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Effectiveness of Transcranial Direct Current Stimulation in Knee Osteoarthritis: A Systematic Review and
Ssu-Hsuan Wu1, Chueh-Ho Lin, Tzu-Yun Hsu
1From the School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan (S-HW); International Ph.D. Program in Gerontology and Long-Term Care, Taipei Medical University, Taipei, Taiwan (C-HL); Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan (C-HL); Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (T-YH, T-HL, H-CC); Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan (T-HL, H-CC); Department of Rehabilitation and Movement Science, University of Vermont, College of Nursing and Health Sciences, Burlington, Vermont (RE); Swiss Paraplegic Research, Nottwil, Switzerland (RE); and Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (H-CC).
Objective:
The aim of the study is to assess the effectiveness of transcranial direct current stimulation in knee osteoarthritis.
Methods:
The study searched PubMed, Cochrane Library, Embase, and Scopus databases until August 3, 2023, and identified randomized controlled trials evaluating the effects of transcranial direct current stimulation in knee osteoarthritis whose outcomes using pain scores or functional scales. The selected randomized controlled trials were subjected to meta-analysis and risk of bias assessment.
Results:
Seven randomized controlled trials involving 488 patients were included in this meta-analysis. Compared with the control group, the transcranial direct current stimulation group exhibited significant improvement in pain scores after treatment (standardized mean difference = 1.03; 95% confidence interval: 0.70 to 1.35; n = 359; I2 = 46%), pain scores during follow-up (standardized mean difference = 0.83; 95% confidence interval: 0.21 to 1.45; n = 358; I2 = 86%), and Western Ontario and McMaster Universities Osteoarthritis scores after treatment (standardized mean difference = 4.76; 95% confidence interval: 0.16 to 9.53; n = 319; I2 = 74 % ), but Western Ontario and McMaster Universities Osteoarthritis scores during follow-up did not differ significantly between the groups (standardized mean difference = 0.06; 95% confidence interval: -0.2 to 0.32; n = 225; I2 = 0%).
Conclusions:
Transcranial direct current stimulation is a promising therapy for knee osteoarthritis. Further investigation using large-scale, high-quality randomized controlled trials is necessary for optimal transcranial direct current stimulation approach in knee osteoarthritis.
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