Transcranial Direct Current Stimulation in Combination with TENS: Effectiveness on Pain and Functional Outcomes in Knee OA Patients:A Study Protocol

Chaturvedi, Rekha; Kulandaivelan, Sivachidambaram; Malik, Manoj; Joshi, Shabnam

doi:10.37506/v10/i12/2019/ijphrd/191988

Cited by 3 publications

(5 citation statements)

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“…A meta-analysis by Nascimento et al 39 assessed the effect of the combination of tDCS with peripheral stimulation on chronic pain. This meta-analysis only included two KOA studies 30,33 and showed that tDCS had a statistically significant decrease in pain but no significant effect on physical function; these findings were in accordance with the results from our meta-analysis. Additionally, a meta-analysis by Teixeira et al 40 investigated the analgesic effect of tDCS combined with physical therapy on common musculoskeletal conditions.…”

Section: Discussionsupporting

confidence: 89%

“…Full texts of 33 records were evaluated, and finally, 13 RCTs met the inclusion criteria (Figure 1). [19][20][21][22][27][28][29][30][31][32][33][34][35] The reasons for excluded trials appear in Supplementary Table 3.…”

Section: Resultsmentioning

confidence: 99%

“…28,31 All studies except one 30 applied stimulations for 20 minutes. Nine studies 19,20,22,27,30,[32][33][34][35] performed stimulations once a day for five days, whereas the other four studies performed twice per week for eight weeks, 28 five times per week for two weeks, 31 three times per week for two weeks, 29 and five times per week for two weeks. 21 For comparison of interventions, seven studies compared tDCS with sham tDCS, [19][20][21]27,32,34,35 five studies compared tDCS plus other non-tDCS with sham tDCS plus other non-tDCS, 22,28,30,31,33 and one study compared tDCS with other non-tDCS.…”

Section: Resultsmentioning

confidence: 99%

“…24 Ten studies reported randomization sequence generation and allocation concealment. 19,21,22,[27][28][29][30][33][34][35] Eleven studies 19,21,22,[27][28][29][30][31][33][34][35] described the method in anonymizing participants, but more than half of studies [20][21][22][28][29][30]32,33 (72.73%) did not report the method in anonymizing outcome assessments. Detailed results appear in Supplementary Figures 6 and 7.…”

Section: Resultsmentioning

confidence: 99%

“…The methodologic quality of all included studies was assessed by two reviewers (J‐MY and YW) according to the Cochrane Handbook for Systematic Reviews of Interventions 24 . Ten studies reported randomization sequence generation and allocation concealment 19,21,22,27–30,33–35 . Eleven studies 19,21,22,27–31,33–35 described the method in anonymizing participants, but more than half of studies 20–22,28–30,32,33 (72.73%) did not report the method in anonymizing outcome assessments.…”

Section: Resultsmentioning

confidence: 99%

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Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Yang,

Li,

Wang

et al. 2024

Arthritis Care & Research

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BackgroundThe effects of transcranial direct current stimulation (tDCS) in the treatment of knee osteoarthritis (KOA) is still unclear.ObjectiveTo evaluate the efficacy and safety of tDCS in improving symptoms in patients with KOA.Data sources and study selectionThe following electronic databases were searched for eligible randomized controlled trials (RCTs): PubMed, EMBASE, Web of Science, and the Cochrane Library. The search was performed from the inception dates to April 30, 2023.Data extraction and synthesisData extraction and quality assessment were performed by 2 independent reviewers. Standard mean differences (SMDs) with 95% confidence intervals (95% CIs) for pooled data were calculated. A random‐effects model was used for the data analyses.Main outcomes and measuresThe primary outcomes were pain and physical function. Secondary outcomes included stiffness, mobility performance, quality of life, pressure pain tolerance, and plasma levels of brain‐derived neurotrophic factor (BDNF).ResultsThis meta‐analysis included 13 RCTs. tDCS was significantly associated with pain decrease compared with sham tDCS (SMD = ‐0.62, 95% CI: [‐0.87, ‐0.37], P < 0.00001). When compared tDCS plus other non‐tDCS with sham tDCS plus other non‐tDCS, there was no longer an significant association with pain decrease (SMD = ‐0.45, 95% CI: [‐1.08, 0.17], P = 0.16). The changes in physical function were not significantly different between the tDCS and sham tDCS groups. (SMD = ‐0.09, 95% CI: [‐0.56, 0.38], P = 0.71). When compared tDCS plus other non‐tDCS with sham tDCS plus other non‐tDCS, there was still no significant association with improvement in physical function (SMD = ‐0.66, 95% CI: [‐1.63, 0.30], P = 0.18). There was no significant difference with improvement in stiffness (SMD = ‐0.21, 95% CI: [‐0.77, 0.34], P = 0.45), mobility performance (SMD = 4.58, 95% CI: [‐9.21, 18.37], P = 0.51), quality of life (SMD = ‐7.01, 95% CI: [‐22.61, 8.59], P = 0.38), pressure pain tolerance (SMD = 0.30, 95% CI: [‐0.09, 0.69], P = 0.13). There was a statistically significant reduction in plasma levels of BDNF (SMD = ‐13.57, 95% CI: [‐24.23, ‐2.92], P = 0.01)ConclusionsIn conclusion, tDCS could significantly alleviate pain, but it might had no efficacy in physical function, stiffness, mobility performance, quality of life, pressure pain tolerance among KOA patients.

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Section: Discussionsupporting

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Yang,

Li,

Wang

et al. 2024

Arthritis Care & Research

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Effectiveness of Tens Therapy for Pain Management by Physical Therapists Working in Tertiary Care Hospitals of Karachi

Khan

2022

Pak. J. Rehabil

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Background and aim: Human illness treated electrically in old concepts back in 2500 BC, electric fish used by ancient Egyptian to manage pain through “Shock”. Electro medical devices gained popularity in 19th century. TENS was developed by Melzack & Wall for pain management which in turn found to be a big invention to the field of medicine. For pain relieve TENS is considered as low budget, easy to used and non-invasive electrotherapeutical equipment around the world. Study was aimed to evaluate the approach of TENS for pain management by physical therapist. Methodology: This cross-sectional study conducted through survey among physiotherapist of Karachi. A total No of 101 physiotherapists recruited in this study. A Self-administrated Questionnaire given to each participant for the evaluation of effectiveness of TENS for pain control. SPSS version 23.0 used for analysis. Results: Almost 90% physiotherapist recommends TENS with other modalities. This indicates high prevalence of TENS as main modality for the management of pain by majority of the participants either solely or in combination with other modalities. Conclusion: TENS found to have a significant effect in managing pain. Type and electrode placement also found important role in reducing pain.

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Effect of transcranial direct current stimulation (tDCS) and transcutaneous electrical nerve stimulation (TENS) in knee osteoarthritis

Chaturvedi¹,

Joshi²

2021

Physiother Quart.

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Introduction. To compare the effectiveness of transcranial direct current stimulation (tdCS) and transcutaneous electrical nerve stimulation (TENS) when used in combination or in isolation on pain, function, and quality of life in primary knee osteoarthritis. Methods. A 4-arm parallel group, participant-blinded, placebo-controlled randomized trial was performed. Patients with chronic knee osteoarthritis as per the American College of Rheumatology criteria were eligible. The lottery method was used for randomization and blocked randomization served to ensure an equal number of patients in each group. The participants were allocated to 4 groups and received tdCS and TENS either in combination or in isolation. Pain, function, and quality of life were measured with a visual analogue scale, 6-minute walk test, and Knee injury and osteoarthritis outcome Score, respectively. The subjects were blinded to group allocation. The outcome measures were evaluated at baseline and day 5, 8, and 20 after the intervention. data were analysed with the SPSS (version 21.0) software. Results. on implementing the inclusion and exclusion criteria, 72 participants were enrolled in this trial; 69 of them completed the protocol. There was a significant reduction in pain in all the 3 experimental groups as compared with the control group. The maximum reduction in pain was seen in the group receiving active tdCS and active TENS at week 6. Conclusions. The combination of tdCS and TENS along with strengthening exercises is effective in reducing pain in knee osteoarthritis.

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Transcranial Direct Current Stimulation in Combination with TENS: Effectiveness on Pain and Functional Outcomes in Knee OA Patients:A Study Protocol

Cited by 3 publications

References 0 publications

Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Effectiveness of Tens Therapy for Pain Management by Physical Therapists Working in Tertiary Care Hospitals of Karachi

Effect of transcranial direct current stimulation (tDCS) and transcutaneous electrical nerve stimulation (TENS) in knee osteoarthritis

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