EFFECTS OF TRANSCRANIAL DIRECT CURRENT STIMULATION COMBINED WITH EXERCISE ON NON-SPECIFIC CHRONIC LOW BACK PAIN
TDCS, Low Back Pain, Chronic Pain, Pilates Exercises
Introduction: Transcranial direct current stimulation (tDCS) is a non-invasive modulation technique that involves the application of a low-intensity current to different areas of the brain. Studies indicate that tDCS can alter pain perception by modulating cortical and subcortical areas involved in pain processing. Among the musculoskeletal conditions that cause dysfunction and pain, low back pain is identified as a public health problem and presents a high incidence, prevalence and recurrence globally.
Objectives:
Study I: development of a protocol to evaluate the effects of the simultaneous application of tDCS with exercises based on the Pilates method in individuals with chronic non-specific low back pain.
Study II: evaluate the effects of the simultaneous application of tDCS with exercises based on the Pilates method on pain and performance in individuals with chronic non-specific low back pain.
Methodology:
Study I: development of a protocol for a double-blind randomized clinical trial. We will include individuals with a history of chronic nonspecific low back pain randomized into two groups: (1) active tDCS, combined with exercises based on the Pilates method and (2) simulated tDCS, combined with the same exercises.
Study II: Methods: randomized and blinded clinical trial, including 36 individuals with a history of low back pain divided into two groups: one with active transcranial stimulation (AG) and the second with simulated transcranial stimulation (GS), both combined with an exercise protocol. The pain sensation in the last 24 hours and in the last week were evaluated through the Numerical Pain Scale (NPS), the pressure pain threshold through algometry and the performance of the muscles of the low back region, through the strength of the paravertebral muscles and the Ito test. The evaluations occurred before the treatment protocol (T0), after four weeks of intervention (T1) and one month after the end of the protocol (T2).
Results: A reduction in weekly pain and in the last 24 hours in the NPS and an increase in the pain threshold were observed in both groups, but with no difference between them. Muscle performance did not change in either group.
Conclusion: The combination of tDCS, simultaneously with an exercise program based on the Pilates method, does not change the perception of pain or muscle performance in people with chronic low back pain.