Motor System Activation With Transcranial Direct Current Stimulation and Physical Exercise to Reduce Pain in Elderly
- Conditions
- Chronic Pain
- Interventions
- Other: Physical exerciseOther: transcranial direct current stimulation
- Registration Number
- NCT04332939
- Lead Sponsor
- Université de Sherbrooke
- Brief Summary
Physical exercises are known to reduce chronic pain in elderly individuals by activating the motor system. However, it seems that exercises are not effective for everyone. The investigators believe that elderly individuals with altered corticospinal tract will be those in whom the exercise alone are not sufficient to relieve pain. For those patients, adding an exogenous stimulation of the motor system such as transcranial direct current stimulation (tDCS) would facilitate the corticospinal tract, and consequently, would help exercises to relieve chronic pain. The investigators hypothesize that combining tDCS with the exercises will be more effective than exercises alone, but only in individuals who initially show low corticospinal projections.
- Detailed Description
Prevalence and intensity of chronic pain increases substantially with age. According to several studies, physical exercises are effective to reduce chronic pain in elderly. However, it seems that exercises are not effective for everyone. One of the hypotheses raised is that the people in whom the exercises have no effect would be those with an alteration of the corticospinal tract. Transcranial direct current stimulation (tDCS) is a non-invasive neurostimulation technique known to facilitate the corticospinal tract when applied over the motor cortex.
Elderly suffering from chronic pain will be recruited in this double-blind, parallel-group, randomised control trial. Participants will be randomized to receive exercises combined to real tDCS (5 daily sessions, 2 mA, 20 minutes) or to sham tDCS. Intervention will last 8 weeks at a rate of 3 workouts per week.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 32
- To have musculoskeletal chronic pain
- Not to change medication and life habits during the study
- People physically active before the study (more then 150 min of moderate to vigorous exercise par week)
- To have an uncontrolled cardiovascular disease
- To have orthopedic limitation or contraindication to physical exercise
- To have contraindication to tDCS
- To have contraindication to TMS
- To have contraindication to MRI
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Exercise + Sham tDCS Physical exercise Intervention will last 8 weeks where participants will be trained at a rate of 3 workouts per week. For the first week, participants will receive 5 daily sessions of sham tDCS. Exercise + real tDCS transcranial direct current stimulation Intervention will last 8 weeks where participants will be trained at a rate of 3 workouts per week. For the first week, participants will receive 5 daily sessions of anodal tDCS (2 mA, 20 min). Exercise + real tDCS Physical exercise Intervention will last 8 weeks where participants will be trained at a rate of 3 workouts per week. For the first week, participants will receive 5 daily sessions of anodal tDCS (2 mA, 20 min).
- Primary Outcome Measures
Name Time Method Changes in Pain intensity Before intervention (T1), First week of intervention (T2), Week 4 (T3), Week 8 (T4), Follow-up 1 week after intervention (T5), Follow-up 1 month after intervention (T6) Pain intensity will be assessed with a pain logbook containing a numerical rating scale from 0 to 10
- Secondary Outcome Measures
Name Time Method Corticospinal excitability (TMS) Before intervention, Follow-up 1 week after, Follow-up 1 month after Corticospinal tract excitability will be assessed with transcranial magnetic stimulation (TMS)
Corticospinal excitability (dMRI) Before intervention, Follow-up 1 week after, Follow-up 1 month after Corticospinal tract excitability will be assessed diffusion magnetic resonance imaging
Functional connectivity Before intervention, Follow-up 1 week after intervention, Follow-up 1 month after intervention Functional connectivity will be assessed with functional magnetic resonance imaging
McGill pain questionnaire Before intervention, Follow-up 1 week after intervention, Follow-up 1 month after intervention McGill pain questionnaire will be used to assess pain in its globality. Score from 0 to 72, higher score means worse outcome.
Brief pain inventory Before intervention, Follow-up 1 week after intervention, Follow-up 1 month after intervention Brief pain inventory will be used to assess pain in its globality. Score from 0 to 70, higher score means worse outcome
Beck depression inventory Before intervention, Follow-up 1 week after intervention, Follow-up 1 month after intervention Beck depression inventory will be used to assess pain in its globality. Score from 0 to 39, higher score means worse outcome
Beck anxiety inventory Before intervention, Follow-up 1 week after intervention, Follow-up 1 month after intervention Beck anxiety inventory will be used to assess pain in its globality. Score from 0 to 63, higher score means worse outcome
Margolis pain drawing and scoring system Before intervention, Follow-up 1 week after intervention, Follow-up 1 month after intervention Margolis pain drawing and scoring system will be used to assess pain in its globality. Score from 0 to 45, higher score means worse outcome
Patient global impression of change questionnaire Before intervention, Follow-up 1 week after intervention, Follow-up 1 month after intervention patient global impression of change questionnaire will be used to assess pain in its globality. Score from 0 to 18 and a percentage from 0 to 100. Higher scores mean better outcome
Tampa questionnaire Before intervention, Follow-up 1 week after intervention, Follow-up 1 month after intervention Tampa questionnaire will be used to assess pain in its globality. Score from 0 to 68, higher score means worse outcome
Pain catastrophizing scale Before intervention, Follow-up 1 week after intervention, Follow-up 1 month after intervention Pain catastrophizing scale will be used to assess pain in its globality. Score from 0 to 52, higher score means worse outcome
Trial Locations
- Locations (2)
Research Centre on Aging
🇨🇦Sherbrooke, Quebec, Canada
Grace Village
🇨🇦Sherbrooke, Quebec, Canada