Reducing pain and recovery of strength and function are major challenges in physical therapy. Transcranial direct current stimulation (tDCS) is a novel intervention that has gained popularity in the rehabilitation of athletic injuries, pain management, and sports performance. Acute application of tDCS has been shown to modulate the perception of effort and fatigue, enhance motor learning, improve endurance performance, and improve muscular power and strength. tDCS has also been shown to reduce pain in patients with chronic pain conditions. Using a double-blind, randomized clinical trial design, we aim to evaluate the effectiveness of tDCS plus standard rehabilitation compared to rehabilitation alone on pain, balance and proprioception, functional performance, and strength following acute ankle inversion sprain. We hypothesize that the group using tDCS will demonstrate superior outcomes in all variables of interest.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
41
The Halo Sport (Halo Neuroscience, San Francisco, CA) is a commercial off-the-shelf tDCS device that delivers a 2.2 mA current to the motor cortex through three elastomer foam scalp pads with a 24 sq. cm surface area (see https://www.haloneuro.com/). The tDCS is controlled through the Halo Sport App where the therapist and patient are blind to an actual or sham treatment. Patients in the tDCS group will complete a 20-minute tDCS session while performing the warm-up.
The Halo Sport (Halo Neuroscience, San Francisco, CA) is a commercial off-the-shelf tDCS device that delivers a 2.2 mA current to the motor cortex through three elastomer foam scalp pads with a 24 sq. cm surface area (see https://www.haloneuro.com/). The tDCS is controlled through the Halo Sport App where the therapist and patient are blind to an actual or sham treatment. Patients in the sham tDCS group will complete a 20-minute sham-tDCS session while performing the warm-up, but the app will discontinue the treatment after 30 seconds.
After the tDCS session is complete, the patient will complete treatment consistent with the standard of care for rehabilitation of acute ankle inversion sprain. The rehabilitation program will be standardized among all patients and will consist of therapeutic exercises, manual physical therapy, and other modalities. Rehabilitation sessions will be performed 2x weekly and sessions will last approximately 45 to 60 minutes. Patients will also perform a standardized home exercise program that reinforces the in-clinic treatment.
Keller Army Community Hospital - Arvin Physical Therapy
West Point, New York, United States
Composite Pain Rating
Numerical Pain Rating Scale assessment of Current, Best 24-hour, Worst 24-hour Pain
Time frame: Change from Baseline to 4-weeks
Composite Pain Rating
Numerical Pain Rating Scale assessment of Current, Best 24-hour, Worst 24-hour Pain
Time frame: Change from Baseline to 8-weeks
Self-Reported Function
Patient report of function assessed by Single Assessment Numeric Evaluation
Time frame: Change from Baseline to 4-weeks
Self-Reported Function
Patient report of function assessed by Single Assessment Numeric Evaluation
Time frame: Change from Baseline to 8-weeks
Muscle Strength
Isometric dorsiflexion, plantarflexion, inversion, eversion assessed by hand-held dynamometry
Time frame: Change from Baseline to 4-weeks
Muscle Strength
Isometric dorsiflexion, plantarflexion, inversion, eversion assessed by hand-held dynamometry
Time frame: Change from Baseline to 8-weeks
Proprioception
Limits of stability test and unilateral stance test assessed by NeuroCom EquiTest
Time frame: Change from Baseline to 4-weeks
Proprioception
Limits of stability test and unilateral stance test assessed by NeuroCom EquiTest
Time frame: Change from Baseline to 8-weeks
Dynamic balance
Dynamic balance assessed by the Y-balance Test
Time frame: Change from Baseline to 4-weeks
Dynamic balance
Dynamic balance assessed by the Y-balance Test
Time frame: Change from Baseline to 8-weeks
Muscle Power
Single leg hop test for distance
Time frame: Change from Baseline to 4-weeks
Muscle Power
Single leg hop test for distance
Time frame: Change from Baseline to 8-weeks
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