Efeitos de um protocolo de estimulação transcraniana por corrente contínua combinada com exercícios baseados no método Pilates no tratamento da dor lombar crônica: ensaio controlado randomizado

Abstract

Introduction: chronic low back pain (CLBP) is a multifactorial condition that significantly impacts functionality and quality of life. Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulation technique that modulates cortical excitability, influencing pain perception. It has been explored as a promising approach for treating chronic pain, although there is still no consensus regarding its effectiveness for CLBP. On the other hand, physical exercises, such as Pilates, are already widely recommended to reduce pain and improve functionality in these patients. Objective: To investigate the effects tDCS combined with Pilates-based exercises in individuals with CLBP. Methodology: A double-blind randomized controlled trial was conducted with 36 participants randomly assigned into two groups: active tDCS + Pilates (ATP) and sham tDCS + Pilates (STP). Pain intensity, disability, pressure pain threshold, and quality of life were assessed before and after four weeks of intervention, as well as one month after the end of the treatment. We recorded the change in the patient's global impression after the first and last day of intervention. Results: There were no statistically significant differences between the groups for all analyzed variables (p > 0.05). Despite this, both groups showed improvements over time compared to baseline in pain (p < 0.001), disability (p < 0.001), pressure pain threshold at L5 (p = 0.005), and in the SF-36 domains: functional capacity (p = 0.003), social aspects (p = 0.045), general health (p = 0.006), and emotional aspects (p = 0.009). Conclusion: Transcranial Direct Current Stimulation did not promote additive effects when combined with Pilates-based exercises in individuals with chronic low back pain.