Ibrahim Aminu A, Klahan Katayan, Sornkaew Kanphajee, Tretriluxana Jarugool, Silfies Sheri P, Wattananon Peemongkon
Physiotherapy Department, Tishk International University, Erbil, Iraq.
Spine Biomechanics Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.
Eur J Phys Rehabil Med. 2025 Jun;61(3):520-531. doi: 10.23736/S1973-9087.25.08870-7. Epub 2025 Jun 19.
Chronic low back pain (CLBP) is a common disabling condition, inflicting a substantial socioeconomic burden. Given its association with neuroplastic changes, as evidenced by central and peripheral sensitization, neuromodulatory techniques such as transcranial direct current stimulation (tDCS) have emerged as potential treatments. This scoping review aimed to identify and map the existing literature on tDCS studies for CLBP to provide insight into how these studies are conducted, and to address their potential gaps in knowledge.
PubMed, Embase, Web of Science, and Cochrane Library were searched for relevant studies from inception to 23 March 2025. Eligible studies included were those examining tDCS alone or with other interventions in adults with CLBP, regardless of the outcome evaluated and included adults with CLBP. The review was conducted using Arksey and O'Malley's six-stage framework and was guided by the PRISMA for scoping review framework.
Of 134 screened records, 26 studies were included: 23 randomized controlled trials and 3 quasi-experimental studies. Half of the studies (50%) had a low risk of bias while one-third (34.6%) showed a high or serious risk of bias. Outcomes evaluated varied and included clinical, biophysical, biomechanical, and psychosocial measures. There was considerable variability in tDCS treatment protocols across studies. The effectiveness of tDCS was inconsistent, particularly for clinical outcomes, with some studies indicating positive effects while others reported no significant effects.
Overall, this review reveals inconsistent results for tDCS effectiveness in CLBP, likely due to variability in study designs, sample characteristics, treatment protocols, and outcome measures. Future well-designed trials are needed to clarify the therapeutic potential of tDCS for CLBP, particularly in combination with other interventions.
慢性下腰痛（CLBP）是一种常见的致残性疾病，造成了巨大的社会经济负担。鉴于其与神经可塑性变化有关，如中枢和外周敏化所证明的那样，经颅直流电刺激（tDCS）等神经调节技术已成为潜在的治疗方法。本范围综述旨在识别和梳理关于tDCS治疗CLBP的现有文献，以深入了解这些研究是如何进行的，并解决其潜在的知识空白。
在PubMed、Embase、Web of Science和Cochrane图书馆中检索了从创刊到2025年3月23日的相关研究。纳入的合格研究包括那些单独研究tDCS或tDCS与其他干预措施联合用于CLBP成人患者的研究，无论评估的结果如何，且研究对象为患有CLBP的成人。本综述采用了阿克西和奥马利的六阶段框架，并以PRISMA范围综述框架为指导。
在筛选的134篇记录中，纳入了26项研究：23项随机对照试验和3项准实验研究。一半的研究（50%）偏倚风险较低，而三分之一（34.6%）显示出高或严重的偏倚风险。评估的结果各不相同，包括临床、生物物理、生物力学和心理社会指标。各研究之间的tDCS治疗方案存在很大差异。tDCS的有效性并不一致，特别是对于临床结果，一些研究表明有积极效果，而另一些研究则报告无显著效果。
总体而言，本综述揭示了tDCS治疗CLBP有效性的结果不一致，这可能是由于研究设计、样本特征、治疗方案和结果测量的差异所致。未来需要设计良好的试验来阐明tDCS对CLBP的治疗潜力，特别是与其他干预措施联合使用时的潜力。
