Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trial
Abstract Objective To evaluate the efficacy of wearable transcutaneous electrical nerve stimulation (TENS) combined with transcranial direct current stimulation (tDCS) in the middle-aged person with mild knee osteoarthritis (KOA). Design Double-blind, randomized clinical trial. Setting A general hos...
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BMC
2025-07-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08924-1 |
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| author | Chun-Ya Xia Hao-Zhi Niu Xin-Wen Zhang Si-Yan Cai Ying-Jie Fan Tian-Pei Xie Peng-Xia Dong Xiao-Tong Zu Ze-Lin Su Xing-Sheng Lu Yong-Gang Hao Min Su |
| author_facet | Chun-Ya Xia Hao-Zhi Niu Xin-Wen Zhang Si-Yan Cai Ying-Jie Fan Tian-Pei Xie Peng-Xia Dong Xiao-Tong Zu Ze-Lin Su Xing-Sheng Lu Yong-Gang Hao Min Su |
| author_sort | Chun-Ya Xia |
| collection | DOAJ |
| description | Abstract Objective To evaluate the efficacy of wearable transcutaneous electrical nerve stimulation (TENS) combined with transcranial direct current stimulation (tDCS) in the middle-aged person with mild knee osteoarthritis (KOA). Design Double-blind, randomized clinical trial. Setting A general hospital. Subjects Participants aged 60–70 with mild KOA (Kellgren–Lawrence grade 1–2). Interventions The experimental group received TENS + tDCS, and the control group received TENS + sham tDCS for four weeks from Monday through Friday. Main measures The primary outcome was Brief Pain Inventory (BPI). The secondary outcomes included participants’ Visual Analog Scale (VAS), step length, cadence, 6-minute walking test (6MWT), active knee range of motion (ROM), and quadriceps strength. The indexes were assessed one week before treatment (T0), two weeks after treatment commencement (T1), four weeks after treatment commencement (T2), one month after treatment cessation (T3), and two months after treatment cessation (T4). Results A total of 110 participants (55 per group) completed the intervention and follow-up. Repeated-measures ANOVA indicated that tDCS significantly improved the efficacy of TENS in alleviating pain and enhancing walking ability among patients with mild KOA. Statistically significant differences in BPI scores were observed between the experimental and control groups at T1 (2.16 vs. 2.45, P = 0.038), T2 (1.17 vs. 1.73, P < 0.001), and T3 (2.17 vs. 2.41, P = 0.021). However, no significant difference was detected at T4 (2.50 vs. 2.63, P = 0.293). Conclusion The four-week combined intervention demonstrated that tDCS potentiated the therapeutic efficacy of TENS in managing mild KOA. The combined protocol exhibited superiority over TENS monotherapy, with sustained benefits observed up to one-month post-intervention. Trial registration This research has been registered in chictr.org.cn (registration number: ChiCTR2200064735) on 15 October 2022, https://www.chictr.org.cn/showproj.html?proj=182561 . |
| format | Article |
| id | doaj-art-bec389826d7e47fdb4274e14233e4d4d |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-bec389826d7e47fdb4274e14233e4d4d2025-08-20T04:01:43ZengBMCBMC Musculoskeletal Disorders1471-24742025-07-0126111210.1186/s12891-025-08924-1Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trialChun-Ya Xia0Hao-Zhi Niu1Xin-Wen Zhang2Si-Yan Cai3Ying-Jie Fan4Tian-Pei Xie5Peng-Xia Dong6Xiao-Tong Zu7Ze-Lin Su8Xing-Sheng Lu9Yong-Gang Hao10Min Su11Department of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)Department of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)Department of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)Department of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)Department of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)Department of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)Department of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)Department of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)Department of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)School of Public Health, Suzhou Medical College of Soochow UniversityDepartment of Rehabilitation Medicine, Rehabilitation Institute of Soochow UniversityDepartment of Physical Medicine and Rehabilitation, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital Affiliated to Soochow University)Abstract Objective To evaluate the efficacy of wearable transcutaneous electrical nerve stimulation (TENS) combined with transcranial direct current stimulation (tDCS) in the middle-aged person with mild knee osteoarthritis (KOA). Design Double-blind, randomized clinical trial. Setting A general hospital. Subjects Participants aged 60–70 with mild KOA (Kellgren–Lawrence grade 1–2). Interventions The experimental group received TENS + tDCS, and the control group received TENS + sham tDCS for four weeks from Monday through Friday. Main measures The primary outcome was Brief Pain Inventory (BPI). The secondary outcomes included participants’ Visual Analog Scale (VAS), step length, cadence, 6-minute walking test (6MWT), active knee range of motion (ROM), and quadriceps strength. The indexes were assessed one week before treatment (T0), two weeks after treatment commencement (T1), four weeks after treatment commencement (T2), one month after treatment cessation (T3), and two months after treatment cessation (T4). Results A total of 110 participants (55 per group) completed the intervention and follow-up. Repeated-measures ANOVA indicated that tDCS significantly improved the efficacy of TENS in alleviating pain and enhancing walking ability among patients with mild KOA. Statistically significant differences in BPI scores were observed between the experimental and control groups at T1 (2.16 vs. 2.45, P = 0.038), T2 (1.17 vs. 1.73, P < 0.001), and T3 (2.17 vs. 2.41, P = 0.021). However, no significant difference was detected at T4 (2.50 vs. 2.63, P = 0.293). Conclusion The four-week combined intervention demonstrated that tDCS potentiated the therapeutic efficacy of TENS in managing mild KOA. The combined protocol exhibited superiority over TENS monotherapy, with sustained benefits observed up to one-month post-intervention. Trial registration This research has been registered in chictr.org.cn (registration number: ChiCTR2200064735) on 15 October 2022, https://www.chictr.org.cn/showproj.html?proj=182561 .https://doi.org/10.1186/s12891-025-08924-1Transcranial direct current stimulationTranscutaneous electrical nerve stimulationKnee osteoarthritisChronic painPhysical therapyRehabilitation |
| spellingShingle | Chun-Ya Xia Hao-Zhi Niu Xin-Wen Zhang Si-Yan Cai Ying-Jie Fan Tian-Pei Xie Peng-Xia Dong Xiao-Tong Zu Ze-Lin Su Xing-Sheng Lu Yong-Gang Hao Min Su Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trial BMC Musculoskeletal Disorders Transcranial direct current stimulation Transcutaneous electrical nerve stimulation Knee osteoarthritis Chronic pain Physical therapy Rehabilitation |
| title | Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trial |
| title_full | Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trial |
| title_fullStr | Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trial |
| title_full_unstemmed | Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trial |
| title_short | Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trial |
| title_sort | transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle aged person a randomized controlled trial |
| topic | Transcranial direct current stimulation Transcutaneous electrical nerve stimulation Knee osteoarthritis Chronic pain Physical therapy Rehabilitation |
| url | https://doi.org/10.1186/s12891-025-08924-1 |
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