Department of Physiotherapy, School of Allied Medical Sciences, Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Department of Physiotherapy, School of Allied Medical Sciences, Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Neurophysiol Clin. 2023 Dec;53(6):102918. doi: 10.1016/j.neucli.2023.102918. Epub 2023 Nov 8.
OBJECTIVE: Transcranial direct current stimulation (tDCS) has demonstrated its efficacy in alleviating pain among individuals with musculoskeletal disorders. This review focuses on the application of tDCS as a therapeutic intervention for managing knee osteoarthritis (OA), a prevalent musculoskeletal condition. The primary objective is to assess the effectiveness of tDCS(add-on tDCS and /or stand-alone tDCS), whether as an add-on to existing treatments or as a standalone therapy, in reducing pain and enhancing functional capacity in patients with knee OA. METHODS: A comprehensive search was conducted across multiple databases, including PubMed, Science Direct, OVID, MEDLINE, CINAHL, EMBASE, ProQuest, and Google Scholar, and Web of Science. The search terms employed were "Transcranial direct current stimulation" or "tDCS" in combination with "Osteoarthritis" or "OA" and "knee." After eliminating duplicates and studies that did not meet the inclusion criteria, a total of 14 relevant articles were identified for review. RESULTS: Among the included studies, twelve reported statistically significant improvements in pain levels when comparing the active tDCS group to the sham tDCS group. Only two studies reported no significant difference in pain intensity between the active tDCS and sham tDCS groups. Findings regarding functional abilities were diverse, with some studies demonstrating a significant enhancement in functional outcomes in the active tDCS group, while others observed no statistically significant differences. CONCLUSION: The results of this review suggest that tDCS holds promise as a pain management intervention for individuals with knee OA. Notably, anodal tDCS applied over the primary motor cortex (M1) appears to be particularly effective in alleviating pain in patients with knee OA. However, the impact of tDCS on functional performance appears to be limited.
目的:经颅直流电刺激(tDCS)已证明其在缓解肌肉骨骼疾病患者疼痛方面的有效性。本综述重点关注 tDCS 作为一种治疗干预措施在管理膝骨关节炎(OA)中的应用,OA 是一种常见的肌肉骨骼疾病。主要目的是评估 tDCS(附加 tDCS 和/或独立 tDCS)的有效性,无论是作为现有治疗的附加治疗还是作为独立治疗,在减轻膝 OA 患者疼痛和提高功能能力方面的效果。
方法:我们在多个数据库(包括 PubMed、Science Direct、OVID、MEDLINE、CINAHL、EMBASE、ProQuest、Google Scholar 和 Web of Science)中进行了全面搜索。使用的搜索词是“经颅直流电刺激”或“tDCS”与“骨关节炎”或“OA”和“膝盖”相结合。在消除重复项和不符合纳入标准的研究后,共确定了 14 篇相关文章进行综述。
结果:在纳入的研究中,有 12 项研究报告称,与假刺激 tDCS 组相比,活跃 tDCS 组的疼痛水平有统计学显著改善。只有两项研究报告称活跃 tDCS 和假刺激 tDCS 组之间的疼痛强度没有显著差异。关于功能能力的研究结果存在差异,一些研究表明活跃 tDCS 组的功能结果有显著改善,而其他研究则没有观察到统计学上的显著差异。
结论:本综述的结果表明,tDCS 作为一种治疗膝骨关节炎患者疼痛的干预措施具有潜力。值得注意的是,在初级运动皮层(M1)上施加阳极 tDCS 似乎特别有效地减轻膝骨关节炎患者的疼痛。然而,tDCS 对功能表现的影响似乎有限。
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