Studies in Sport Medicine

Comparison of the Effects of tDCS and tPCS Combined with Closed Kinetic Chain Exercises on Neuromuscular Balance Control in Patients with Knee Osteoarthritis: A Randomized Controlled Trial.

Document Type : Research Paper

Authors

Niloofar Afrasiaby 1
Farzaneh Gandomi 2
Ali Yalfani 3
Parviz Soufivand 4

1 Department of Pathology, Sports and Corrective Exercises, Faculty of Sport Sciences, Razi University, Kermanshah

2 Department of Pathology and Corrective Exercises, Faculty of Sport Sciences, Razi University, Kermanshah

3 Department of Pathology and Corrective Exercises, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan

4 Department of Rheumatology, Faculty of Medicine, Kermanshah University of Medical Sciences

10.22089/smj.2026.19516.1865
Abstract
Impaired postural control and increased center of pressure (COP) sway are common consequences of knee osteoarthritis and may contribute to a higher risk of falls. Therefore, this study aimed to investigate the effects of closed kinetic chain (CKC) exercises combined with non-invasive brain stimulation (NIBS) on postural control in women with knee osteoarthritis. In this randomized, double-blind clinical trial, 54 women with knee osteoarthritis were assigned to three groups: transcranial direct current stimulation (tDCS), transcranial pulsed current stimulation (tPCS), and sham stimulation. The intervention consisted of seven brain stimulation sessions and twelve CKC exercise sessions over four weeks. COP parameters were assessed under eyes-open and eyes-closed conditions before and after the intervention. Mixed-design analysis of variance revealed a significant main effect of time for COP variables under both visual conditions (P<0.05), indicating improvements in postural control across all groups. However, the group × time interaction was not significant for most variables (P>0.05). A significant group × time interaction was observed only for COP path length under the eyes-open condition (P<0.05). Since all groups received CKC exercises, the independent contributions of exercise and NIBS to the observed changes cannot be clearly distinguished. Overall, the findings suggest that CKC-based interventions may contribute to improved postural control, whereas the additional effects of NIBS were limited under the present experimental conditions and require further investigation.

Keywords

Knee osteoarthritis
center of pressure
postural control
balance
closed-chain exercises
Subjects

  • Receive Date 13 June 2026
  • Revise Date 17 July 2026
  • Accept Date 01 September 2026

Home

Publication Ethics

Submit Manuscript

news

Journal Metrics

Contact Us