The Effects of Combining Sensorimotor Training With Transcranial Direct Current Stimulation on the Anticipatory and Compensatory Postural Adjustments in Patients With Chronic Low Back Pain Publisher Pubmed



Hejazi HS¹ ; Khanmohammadi R¹ ; Olyaei G¹ ; Qanbari S¹ Show Affiliations
Source: Disability and Rehabilitation Published:2025

Abstract

Purpose: To investigate the effects of concurrent sensorimotor training (SMT) and transcranial direct current stimulation (tDCS) on the anticipatory and compensatory postural adjustments (APAs and CPAs) in patients with chronic low back pain (CLBP). Method: The interventions included (1) SMT plus tDCS and (2) SMT plus sham tDCS. Outcome measures were the normalized integrals of electromyography activity (NIEMG) during the phases of anticipatory and compensatory, and muscle onset latency. The investigated muscles were ipsilateral and contralateral multifidus (MF), transversus abdominus/internal oblique (TrA/IO), and gluteus medius (GM). Results: Between-group comparisons demonstrated that ipsilateral TrA/IO NIEMG during CPA1 (p = 0.010) and ipsilateral GM NIEMG during CPA1 (p = 0.002) and CPA2 (p = 0.025) were significantly lower in the SMT combined with tDCS than in the control group. Furthermore, this group had greater NIEMG for contralateral GM during APA1 than the control group (p = 0.032). Moreover, the onset latency of contralateral TrA/IO was significantly earlier after SMT combined with tDCS (p = 0.011). Conclusions: Both groups that received SMT showed positive effects, but anodal tDCS had an added value over sham stimulation for improving postural control strategies in patients with CLBP. Indeed, SMT combined with tDCS leads to stronger APA and less demand for CPA. RCT registration number: IRCT20220228054149N1 Registration date: 2022-04-04. © 2024 Informa UK Limited, trading as Taylor & Francis Group.