Effects of Transcranial Direct Current Stimulation and Manual Therapy on Musculoskeletal Pain in Adolescent Dancers

October 31, 2026 updated by: Gwangju Health University

Effects of Non-invasive Brain Stimulation and Manual Therapy on Musculoskeletal Pain in Adolescent Dancers: A Three-Arm Randomized Controlled Trial

Adolescent dancers are at high risk of musculoskeletal pain due to repetitive, high-intensity training. Persistent pain may lead to kinesiophobia (fear of movement), which can further impair physical function according to the fear-avoidance model. Transcranial direct current stimulation (tDCS) has been used as a top-down intervention for musculoskeletal pain; however, it remains unclear whether its analgesic effect results from true neural stimulation or from contextual factors such as treatment expectation.

This three-arm, single-blind randomized controlled trial will enroll 24 adolescent dancers aged 13 to 18 years with musculoskeletal pain lasting at least 3 months. Participants will be randomly allocated, stratified by pain site, to (1) active tDCS plus manual therapy, (2) sham tDCS plus manual therapy, or (3) sham tDCS plus manual therapy plus structured expectation-enhancement education. Each participant will receive a single intervention session. Outcomes will be assessed before, immediately after, and 1 week after the intervention. The study aims to distinguish the neurophysiological effect of tDCS from the effect of treatment expectation on pain, kinesiophobia, and related outcomes.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

24

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Hyunjoong Kim, PhD
  • Phone Number: +82-62-958-7598
  • Email: hjkim@ghu.ac.kr

Study Locations

      • Gwangju, South Korea
        • Jin's Ballet Academy, Pulse Dance Academy

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

13 years to 18 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Adolescent dancers or dance majors aged 13 to 18 years
  • Musculoskeletal pain in a specific body region (e.g., lower back, ankle) for at least 3 months
  • Understanding of the study purpose and voluntary assent from the participant, with written informed consent from a legal guardian

Exclusion Criteria:

  • Metal implants in the head or implanted electronic devices (e.g., cardiac pacemaker)
  • Current pregnancy
  • Current use of psychiatric medication
  • Acute inflammatory disease
  • Bleeding disorder or current use of anticoagulants
  • Recent trauma, surgery, or skin disease at the painful (measurement) site
  • History of epilepsy
  • Any other physical condition that makes participation in the study or intervention inappropriate

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Active tDCS + Manual Therapy (ANT)

Anodal tDCS delivered at 2 mA for 20 minutes using saline-soaked sponge electrodes, with the anode over the primary motor cortex (C3/C4) and the cathode over the contralateral frontal area according to the international 10-20 system. Current is ramped up and down gradually.

Manual therapy including instrument-assisted soft tissue mobilization (Graston technique) applied to the painful region for 15 minutes, with the tool held at 30 to 60 degrees, within a tolerable pain range (VAS 3 to 4).

Sham Comparator: Sham tDCS + Manual Therapy (SCT)

Manual therapy including instrument-assisted soft tissue mobilization (Graston technique) applied to the painful region for 15 minutes, with the tool held at 30 to 60 degrees, within a tolerable pain range (VAS 3 to 4).

Identical electrode placement and procedure as active tDCS for 20 minutes, with current delivered only for the first 30 seconds and then turned off.

Experimental: Sham tDCS + Manual Therapy + Expectation-Enhancement Education (ECT)

Manual therapy including instrument-assisted soft tissue mobilization (Graston technique) applied to the painful region for 15 minutes, with the tool held at 30 to 60 degrees, within a tolerable pain range (VAS 3 to 4).

Identical electrode placement and procedure as active tDCS for 20 minutes, with current delivered only for the first 30 seconds and then turned off.

A 5- to 10-minute structured education session delivered by the investigator using a standardized script that explains the principles and expected effects of the treatment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Pain Intensity (Numeric Pain Rating Scale, NPRS)
Time Frame: Baseline (before intervention), immediately after intervention, and 1 week after intervention

Pain intensity rated on a 0 to 10 scale (0 = no pain, 10 = worst pain imaginable). Higher scores indicate greater pain.

Baseline (before intervention), immediately after intervention, and 1 week after intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Hyunjoong Kim, PhD, Gwangju Health University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 9, 2026

Primary Completion (Estimated)

December 9, 2026

Study Completion (Estimated)

December 15, 2026

Study Registration Dates

First Submitted

October 31, 2026

First Submitted That Met QC Criteria

October 31, 2026

First Posted (Actual)

November 4, 2026

Study Record Updates

Last Update Posted (Actual)

November 4, 2026

Last Update Submitted That Met QC Criteria

October 31, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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