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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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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
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author Chang, Wei-Ju
Bennell, Kim L.
Hodges, Paul W.
Hinman, Rana S.
Young, Carolyn L.
Buscemi, Valentina
Liston, Matthew B.
Schabrun, Siobhan M.
author_facet Chang, Wei-Ju
Bennell, Kim L.
Hodges, Paul W.
Hinman, Rana S.
Young, Carolyn L.
Buscemi, Valentina
Liston, Matthew B.
Schabrun, Siobhan M.
author_sort Chang, Wei-Ju
collection PubMed
description 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.
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spelling pubmed-54933772017-07-18 Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial Chang, Wei-Ju Bennell, Kim L. Hodges, Paul W. Hinman, Rana S. Young, Carolyn L. Buscemi, Valentina Liston, Matthew B. Schabrun, Siobhan M. PLoS One Research Article 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. Public Library of Science 2017-06-30 /pmc/articles/PMC5493377/ /pubmed/28665989 http://dx.doi.org/10.1371/journal.pone.0180328 Text en © 2017 Chang et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chang, Wei-Ju
Bennell, Kim L.
Hodges, Paul W.
Hinman, Rana S.
Young, Carolyn L.
Buscemi, Valentina
Liston, Matthew B.
Schabrun, Siobhan M.
Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial
title Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial
title_full Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial
title_fullStr Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial
title_full_unstemmed Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial
title_short Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial
title_sort addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: a pilot randomised controlled trial
topic Research Article
url 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
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