BDTD - Biblioteca Digital de Teses e Dissertações
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Master Thesis Ciclo de melhoria para prevenção de quedas em pessoas idosas hospitalizadas(Universidade Federal do Rio Grande do Norte, 2025-10-28) Melo, Giselle Karine Muniz de; Nunes, Vilani Medeiros de Araújo; Pennafort, Viviane Peixoto dos Santos; https://orcid.org/0000-0002-5187-4766; https://orcid.org/0000-0002-9547-0093; Mendonça, Ana Elza Oliveira de; Cecagno, SusanaIntroduction: Aging is an irreversible physiological process that increases vulnerability to diseases and adverse events such as falls. The Brazilian elderly population is growing rapidly, posing challenges for public health and hospital care. Falls among hospitalized older adults are frequent, cause morbidity, mortality, and psychological impacts, and demand effective preventive strategies. Implementing international safety goals and identifying risk factors contribute to reducing these events. Quality improvement cycles allow the integration of evidence-based practices, promoting safety and active surveillance in elderly care. Objective: To develop a quality improvement cycle for fall prevention among hospitalized older adults in a public hospital in Northeastern Brazil. Methodology: This quasiexperimental before-and-after study with a quantitative approach was conducted from October 2024 to August 2025, following the Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE). Thirty elderly patients hospitalized in the Orthopedic Clinic of a university hospital were observed before and 30 after interventions aimed at fall prevention. Five quality criteria were defined based on ANVISA and institutional protocols, and quality improvement tools were applied. Interventions included daily risk assessment, standardization of nursing care, proper signaling, and education for patients, families, and staff. Conformities were analyzed using absolute and relative frequencies, 95% confidence intervals, and chi-square test (p ≤ 0.05). Results: After the interventions, significant improvement was observed in all five criteria. Daily fall risk assessment with the Morse Scale (C1) increased from 0% to 100% compliance (p < 0.001). Nursing prescription regarding patient/family education (C5) improved by 70%, and nursing prescription regarding companion guidance (C4) by 63% (both p < 0.001). Execution of safety measures—locked bed and raised side rails (C2)—showed a 27% improvement, and proper visual signaling and wristband for high fall risk (C3) improved by 23% (p < 0.05). Overall, nonconformities decreased by 74%. Conclusions: The implementation of a quality improvement cycle significantly increased adherence to fall prevention practices, reducing care-related risks. These findings highlight the relevance of continuous interventions to strengthen the safety culture for hospitalized older adults.Master Thesis Validação de um protocolo de conduta multiprofissional para tratamento de recém-nascidos submetidos a hipotermia terapêutica na UTI Neonatal(Universidade Federal do Rio Grande do Norte, 2025-10-29) Medeiros, Maria da Guia de; Arrais, Ricardo Fernando; Arrais, Nívia Maria Rodrigues; http://lattes.cnpq.br/6662490613737602; https://orcid.org/0000-0002-9258-4263; http://lattes.cnpq.br/8440147955869198; http://lattes.cnpq.br/0850498813926896; Silva, José Adailton da; https://orcid.org/0000-0002-6037-7649; http://lattes.cnpq.br/0353536075419724; Medeiros, Lays Pinheiro de; http://lattes.cnpq.br/0040523308979789Therapeutic Hypothermia (TH) has been implemented in Neonatal Intensive Care Units (NICUs) for the past 20 years as a strategy to protect the central nervous system of newborns (NBs) diagnosed with moderate to severe Hypoxic-Ischemic Encephalopathy (HIE). Treatment consists of cooling the head or entire body of the newborn to temperatures between 33.5°C and 34.5°C for 72 hours. However, practical tools to guide and improve neonatal care are needed. The objective of this study was to adapt and validate a TH protocol to guide the actions of the multidisciplinary team in the treatment of newborns with HIE admitted to the NICU. This is a qualitative and quantitative methodological study, with a systematic review of the literature on the benefits of TH in neonatal neuroprotection, and the formation of a remote focus group to discuss and validate a clinical protocol. The Content Validation Index (CVI) was the instrument used by participants to analyze the protocol items. The research was conducted in a NICU of a university hospital located in the interior of Rio Grande do Norte, which has five neonatal beds. The study population included 48 professionals, including physicians, nurses, physical therapists, and nursing technicians. In accordance with Ministerial Ordinance No. 930 of May 10, 2012, and the application of a questionnaire to assess professional profile and qualifications, 12 specialists were selected to compose the sample. The participants had between two and ten years of experience in the field, with specialization, master's, and doctoral degrees. Most reported partial mastery of the practice in low temperatures and insecurity in administering the therapy, reinforcing the need for instruments that support the multidisciplinary team and ensure safety in treatment implementation. The remote meeting with the specialists and the researcher to validate the protocol took place in February 2025, via the Google Meet platform. During the discussions, modifications to some protocol items were suggested to improve clarity and implementation. The content analysis performed using the CVI yielded scores above 0.78, considered satisfactory according to the assessment instrument. The focus group's suggestions were compiled and incorporated into the HT protocol, in addition to the development of a flowchart to optimize the care team's activities. The results of the systematic review studies supported the validation of the protocol, demonstrating that hypothermia has proven effective in the neuroprotection of newborns asphyxiated at birth. Among the observed benefits are a reduction in seizures, epileptic seizures, and mortality rates, as well as satisfactory scores in Intelligence Quotient (IQ), cognitive outcomes, motor function, and manual ability. The study contributed to the improvement of neonatal care by validating an instrument that guides and standardizes care practices.Master Thesis Plataforma CIEGES: contribuições para implantação do monitoramento das arboviroses no Estado do RN(Universidade Federal do Rio Grande do Norte, 2025-08-29) Silva, Laís Mayara da; Machado, Flávia Christiane de Azevedo; http://lattes.cnpq.br/0790763211909338; http://lattes.cnpq.br/4792653016812697; Cavalcante, Elisângela Franco de Oliveira; https://orcid.org/0000-0002-3578-0153; http://lattes.cnpq.br/9020549482920149; Souza, Talita Araújo de; https://orcid.org/0000-0002-3138-6626; http://lattes.cnpq.br/0631326687250908Epidemiological surveillance is a continuous and systematic process of collecting, analyzing, and interpreting data on diseases and public health events. This ongoing monitoring enables the identification of trends, guides interventions, and strengthens timely decision-making. When organized in situation rooms, indicators become strategic monitoring tools that enable real-time surveillance through dashboards and control charts. In this context, the Centro de Inteligência Estratégica de Gestão Estadual do Sistema Único de Saúde (CIEGES), an initiative of the Conselho Nacional de Secretários de Saúde (CONASS), promotes management integration and qualification by providing interactive panels whose participatory construction enhances legitimacy and institutional ownership. This study aims to promote participatory management to support the implementation of the CIEGES platform at the Secretaria de Estado da Saúde Pública do Rio Grande do Norte (SESAP/RN), qualify arbovirus monitoring, and develop a guidebook to expand its use in other surveillance areas. It is a qualitative study with an action research design, conducted through two focus groups and thematic data analysis to foster participatory management and identify strategies to improve platform utilization. An instructional guidebook was developed in three phases—planning, elaboration, and validation—by experts who assessed criteria such as clarity, relevance, accessibility, interactivity, and visual organization. Communication and continuing education are essential for strengthening epidemiological surveillance and participatory management, situation rooms, as strategic spaces for analysis and decision-making, promote the qualified use of data and technical integration, fostering innovation and timely responses to public health threats. The CIEGES guidebook consolidates a data-driven culture, democratizes information, and enhances work processes; the articulation among communication, education, and information management supports a more effective, collaborative, and continuously improving health surveillance aligned with the strengthening of Brazil’s Unified Health System (SUS).Master Thesis Construção de um guia ilustrado para a assistência de enfermagem na hemorragia pós-parto(Universidade Federal do Rio Grande do Norte, 2025-10-01) Araújo, Aline Fernandes de; Costa, Maria Cláudia Medeiros Dantas de Rubim; Santiago, Janmilli da Costa Dantas; https://orcid.org/0000-0001-7842-7117; http://lattes.cnpq.br/6472536626945111; https://orcid.org/0000-0002-8395-8788; http://lattes.cnpq.br/9782490389460142; Souza, Francisca Marta de Lima Costa; https://orcid.org/0000-0002-2442-9499; http://lattes.cnpq.br/4000378013446633; Silva, José Adailton da; https://orcid.org/0000-0002-6037-7649; http://lattes.cnpq.br/0353536075419724; Soares, Juliana Pontes; http://lattes.cnpq.br/2980866796605529Postpartum hemorrhage is one of the leading causes of preventable maternal death worldwide and in Brazil, representing a serious challenge for healthcare services and nursing practice. This study aimed to develop an illustrated guide for nursing care in postpartum hemorrhage. It is a methodological study focused on the development of health technology, conducted in three stages: (1) a scoping review, designed to map and synthesize scientific evidence on nursing care in postpartum hemorrhage, which resulted in 14 articles and allowed the identification of 29 preventive measures, 18 aimed at identification, and 42 related to treatment and stabilization; (2) content definition, in which the findings were selected and organized to compose the guide; and (3) design development, incorporating visual elements such as typography, colors, thematic icons, images, flowcharts, and plain language. The final product consists of an illustrated guide that organizes nursing care for women with postpartum hemorrhage, combining concise textual explanations with graphic resources. It is concluded that the developed technology constitutes an innovative tool aimed at improving the quality of nursing care and strengthening continuing education, with the potential to support clinical practice, reinforce maternal health policies, and contribute to reducing preventable maternal deaths.Master Thesis Desenvolvimento de um sérum facial microemulsionado multifuncional utilizando o planejamento experimental Box-Behnken(Universidade Federal do Rio Grande do Norte, 2025-09-24) Cruz, Yasmin Ferreira da; Egito, Eryvaldo Sócrates Tabosa do; http://lattes.cnpq.br/6907806915889763; https://orcid.org/0000-0002-7726-1933; http://lattes.cnpq.br/7115213545673756; Oshiro Júnior, João Augusto; https://orcid.org/0000-0001-7247-1598; http://lattes.cnpq.br/7718234509377672; Ferreira, Leandro De Santis; https://orcid.org/0000-0002-8408-5886; http://lattes.cnpq.br/6622861873027635The international cosmetic market has been highlighted for the production and commercialization of multifunctional products, characterized by presence of several active ingredients. Then, the development of microemulsions (ME) as a cosmetic product stands out due to its ability to deliver different active ingredients to obtain properties as moisturizing, photoprotective and antioxidant. Based on this, the aim of this study was to produce and characterize a multifunctional facial booster (MFB) based on a Linum Usitatissimum (Linseed) Seed Oil (LO) ME containing Tocopherol, Hyaluronic Acid (HA), and Phenylbenzimidazole Sulfonic Acid (PBSA) by the Box-Benhken experimental design (BBD). The active ingredients concentrations were defined based on the BBD results of antioxidant activity, sun protector factor (SPF) and occlusivity. The MFB was characterized by its antioxidant activity, occlusivity, SPF and spreadability in vitro. In addition, MFB was physicochemically characterized by hydrodynamic droplet size distribution, polydispersity index (PdI) and pH. The BBD proposed a MFB composed by HA 5 %, Tocopherol 5 % and PBSA 7.5 %, that showed an antioxidant activity, SPF, occlusivity and spreadability of 8.02 ± 1.20 %, 12.65 ± 1.33, 27.65 ± 1.67 % and 2923 ± 167 mm², respectively. These results represent an effective radical scavenging ability, photoprotection, water loss prevention and adequate spreadability. Moreover, MFB showed a droplet size, PdI and pH of 34.74 ± 0.14 nm, 0.184 ± 0.02, 7.14 ± 0.02, respectively. The MFB showed physicochemical characteristics suitable for microemulsion systems and presented suitable stability for 90 days. Finally, the MFB was successfully produced and stands itself as a promising multifunctional cosmetic product.Master Thesis Estratégias para a melhoria da atenção de enfermagem em cuidados paliativos no ambiente hospitalar(Universidade Federal do Rio Grande do Norte, 2025-09-10) Pontes, Vamilson Oliveira de; Silva, José Adailton da; Valentim, Janaína Luana Rodrigues da Silva; https://orcid.org/0000-0001-8525-8155; http://lattes.cnpq.br/8236259645905686; https://orcid.org/0000-0002-6037-7649; http://lattes.cnpq.br/0353536075419724; http://lattes.cnpq.br/8229645154492913; Sales, Jaqueline Carvalho e Silva; https://orcid.org/0000-0001-7657-5829; http://lattes.cnpq.br/7516931521540612; Martins, Quenia Camille Soares; http://lattes.cnpq.br/5126798976942401With the demographic transition experienced worldwide, the aging population is increasingly suffering from chronic degenerative diseases, requiring comprehensive care to manage the numerous health needs that affect this population. However, this approach must take into account that this care, in most cases, is not aimed at curing these illnesses, but rather at alleviating suffering and preserving the individual's autonomy in the final stages of life. In this context, palliative care (PC) emerges: a philosophy of care and a multidisciplinary approach aimed at people with a serious, progressive illness and their families, addressing the problems caused by preventing and alleviating suffering. The principles that guide palliative care can be used as an ethical imperative in optimizing resources. Some hospitals offer this type of care in their services. However, this model suffers negative impacts, as it tends to maintain the curative model in evidence. It is known that nurses are the healthcare professionals who spend the longest time with patients undergoing palliative care and, according to the nursing code of ethics, must provide all available care to ensure their physical, psychological, social, and spiritual comfort, regardless of their specialization. Therefore, this research aims to analyze nursing care in palliative care in the hospital setting. To this end, an exploratory, descriptive, multimethod study was conducted in three stages: 1) a scoping review to map and summarize the role of nurses in palliative care in the hospital setting; 2) a qualitative study with nine clinical nurses working in various inpatient units of a university hospital in northeastern Brazil to identify the knowledge and practices currently used in palliative care, as well as the difficulties and challenges they experience; and 3) a methodological study to develop an open educational resource, in podcast format, to raise awareness and disseminate knowledge about palliative care. The results presented in this dissertation defense document include: 1) a book chapter with a critical analysis of the evolution of public policies in palliative care in Brazil and worldwide; 2) article 1 published in a scientific journal with a protocol for scoping review according to the JBI model; 3) article 2 to be published in a scientific journal with the results of the scoping review according to the PRISMA-ScR checklist; 4) article 3 to be published in a scientific journal with the results of the focus group using Bardin's content analysis technique; and 5) the scripts for producing a podcast playlist according to the Manual for Digital Media Production in Podcast Format as a Strategy for Strengthening Internal Communication of the EBSERH Network. Based on the findings, the aim is to disseminate content within the hospital network aimed at informing and raising awareness about the need for adaptation to the national palliative care policy within the Brazilian Unified Health System (SUS).Master Thesis Ciclo de melhoria na prevenção de lesão por pressão em Unidade de Terapia Intensiva(Universidade Federal do Rio Grande do Norte, 2025-08-27) Azevedo, Sâmia Jamylle Santos de; Pennafort, Viviane Peixoto dos Santos; Mendonça, Ana Elza Oliveira de; https://orcid.org/0000-0001-9015-211X; http://lattes.cnpq.br/5531967242281430; https://orcid.org/0000-0002-5187-4766; http://lattes.cnpq.br/4210339574579951; https://orcid.org/0000-0002-7178-7379; http://lattes.cnpq.br/9663879504663280; Cecagno, Susana; Nunes, Vilani Medeiros de Araújo; https://orcid.org/0000-0002-9547-0093; http://lattes.cnpq.br/8169308778262070Introduction: Pressure Injuries (PIs) are one of the most prevalent adverse events, with patients in Intensive Care Units (ICUs) having a higher risk of developing them. Implementing a quality improvement cycle for PI prevention is essential to promote safe care. Objective: To develop a quality improvement cycle for PI prevention in adult patients admitted to an ICU. Methodology: This was a quantitative, quasi-experimental, pre- and post-intervention study without a control group, conducted from January 2024 to June 2025. It was developed by applying a quality improvement cycle following the Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE) guidelines. The population consisted of 80 users admitted to the adult ICU of a university hospital. Seven quality criteria were evaluated before and after the interventions. The improvement estimate between the initial assessment and the reassessment was calculated by considering the absolute and relative improvements for each of the criteria. To prove the statistical significance of the improvement, a one-tailed hypothesis test was applied by calculating the Z-value, considering the absence of improvement as the null hypothesis, which was rejected when the p-value was less than 0.05. The study was approved by the CEP/HUOL under opinion No. 6,923,839. Results: During the reassessment, it was found that all criteria showed an increase in the percentage of compliance when comparing the results of the assessments before and after the interventions. Criterion 7, "The nursing team must check the prescribed care according to the risk of pressure injury," showed the largest absolute growth, rising from 35% to 58% compliance. Criterion 2, "Nurses must apply the Braden Scale daily," showed the smallest improvement, with an increase of eight percentage points (from 85% to 93%). Conclusions: The quality improvement cycle is an effective tool for qualifying health services, promoting patient safety and excellence in care. The interventions implemented in this study contributed to the improvement of the team's practices in the ICU. To consolidate these advances and ensure sustainable results, it is essential to continue the improvement actions, invest in permanent team education, and adapt strategies to the particularities of the intensive care environment.Doctoral Thesis Efeito do extrato livre e nanoparticulado das folhas de Commiphora leptophloeos (Mart.) J.B. Gillet em modelos de inflamação intestinal e câncer colorretal quimicamente induzidos(Universidade Federal do Rio Grande do Norte, 2025-03-31) Silva, Valéria Costa da; Langassner, Silvana Maria Zucolotto; Guerra, Gerlane Coelho Bernardo; http://lattes.cnpq.br/5677318431530876; https://orcid.org/0000-0002-2768-0793; http://lattes.cnpq.br/7390416147619446; https://orcid.org/0000-0003-0090-1784; http://lattes.cnpq.br/9690791898073916; Nascimento, Ednaldo Gomes do; http://lattes.cnpq.br/0934984562153634; Ururahy, Marcela Abbott Galvão; https://orcid.org/0000-0003-0229-9416; http://lattes.cnpq.br/8016222352823817; Damasceno, Renan Oliveira Silva; https://orcid.org/0000-0002-4810-7558; http://lattes.cnpq.br/7699067518129569; Vezza, TeresaCommiphora leptophloeos (Mart.) J.B. Gillet, from the Burseraceae family, is a plant native to Brazil, found in the Caatinga, Cerrado, and Amazon biomes. It is popularly known as imburana and is widely recognized for its medicinal properties in treating inflammation in general. Moreover, there are reports of its effectiveness in alleviating gastrointestinal symptoms such as colic and diarrhea. The species contains important secondary metabolites, including the flavonoids isoorientin, isovitexin, and quercetin, which are known for their intestinal antiinflammatory activity. Thus, this study aimed to evaluate the effects of the free and nanoparticle-loaded hydroethanolic extract (NPE) of C. leptophloeos leaves in models of intestinal inflammation (both preventive and therapeutic protocols) and colitis-associated colorectal cancer (CAC). Additionally, it sought to perform the phytochemical analysis of the extract and to develop and characterize the nanoformulation containing the extract. Phytochemical profiling identified C-glycosylated flavonoids (quercetin, isovitexin, isoorientin, and orientin), O-glycosylated flavonoids (quercetin-O-(O-galloyl)-hexose and quercetin-O-feruloyl-O-hexose), and quinic acid, with total phenolic and flavonoid contents of 311.02 ± 0.03 mg/g and 174.90 ± 0.02 mg/g, respectively. The physicochemical characterization of the NPE revealed particle sizes up to 100 nm, a PdI value of 0.13, and a stable zeta potential. Its use significantly reduced the effective dose needed for modulating signaling pathways involved in inflammation and tumorigenesis, from 400 mg/kg for the free extract to just 4 mg/kg for the nanoparticle-loaded extract. Treatment with the free extract significantly (p<0.05) regulated inflammatory markers such as NF-κB p65/Cox-2, TNF-α, IL1β, IL-6, Il-17, and mTOR in the 2,4-dinitrobenzene sulfonic acid-induced colitis model. Both free and nanoparticulate extracts, in the dextran sulfate sodium-induced colitis model, regulated Tlr2/4, Jnk1/2, Cox-2, Tnf-α, Il-1β, Il-6, Il-17, Mip2, and Icam-1. Improvements in clinical symptoms and intestinal cytoarchitecture were observed in both models. Furthermore, the free extract and NPE showed antitumor activity in the CAC model by modulating key tumorigenesis signaling pathways such as Tp53, Ctnnb1, Bax, and Bcl-2, reducing tumor volume, and increasing the abundance of the bacterium Akkermansia muciniphila. In conclusion, C. leptophloeos exhibits both preventive and therapeutic intestinal anti-inflammatory activity in experimental models, in addition to antitumor effects, supporting the potential development of a phytotherapeutic ingredient for the treatment of chronic inflammatory diseases.Doctoral Thesis Desenvolvimento tecnológico de nanoemulsão de óleo de linhaça contendo avobenzona e tris-bifenil triazina: validação analítica, fotoestabilidade, fotoproteção in vitro e segurança cutânea ex vivo(Universidade Federal do Rio Grande do Norte, 2025-08-01) Miranda, Júlio Abreu; Egito, Eryvaldo Sócrates Tabosa do; http://lattes.cnpq.br/6907806915889763; https://orcid.org/0000-0003-0783-7447; http://lattes.cnpq.br/0126922350258900; Freitas, Rodrigo Pegado de Abreu; http://lattes.cnpq.br/3462462933163509; Verissimo, Lourena Mafra; https://orcid.org/0000-0002-9289-0455; http://lattes.cnpq.br/9173400981540256; Rosseto, Hélen Cássia; http://lattes.cnpq.br/7417144807480582; Soares, Daniel Cristian Ferreira; http://lattes.cnpq.br/0451950971908426Ultraviolet (UV) radiation is a major risk factor for various skin damages, including skin cancer, making sunscreens a key preventive strategy. In this context, the development of effective and safe sunscreen formulations remains a constant challenge in the cosmetic field. Therefore, this study aimed to develop, characterize, and evaluate in vitro a linseed oil-based nanoemulsion containing the UV filters avobenzone (AVO) and tris-bifenil triazine (TBPT), with a focus on improving AVO photostability, photoprotective efficacy, and skin safety. Initially, an HPLC method was developed and validated for the simultaneous quantification of AVO and TBPT, following the ICH guidelines and employing a Box-Behnken design. A nanoemulsion was then formulated, produced and optimized (NEUVMIXopt), containing 10% of linseed oil, 10% surfactant mixture (Kolliphor® RH 40:Span® 80 8,7:1,3), 1% AVO, 8% TBPT, 1% vitamin E, 0.2% potassium sorbate, 0.5% xanthan gum, and purified water to 100%. This formulation was characterized by transmission electron microscopy and dynamic light scattering, showing spherical morphology, clear distinction between TBPT particles and oil droplets, mean diameter of 147.48 ± 0.58 nm, polydispersity index of 0.23 ± 0.02, zeta potential of -25.09 ± 0.40 mV, and pH of 6.52 ± 0.10, indicating colloidal stability and suitability for topical application. Photostability assays demonstrated a significant increase in AVO half-life, from 39.24 minutes in linseed oil solution to 138.16 minutes in NEUVMIXopt. Furthermore, photoprotective efficacy studies using diffuse reflectance spectrophotometry showed that the developed formulation provided UV protection for all skin phototypes, with SPF values of 21.67 ± 6.67, a UVA/UVB ratio of 0.88 ± 0.01, and a critical wavelength of 381.67 ± 0.43 nm. Skin safety studies using porcine ear skin revealed that the formulation had no transdermal permeation potential, favoring local deposition of UV filters in the outer skin layers. Finally, histological analysis of the treated pig skin showed no morphological changes, indicating the absence of irritant potential. Altogether, these results reinforce the potential of combining nanotechnology with natural oils as a promising strategy for developing more effective and safer sunscreen products.Master Thesis Efeitos da estimulação transcraniana por corrente contínua combinada com exercícios físicos sobre a dor, função física e percepção de mudança em indivíduos com osteoartrite de joelho: um ensaio clínico randomizado triplo-cego(Universidade Federal do Rio Grande do Norte, 2025-07-24) Lima, Vinícius Batista; Souza, Clécio Gabriel de; https://orcid.org/0000-0001-9005-7956; http://lattes.cnpq.br/6308219057546985; http://lattes.cnpq.br/3559301823598081; Matos, Areolino; https://orcid.org/0000-0002-3437-5105; http://lattes.cnpq.br/5013499072708263; Freitas, Rodrigo Pegado de Abreu; http://lattes.cnpq.br/3462462933163509Introduction: 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 nonconsecutive 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.