Transcranial direct current stimulation (a-tCDS) after subacromial injections in patients with subacromial pain syndrome: a randomized controlled pilot study

Samuel Larrivée, Frédéric Balg, Guillaume Léonard, Sonia Bédard, Michel Tousignant, Patrick Boissy, Samuel Larrivée, Frédéric Balg, Guillaume Léonard, Sonia Bédard, Michel Tousignant, Patrick Boissy

Abstract

Background: Subacromial pain syndrome (SAPS) is a common complaint in orthopaedics. Subacromial corticosteroid injections (CSI) can relieve pain in the short term. Anodal transcranial direct current stimulation (a-tDCS) has been used for symptomatic pain relief in a variety of chronic pain conditions. The aim of this pilot study was to assess whether the application a-tDCS could enhance the symptomatic relief provided by CSI in patients affected by SAPS.

Methods: Thirty-eight participants (18 to 65-year-old) suffering from SAPS were recruited to have a CSI and randomly allocated to receive, 1 weeks post CSI, real a-tDCS (r-tDCS), sham tDCS (s-tDCS) or no intervention (Control). Upper limb function was measured 1 week prior to the CSI, at the 2- and 4-week follow-ups using self-administered questionnaires and physical measures. Self-reported pain and activity during each day were logged by the participants using visual analog scales (VAS). Differences between groups were tested using repeated-measures ANOVAs.

Results: Pain VAS and the Single Assessment Numeric Evaluation scale (SANE) showed significant improvement from baseline 2 weeks and 4 weeks after CSI in all groups (p < 0.05). There were no significant group X time interaction 2 weeks following tDCS treatment in any of the variables.

Conclusion: All groups showed significant improvement in pain VAS and SANE scores following the CSI. One session of a-tDCS treatment 2 weeks following CSI did not result in any additive or potentializing effects when compared to a s-tDCS or a control group.

Trial registration: ClinicalTrials.gov, NCT03967574 . Registered 30 May 2019 - Retrospectively registered.

Keywords: Accelerometry; Rotator cuff tendinitis; Shoulder activity; Subacromial bursitis; Subacromial pain syndrome.

Conflict of interest statement

The funding sources were not involved in the study design, conduct or reporting. The authors reported no financial affiliation or involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript.

Figures

Fig. 1
Fig. 1
a-tDCS assembly. The anode (a) was applied on the M1 cortical zone for the rotator cuff as identified using TMS. The cathode (b) was applied over the contralateral eyebrow. The sponge electrodes where then secured with rubber band and adhesive tape and soaked in saline
Fig. 2
Fig. 2
The WIMU-GPS accelerometer
Fig. 3
Fig. 3
CONSORT flow diagram

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