Related Experiment Video
Updated: Feb 4, 2026

The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb
Published on: September 23, 2018
Transcranial direct current stimulation combined with exercise therapy for chronic low back pain: a systematic review
Rui Xia1, Shihan Lu2, Lunan Zhao1
1College of Sports Science, Qufu Normal University, Qufu, China.
Background:
Chronic low-back pain (CLBP) is a leading cause of disability, with current treatments offering only modest benefits. Transcranial direct-current stimulation (tDCS) may enhance exercise therapy by modulating cortical excitability and pain-inhibitory pathways. This systematic review and meta-analysis quantified the additive effect of combining tDCS with structured exercise in adults with CLBP.
Methods:
We searched PubMed, Web of Science, CENTRAL, Embase, and CNKI up to 25 September 2025. Randomized controlled trials (RCTs) comparing active tDCS plus identical exercise therapy vs. sham tDCS plus the same exercise in adults with CLBP (≥ 12 weeks) were included. Risk of bias was assessed using Cochrane RoB 2.0. Weighted mean difference (WMD) and standardized mean difference (SMD) were calculated for pain and function, respectively.GRADE was used to assess certainty.
Results:
Five RCTs (n = 195) were included. For pain intensity (4 studies, n = 173), tDCS showed a significant additive effect (WMD = -0.99, 95% CI: -1.68 to -0.31, p = 0.006, I 2 = 60.1%). For physical function (five studies, n = 195), the effect was favorable but non-significant (SMD = -0.65, 95% CI: -1.87 to 0.57, p = 0.28, I 2 = 90.7%). Meta-regression indicated intervention duration significantly moderated functional outcomes (β = 0.56, p < 0.001). GRADE certainty was moderate for pain and low for function.
Conclusion:
Anodal tDCS combined with exercise provides a modest but significant additional reduction in pain intensity for CLBP. Longer intervention duration may enhance functional outcomes. Clinical significance should be interpreted cautiously. Larger, well-designed trials are needed to confirm these findings and optimize stimulation parameters.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251151315, identifier CRD420251151315.
Related Concept Videos
Directing Effect of Substituents: meta-Directing Groups
Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
meta-Directing Deactivators: –NO2, –CN, –CHO, –⁠CO2R, –COR, –CO2H
Review and Preview
Percentiles are a type of fractile that partition data into...
Review and Preview
Mesh Analysis with Current Sources
Current Source in One Mesh: The analysis process is straightforward when a current source is found in only one mesh within the circuit. Mesh currents are assigned as usual, with the mesh containing the current source excluded from the analysis. Kirchhoff's voltage law...

