99%

Hyperalgesia and Central Sensitization in Subjects With Chronic Orofacial Pain: Analysis of Pain Thresholds and EEG Biomarkers

et al. 2020

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Introduction: The presence of a temporomandibular disorder is one of the most frequent causes of orofacial pain (OFP). When pain continues beyond tissue healing time, it becomes chronic and may be caused, among other factors, by the sensitization of higher-order neurons. The aim of this study is to describe psychological characteristics of patients with chronic OFP, their peripheral pain threshold, and electroencephalography (EEG) recording, looking for possible signs of central sensitization (CS). Materials and methods: Twenty-four subjects with chronic OFP caused by temporomandibular disorder were evaluated using the Research Diagnostic Criteria for Temporomandibular Disorders Axis I and Axis II. Pain intensity, catastrophizing, and presence of CS were assessed through self-reported questionnaires. Pressure pain threshold (PPT) was recorded in facial and peripheral sites; EEG activity was recorded during open and closed eyes resting state and also during the pain threshold assessment. Pain thresholds and EEG recordings were compared with a cohort of pain-free age- and sex-matched healthy subjects. Results: Patients with chronic OFP showed a significant reduction in their pain threshold compared to healthy subjects in all sites assessed. Greater reduction in pain threshold was recorded in patients with more severe psychological symptoms. Decreased alpha and increased gamma activity was recorded in central and frontal regions of all subjects, although no significant differences were observed between groups. Discussion: A general reduction in PPT was recorded in people who suffer from chronic OFP. This result may be explained by sensitization of the central nervous system due to chronic pain conditions. Abnormal EEG activity was recorded during painful stimulation compared to the relaxed condition in both chronic OFP subjects and healthy controls.

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The effects of transcranial direct current stimulation (tDCS) combined with group exercise treatment in subjects with chronic low back pain: a pilot randomized control trial

Abstract: Our results showed that real-tDCS can induce significant larger effects on pain and psychological well-being, compared to sham-tDCS, when it is associated with a group exercise program. The effects were observed mostly in the follow-up.

Cited by 42 publications

References 39 publications

The Analgesic Effect of Transcranial Direct Current Stimulation (tDCS) combined with Physical Therapy on Common Musculoskeletal Conditions: A Systematic Review and Meta-Analysis

The Analgesic Effect of Transcranial Direct Current Stimulation (tDCS) combined with Physical Therapy on Common Musculoskeletal Conditions: A Systematic Review and Meta-Analysis

Latin American and Caribbean consensus on noninvasive central nervous system neuromodulation for chronic pain management (LAC2-NIN-CP)

Hyperalgesia and Central Sensitization in Subjects With Chronic Orofacial Pain: Analysis of Pain Thresholds and EEG Biomarkers

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