Transcranial Direct Current Stimulation Combined with Stabilization Exercises in Chronic Neck Pain: A Randomized Controlled Trial.

Abstract

Objective: The study aimed to investigate the effect of Transcranial Direct Current Stimulation combined with cervical stabilization exercises on functional status, cognitive functions, and sleep quality in individuals with chronic neck pain.

Materials and methods: The study involved 29 individuals (mean age 33.06 ± 14.81 years). The experimental group (n=10) received combined Transcranial Direct Current Stimulation (2 mA/20 min) with cervical stabilization exercises, while the control group (n=10) received only cervical stabilization exercises. The sham group (n=9) received placebo Transcranial Direct Current Stimulation (0 mA/20 min) with cervical stabilization exercises. Assessments were conducted before and after completing 8 weeks with 2 days per week of intervention, i.e., 16 sessions.

Primary outcome measures: Pain severity was assessed using the 10 cm Visual Analogue Scale and the Neck Bournemouth Questionnaire. Muscle endurance was measured by testing cervical flexors, extensors, and deep flexor muscles. Functional limitations were evaluated with the Profile Fitness Mapping neck questionnaire. Cognitive status was assessed using the Montreal Cognitive Assessment and the Trail Making Test. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index.

Results: After 16 sessions, all groups demonstrated a significant increase in cervical flexor muscle endurance (P < .05) and a significant decrease in Visual Analogue Scale pain scores at rest and at activity. Additionally, the experimental group exhibited a significant improvement in Visual Analogue Scale with activity, Profile Fitness Mapping neck questionnaire, and Montreal Cognitive Assessment scores. No significant difference was found between the groups in cognitive function or sleep quality (P > .05).

Conclusion: The importance of Transcranial Direct Current Stimulation combined with cervical stabilization exercises as a tool for pain management and rehabilitation of impaired motor control in cervical muscles in individuals with chronic neck pain is emphasized. It is suggested that combined approaches are considered instead of cervical stabilization exercises alone.