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

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 counter...

Descripción completa

Detalles Bibliográficos
Autores: Luz-Santos, Cleber, Camatti, Janine Ribeiro, Paixao, Alai Barbosa, Sa, Katia Nunes, Montoya, Pedro, Lee, Michael, Baptista, Abrahao Fontes
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/9516
Acceso en línea:https://hdl.handle.net/20.500.13003/9516
Access Level:acceso abierto
Palabra clave:Humans
Electric Stimulation Therapy
Osteoarthritis, Knee
Transcranial Direct Current Stimulation
Exercise Therapy
Randomized Controlled Trials as Topic
Data Interpretation, Statistical
Pain Management
Ensayos Clínicos Controlados Aleatorios como Asunto
Manejo del Dolor
Estimulación Transcraneal de Corriente Directa
Terapia por Ejercicio
Humanos
Terapia por Estimulación Eléctrica
Interpretación Estadística de Datos
Osteoartritis de la Rodilla
Knee osteoarthritis
Pain
Exercise
Transcranial direct current stimulation
id ES_ae0066ffaa9dcd103991d33d65f310d4
oai_identifier_str oai:docusalut.com:20.500.13003/9516
network_acronym_str ES
network_name_str España
repository_id_str
spelling 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 trialLuz-Santos, CleberCamatti, Janine RibeiroPaixao, Alai BarbosaSa, Katia NunesMontoya, PedroLee, MichaelBaptista, Abrahao FontesHumansElectric Stimulation TherapyOsteoarthritis, KneeTranscranial Direct Current StimulationExercise TherapyRandomized Controlled Trials as TopicData Interpretation, StatisticalPain ManagementEnsayos Clínicos Controlados Aleatorios como AsuntoManejo del DolorEstimulación Transcraneal de Corriente DirectaTerapia por EjercicioHumanosTerapia por Estimulación EléctricaInterpretación Estadística de DatosOsteoartritis de la RodillaKnee osteoarthritisPainExerciseTranscranial direct current stimulationBackground: 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.BMC20172017-12-2120172017-12-21research articlehttp://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.13003/9516reponame:Docusalutinstname:Conselleria de Salut i Consum del Govern de les Illes BalearsInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:docusalut.com:20.500.13003/95162026-06-22T12:44:07Z
dc.title.none.fl_str_mv 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
title 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
spellingShingle 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
Luz-Santos, Cleber
Humans
Electric Stimulation Therapy
Osteoarthritis, Knee
Transcranial Direct Current Stimulation
Exercise Therapy
Randomized Controlled Trials as Topic
Data Interpretation, Statistical
Pain Management
Ensayos Clínicos Controlados Aleatorios como Asunto
Manejo del Dolor
Estimulación Transcraneal de Corriente Directa
Terapia por Ejercicio
Humanos
Terapia por Estimulación Eléctrica
Interpretación Estadística de Datos
Osteoartritis de la Rodilla
Knee osteoarthritis
Pain
Exercise
Transcranial direct current stimulation
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
dc.creator.none.fl_str_mv Luz-Santos, Cleber
Camatti, Janine Ribeiro
Paixao, Alai Barbosa
Sa, Katia Nunes
Montoya, Pedro
Lee, Michael
Baptista, Abrahao Fontes
author Luz-Santos, Cleber
author_facet Luz-Santos, Cleber
Camatti, Janine Ribeiro
Paixao, Alai Barbosa
Sa, Katia Nunes
Montoya, Pedro
Lee, Michael
Baptista, Abrahao Fontes
author_role author
author2 Camatti, Janine Ribeiro
Paixao, Alai Barbosa
Sa, Katia Nunes
Montoya, Pedro
Lee, Michael
Baptista, Abrahao Fontes
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Humans
Electric Stimulation Therapy
Osteoarthritis, Knee
Transcranial Direct Current Stimulation
Exercise Therapy
Randomized Controlled Trials as Topic
Data Interpretation, Statistical
Pain Management
Ensayos Clínicos Controlados Aleatorios como Asunto
Manejo del Dolor
Estimulación Transcraneal de Corriente Directa
Terapia por Ejercicio
Humanos
Terapia por Estimulación Eléctrica
Interpretación Estadística de Datos
Osteoartritis de la Rodilla
Knee osteoarthritis
Pain
Exercise
Transcranial direct current stimulation
topic Humans
Electric Stimulation Therapy
Osteoarthritis, Knee
Transcranial Direct Current Stimulation
Exercise Therapy
Randomized Controlled Trials as Topic
Data Interpretation, Statistical
Pain Management
Ensayos Clínicos Controlados Aleatorios como Asunto
Manejo del Dolor
Estimulación Transcraneal de Corriente Directa
Terapia por Ejercicio
Humanos
Terapia por Estimulación Eléctrica
Interpretación Estadística de Datos
Osteoartritis de la Rodilla
Knee osteoarthritis
Pain
Exercise
Transcranial direct current stimulation
description 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.
publishDate 2017
dc.date.none.fl_str_mv 2017
2017-12-21
2017
2017-12-21
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.13003/9516
url https://hdl.handle.net/20.500.13003/9516
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:Docusalut
instname:Conselleria de Salut i Consum del Govern de les Illes Balears
instname_str Conselleria de Salut i Consum del Govern de les Illes Balears
reponame_str Docusalut
collection Docusalut
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869416524397150208
score 15,228081

Similares en LA Referencia