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Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial

A randomised, assessor- and participant-blind, sham-controlled trial was conducted to assess the safety and feasibility of adding transcranial direct current stimulation (tDCS) to quadriceps strengthening exercise in knee osteoarthritis (OA), and provide data to inform a fully powered trial. Partici...

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Detalles Bibliográficos
Autores principales: Chang, Wei-Ju, Bennell, Kim L., Hodges, Paul W., Hinman, Rana S., Young, Carolyn L., Buscemi, Valentina, Liston, Matthew B., Schabrun, Siobhan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5493377/
https://www.ncbi.nlm.nih.gov/pubmed/28665989
http://dx.doi.org/10.1371/journal.pone.0180328
Descripción
Sumario:A randomised, assessor- and participant-blind, sham-controlled trial was conducted to assess the safety and feasibility of adding transcranial direct current stimulation (tDCS) to quadriceps strengthening exercise in knee osteoarthritis (OA), and provide data to inform a fully powered trial. Participants were randomised to receive active tDCS+exercise (AT+EX) or sham tDCS+exercise (ST+EX) twice weekly for 8 weeks whilst completing home exercises twice per week. Feasibility, safety, patient-perceived response, pain, function, pressure pain thresholds (PPTs) and conditioned pain modulation (CPM) were assessed before and after treatment. Fifty-seven people were screened for eligibility. Thirty (52%) entered randomisation and 25 (84%) completed the trial. One episode of headache in the AT+EX group was reported. Pain reduced in both groups following treatment (AT+EX: p<0.001, partial η(2) = 0.55; ST+EX: p = 0.026, partial η(2) = 0.18) but no between-group differences were observed (p = 0.18, partial η(2) = 0.08). Function improved in the AT+EX (p = 0.01, partial η(2) = 0.22), but not the ST+EX (p = 0.16, partial η(2) = 0.08) group, between-group differences did not reach significance (p = 0.28, partial η(2) = 0.052). AT+EX produced greater improvements in PPTs than ST+EX (p<0.05) (superolateral knee: partial η(2) = 0.17; superior knee: partial η(2) = 0.3; superomedial knee: partial η(2) = 0.26). CPM only improved in the AT+EX group but no between-group difference was observed (p = 0.054, partial η(2) = 0.158). This study provides the first feasibility and safety data for the addition of tDCS to quadriceps strengthening exercise in knee OA. Our data suggest AT+EX may improve pain, function and pain mechanisms beyond that of ST+EX, and provides support for progression to a fully powered randomised controlled trial.