Banca de DEFESA: VINÍCIUS BATISTA LIMA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : VINÍCIUS BATISTA LIMA
DATE: 24/07/2025
TIME: 14:00
LOCAL: Vídeo-conferência
TITLE:

EFFECTS OF TRANSCRANIAL DIRECT CURRENT STIMULATION COMBINED WITH PHYSICAL EXERCISE ON PAIN AND PHYSICAL FUNCTION IN INDIVIDUALS WITH KNEE OSTEOARTHRITIS: A TRIPLE-BLIND RANDOMIZED CLINICAL TRIAL.

KEY WORDS:

Knee Osteoarthritis. Chronic Pain. Transcranial Direct Current Stimulation.

PAGES: 54
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Knee osteoarthritis (KOA) is a degenerative and progressive joint condition that causes pain and limitation of physical function, in addition to negatively influencing functionality and quality of life. Physical exercise is described as the most effective intervention, since individuals with this condition most often present, in addition to pain, muscle weakness and balance deficit. In addition, it has been observed that individuals with KOA also present signs of central sensitization to pain. Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulation technique that has been investigated with the aim of promoting changes in pain perception, by changing cortical excitability. Considering that physical exercise is a robust evidence for the treatment of OA, we intend to observe whether there may be additional effects with non-invasive neuromodulation. Objective: To evaluate the effects of the combined application of tDCS with a specific physical exercise protocol for knee osteoarthritis on pain, physical function and perception of improvement. Methods: This is a triple-blind randomized clinical trial, which was carried out from August 2024 to February 2025, in the city of Santa Cruz-RN. Initially, participants were randomly distributed into two groups: active tDCS combined with physical exercises (G1) and Sham tDCS combined with physical exercises (G2). The intervention protocol took place over 5 weeks, with two sessions per week, on non-consecutive days. The following outcomes were evaluated: primary (pain) and secondary (physical function, central sensitization, global perception of change and adherence). The evaluations occurred at three different times: before starting the protocol (T0), immediately after five weeks (T1) and seven days after the intervention protocol (T2). Results: Forty-one women with a mean age of 64.41 ± 8.93 years and a mean BMI of 30.02 ± 6.24 participated in the study. Participants had an average of six years of diagnosis of KOA and an average pain score of 6.76 at baseline. After participating in the intervention protocol, 76.6% adherence to the frequency was observed. After the exercise intervention protocol combined with tDCS, both groups obtained better results over time compared to baseline in the variables pain, NRS (p < 0.001), WOMAC physical function (p < 0.001) and BP-CSI central sensitization (p < 0.001). Regarding physical performance, there was an improvement in the sit-to-stand test (p < 0.001), 6-step climb test (p < 0.001) and 6-minute walk test (p < 0.017). However, there was no difference in the time and group interaction for any of the variables described above (p > 0.05). At the end, a significant difference was detected in the global perception of change PGIC [U = 135.5; p=0.036], for the active group, which presented higher values in relation to the Sham group. Conclusion: Transcranial Direct Current Stimulation did not promote additional effects on pain and physical function in individuals with knee osteoarthritis, when combined with physical exercises, but participants who received real stimulation reported a greater perception of improvement in symptoms.

COMMITTEE MEMBERS:
Presidente - 4964489 - CLECIO GABRIEL DE SOUZA
Interno - 2646619 - RODRIGO PEGADO DE ABREU FREITAS
Externo à Instituição - AREOLINO MATOS - UFPA