Additive effect of tDCS combined with Peripheral Electrical Stimulation to an exercise program in pain control in knee osteoarthritis: study protocol for a randomized controlled trial

Autor: Abrahão Fontes Baptista, Cleber Luz-Santos, Michael Lee, Janine Ribeiro Camatti, Katia Nunes Sá, Alaí Barbosa Paixão, Pedro Montoya
Rok vydání: 2017
Předmět:
medicine.medical_treatment
humanos
Medicine (miscellaneous)
Osteoarthritis
Transcranial Direct Current Stimulation
law.invention
Study Protocol
0302 clinical medicine
Randomized controlled trial
law
Outcome Assessment
Health Care
Medicine
Pharmacology (medical)
Randomized Controlled Trials as Topic
lcsh:R5-920
Transcranial direct-current stimulation
ensayos clínicos controlados aleatorizados como asunto
tratamiento por actividad física
Chronic pain
Osteoarthritis
Knee
Exercise Therapy
Data Interpretation
Statistical
Anxiety
Knee osteoarthritis
medicine.symptom
lcsh:Medicine (General)
medicine.medical_specialty
WOMAC
Pain
Electric Stimulation Therapy
Outcome Assessment (Health Care)
03 medical and health sciences
Physical medicine and rehabilitation
General & Internal Medicine
tratamiento del dolor
Humans
Pain Management
tratamiento con estimulación eléctrica
Exercise
030203 arthritis & rheumatology
business.industry
medicine.disease
Clinical trial
Transcranial magnetic stimulation
osteoartritis
Cardiovascular System & Hematology
evaluación de resultados (asistencia sanitaria)
business
human activities
030217 neurology & neurosurgery
Zdroj: Trials
Trials, Vol 18, Iss 1, Pp 1-11 (2017)
ISSN: 1745-6215
Popis: Background Knee osteoarthritis (OA) has been linked to maladaptive plasticity in the brain, which may contribute to chronic pain. Neuromodulatory approaches, such as Transcranial Direct Current Stimulation (tDCS) and Peripheral Electrical Stimulation (PES), have been used therapeutically to counteract brain maladaptive plasticity. However, it is currently unclear whether these neuromodulatory techniques enhance the benefits of exercise when administered together. Therefore, this protocol aims to investigate whether the addition of tDCS combined or not with PES enhances the effects of a land-based strengthening exercise program in patients with knee OA. Methods Patients with knee OA (n = 80) will undertake a structured exercise program for five consecutive days. In addition, they will be randomized into four subgroups receiving either active anodal tDCS and sham PES (group 1; n = 20), sham tDCS and active PES (group 2, n = 20), sham tDCS and PES (group 3, n = 20), or active tDCS and PES (group 4, n = 20) for 20 min/day for five consecutive days just prior to commencement of the exercise program. The primary outcomes will be subjective pain intensity (VAS) and related function (WOMAC). Secondary outcomes will include quality of life (SF-36), anxiety and depression symptoms (HAD), self-perception of improvement, pressure pain thresholds over the knee, quadriceps strength, and quadriceps electromyographic activity during maximum knee extension voluntary contraction. We will also investigate cortical excitability using transcranial magnetic stimulation. Outcome measures will be assessed at baseline, 1 month after, before any intervention, after 5 days of intervention, and at 1 month post exercise intervention. Discussion The motor cortex becomes less responsive in knee OA because of poorly adapted plastic changes, which can impede exercise therapy benefits. Adding tDCS and/or PES may help to counteract those maladaptive plastic changes and improve the benefits of exercises, and the combination of both neuromodulatory techniques must have a higher magnitude of effect. Trial registration: Brazilian Registry on Clinical Trials (ReBEC) – Effects of electrical stimulation over the skull and tight together with exercises for knee OA; protocol number RBR-9D7C7B. Trial registration ID: RBR-9D7C7B. Registered on 29 February 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2332-6) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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