Low Back Pain, Transcranial Direct Current Stimulation
Conditions
Keywords
Transcranial Direct Current Stimulation, Low back pain, Exercise, Chronic pain, Combined modality therapy, Motor cortex
Brief summary
The purpose of this study is to evaluate the effects of transcranial direct current stimulation combined with Pilates based exercise on chronic low back pain. This is a randomized clinical trial composed of two arms.
Detailed description
Chronic low back pain may be associated with pathoanatomical, neurophysiological, physical, psychological and social factors. Treatments that relieve the symptoms of these patients are of great importance to improve the quality of life of these individuals. Thus, this study aims to evaluate the effects of transcranial direct current stimulation combined with Pilates based exercise on chronic low back pain. This is a randomized clinical trial that will be composed of men and women between 18 and 65 years of age, with a history of low back pain for more than 12 weeks and a minimum pain intensity equal to 3 cm on the numerical pain scale. The volunteers will be randomized into two distinct groups: stimulation + exercise group (EG - will perform a Pilates based exercise protocol combined with transcranial direct current stimulation) and sham stimulation + exercise group (SG - will perform the same exercise program combined with sham stimulation). The interventions, regardless of the group, will be carried out three times a week for four weeks. Participants will be submitted to three assessments: the first (T0) will be performed before the treatment protocols; the second (T1) will be performed after the four weeks of intervention; and the third (T2) will be a follow-up one month after the end of the treatment protocol. Pain sensation, functional performance, central sensitization, quality of life, pressure pain threshold, global impression of change, adverse events and medication use will be evaluated. For the statistical analysis, a mixed model ANOVA will be performed for the inter and intragroup comparison, with Tukey's post hoc, considering a significance level of 5%.
Interventions
DEVICETranscranial direct current stimulation
Exercise protocol + application of active direct current stimulation for 30 minutes.
DEVICESham Transcranial direct current stimulation
Exercise protocol + application of simulation of direct current stimulation for 30 minutes. The stimulator will be turned off after 30 seconds and the volunteers will not receive current for the rest of the session.
Sponsors
Universidade Federal do Rio Grande do Norte
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Men and women with chronic nonspecific low back pain (for more than 12 weeks) and minimum pain intensity of 3 on numerical pain rating scale.
Exclusion criteria
* diagnosis of fracture and spine pathologies, fibromyalgia, spine surgery in the last year; * low cognitive level assessed by the Mini Mental State Examination; * presence of central neurological diseases (such as Parkinson's and stroke) or psychiatric (such as depression or schizophrenia); * history of epileptic illness; * seizure history; * brain implants; * pacemaker; * pregnancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity | Change from baseline in pain intensity at four weeks after intervention and 1 month of follow-up | Pain intensity measured by numerical pain rating scale (11 points scale) |
| Functional performance associated to back pain | Change from baseline in functional performance at four weeks after intervention and 1 month of follow-up | Functional performance associated with low back pain measured by Roland Morris Disability Questionnaire (24 itens) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient global impression of change | Change from baseline in Patient global impression of change at each intervention day and at four weeks of intervention and 1 month of follow-up. | Patient global impression of change measured by a scale with seven points, where 1 is equal to no change or worse and 7 is much better. |
| Central Sensitization | Change from baseline of central sensitization at four weeks after intervention and 1 month of follow-up. | Evaluation of Central Sensitization using Central Sensitization Inventory (CSI).The questionnaire is divided into two parts, the first with a score from 0 to 100 measures 25 somatic and emotional symptoms, while the second part relates to specific previous diagnoses. |
| Pressure pain threshold | Change from baseline in pressure pain threshold at four weeks after intervention and 1 month of follow-up | Pressure pain threshold measured by pressure algometer. |
| Use of medications | Up to 4 weeks of intervention and 1 month of follow-up. | Patient declaration of medication use. |
| Adverse events | Up to 4 weeks of intervention and 1 month of follow-up. | Patient perception of any adverse event during the intervention protocol. |
| Individual quality of life | Change from baseline in quality of life questionnaires at four weeks after intervention and 1 month of follow-up | Measurement of quality of life using SF-36 questionnaire (36 items, divided into 8 subscales) |
Contacts
Primary ContactLiane B Macedo, PhD
Outcome results
None listed