The effect of transcranial direct stimulation as an add-on treatment to conventional physical therapy on pain intensity and functional ability in individuals with knee osteoarthritis: A randomized controlled trial - 11/09/21

Doi : 10.1016/j.neucli.2021.06.002

Fatemeh Rahimi ^a, Vahid Nejati ^b, Gholamhossein Nassadj ^a,⁎ , Bahare Ziaei ^a, Hossein Kouhzad Mohammadi ^a
^a Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Rehabilitation School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
^b Department of Psychology, Shahid Beheshti University, Tehran, Iran

^⁎Corresponding author.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Saturday 11 September 2021
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Abstract

Objective

To investigate the effect of adding transcranial direct current stimulation (tDCS) to conventional physiotherapy treatment (PT) on pain and performance of individuals with knee osteoarthritis (KOA).

Methods

Eighty people suffering from chronic KOA participated in this study. They were randomly divided into four treatment groups, including PT combined with tDCS over the primary motor cortex (M1), PT combined with tDCS over the primary sensory cortex (S1), PT combined with tDCS over the dorsolateral prefrontal cortex (DLPFC), and PT combined with sham tDCS. A visual analog scale (VAS) for pain intensity, the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire for knee-related disability, and several performance tests (stepping 15 s, chair stand test in 30 s, and walking 4 × 10 m) were used for assessment following 10 sessions of tDCS (T1), and one month after the last session of tDCS (T2).

Results

Differential effects on pain intensity, knee-related disability, and performance were found between groups. Compared to sham tDCS: (i) tDCS over M1 improved VAS pain score, KOOS disability score, and performance tests at T1 and T2; (ii) tDCS over S1 improved VAS pain score at T1 and T2 and KOOS disability score and performance tests at T2; (iii) tDCS over the DLPFC improved VAS pain score at T1 and performance tests at T1 and T2.