Efeitos da estimulação transcraniana por corrente contínua combinada a exercícios na dor lombar crônica não específica

Abstract

Introduction: Transcranial Direct Current Stimulation (tDCS) is a non-invasive modulation technique that involves the application of 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 musculoskeletal conditions that cause dysfunction and pain, low back pain is identified as a public health problem and is globally prevalent, with high incidence and recurrence. Objective: Study I: Development of a protocol to assess the effects of simultaneous application of tDCS with exercises based on the Pilates method in individuals with nonspecific chronic low back pain. Study II: Evaluate the effects of simultaneous application of tDCS with exercises based on the Pilates method on pain and performance of individuals with non-specific chronic 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 non-specific chronic low back pain, randomized into two groups: (1) active tDCS combined with exercises based on the Pilates method and (2) sham 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 (GA) and the second with sham transcranial stimulation (GS), both combined with an exercise protocol. Pain sensation, pressure pain threshold through algometry, and lumbar muscle performance, including paravertebral muscle strength and the Ito test, were assessed. Evaluations were conducted 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 pain in the last 24 hours was observed on the numerical scale, and an increase in the pain threshold in both groups, but without differences between them. Muscle performance did not change in any of the groups. Conclusion: The combination of tDCS simultaneously with an exercise program based on the Pilates method does not alter pain perception or muscle performance in people with chronic low back pain.