Concurrent postural training and M۱ anodal transcranial direct current stimulation improve postural impairment in patients with chronic low back pain

Background & Objectives and Aim: Changes in different regions of the brain due to postural disturbances were found in patients with chronic low back pain (LBP). The aims of study were to investigate enhancing effects of concurrent postural training and primary motor cortex (M۱) anodal transcranial direct current stimulation (a-tDCS) on postural stability, balance and pain in chronic LBP patients.Methods: In this clinical trial study, ۳۸ patients with chronic LBP were randomly assigned to experimental, sham and control groups. All groups received identical postural training for ۲۰ minutes, three sessions per week for two weeks, while the experimental group received ۲۰-minute M۱ a-tDCS concurrent with training. Before, immediately and one-month after the interventions, postural stability, balance and pain were assessed using Biodex Balance System, Berg Balance Scale (BBS) and Visual Analog Scale (VAS), respectively.Results: The postural stability indices, BBS and VAS scores significantly improved immediately and one-month after the intervention in the experimental group (p<۰.۰۰۱), while there were significant differences between experimental and other two groups (p<۰.۰۰۱).Conclusionss: M۱ a-tDCS significantly improves the effects of postural training on posture, balance and pain in patients with chronic LBP. Two-week postural training alone cannot improve postural impairment in patients with chronic LBP.