Expert review of neurotherapeutics
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Expert Rev Neurother · Apr 2020
Meta AnalysisNoninvasive brain stimulation combined with exercise in chronic pain: a systematic review and meta-analysis.
Background: The use of noninvasive brain stimulation (NIBS) combined with exercise could produce synergistic effects on chronic pain conditions. This study aims to evaluate the efficacy and safety of NIBS combined with exercise to treat chronic pain as well as to describe the parameters used to date in this combination. Methods: The search was carried out in Medline, Central, Scopus, Embase, and Pedro until November 2019. ⋯ Regarding NIBS techniques, the pooled effect sizes were significant for both tDCS (ES: -0.59, 95% CI: -0.89 to -0.29, I2 = 0.0%) and rTMS (ES: -0.76, 95% CI: -1.41 to -0.11, I2 = 0.0%). Conclusions: This meta-analysis suggests a significant moderate to large effects of the NIBS and exercise combination in chronic pain. The authors discuss the potential theoretical framework for this synergistic effect.