Transcranial Direct Current Stimulation in Clinical Setting to Reduce Pain in Older Workers

Study Overview
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Brief Summary
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Chronic pain is one of the main factors influencing workers' retention at work. Considering that the prevalence of suffering from chronic pain increases with age, older workers are most likely to be absent from work because of their pain. Transcranial direct current stimulation (tDCS) is a treatment option to reduce chronic pain. This study aims to document the effect of tDCS on pain and work retention in older workers and to compare the traditional tDCS protocol (5 sessions) with an enhanced protocol (11 sessions).

Detailed Description
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Chronic pain affects many spheres of the lives of affected individuals and those around them. In Canada, the prevalence of chronic pain is estimated at 15% of adults aged 18 and over. Among seniors, the prevalence of this health problem can reach up to 50% and affect one in two seniors. Chronic pain is one of the leading causes of work disability. In this context, pain reduction remains one of the most effective methods to enable the worker to stay at work. Considering the aging Quebec population, labor needs and the average retirement age which is increasingly postponed, it becomes crucial to take an interest in aging workers and their continued employment. Transcranial direct current stimulation (tDCS) is a non-invasive neurostimulation method that has shown promise in reducing chronic pain. Recently, several research teams have shown that tDCS has beneficial effects on pain, physical function and social participation in seniors. Despite all these recent advances, very few studies have focused on optimizing tDCS treatment modalities and no studies have focused on the impact of tDCS on return to work or retention. The vast majority of studies using tDCS to reduce pain give one tDCS session per day for 5 consecutive days. This study aims to document the effect of tDCS on pain and work retention in older workers and to compare the traditional tDCS protocol (5 sessions) with an enhanced protocol (11 sessions).

Official Title
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Observation et Analyse Des Effets de la Stimulation transcrânienne à Courant Continu en Milieu Clinique Pour Soulager la Douleur Chronique Chez Les Travailleurs Vieillissants

Conditions
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Chronic Pain, Aging

Intervention / Treatment
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* Device: transcranial direct current stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: To be more than 55 years old To have chronic pain To have employment relationship To have pain that interferes with work tasks Exclusion Criteria: - tDCS contraindications (epilepsy, metallic implant in the head, pacemaker, cochlear implant)

Ages Eligible for Study
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Minimum Age: 56 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Standard protocol<br>5 tDCS sessions in 1 week | Device: transcranial direct current stimulation<br>* Anodal, 2mA, tDCS session applied on M1 for 20 minutes.<br>|
| Experimental: Enhanced protocol<br>11 tDCS sessions devised in 4 weeks | Device: transcranial direct current stimulation<br>* Anodal, 2mA, tDCS session applied on M1 for 20 minutes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity | 0-10 Numerical rating scale | Before tDCS | 
| Pain intensity | 0-10 Numerical rating scale | 1 week | 
| Pain intensity | 0-10 Numerical rating scale | 4 weeks | 
| Pain intensity | 0-10 Numerical rating scale | 4 weeks after the last tDCS session | 
| Disability | Pain Disability Index | Before tDCS | 
| Disability | Pain Disability Index | 1 week | 
| Disability | Pain Disability Index | 4 weeks | 
| Disability | Pain Disability Index | 4 weeks after the last tDCS session | 
| Work role functioning | Work Role Functioning Questionnaire | Before tDCS | 
| Work role functioning | Work Role Functioning Questionnaire | 1 week | 
| Work role functioning | Work Role Functioning Questionnaire | 4 weeks | 
| Work role functioning | Work Role Functioning Questionnaire | 4 weeks after the last tDCS session | 
| Physical Functioning | Brief Pain Inventory | Before tDCS | 
| Physical Functioning | Brief Pain Inventory | 1 week | 
| Physical Functioning | Brief Pain Inventory | 4 weeks | 
| Physical Functioning | Brief Pain Inventory | 4 weeks after the last tDCS session | 
| Anxiety | Beck anxiety inventory | Before tDCS | 
| Anxiety | Beck anxiety inventory | 1 week | 
| Anxiety | Beck anxiety inventory | 4 weeks | 
| Anxiety | Beck anxiety inventory | 4 weeks after the last tDCS session | 
| Depression | Beck depression inventory | Before tDCS | 
| Depression | Beck depression inventory | 1 week | 
| Depression | Beck depression inventory | 4 weeks | 
| Depression | Beck depression inventory | 4 weeks after the last tDCS session | 
| Impression of change | Patient Global impression of change | 1 week | 
| Impression of change | Patient Global impression of change | 4 weeks | 
| Impression of change | Patient Global impression of change | 4 weeks after the last tDCS session | 
| Central sensitization | central sensitization inventory | Before tDCS | 
| Central sensitization | central sensitization inventory | 1 week | 
| Central sensitization | central sensitization inventory | 4 weeks | 
| Central sensitization | central sensitization inventory | 4 weeks after the last tDCS session | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Recruitment | Feasibility of the study | through study completion, about 2 years | 
| Security | Feasibility of the study | through study completion, about 2 years | 
| Intervention | Feasibility of the study | through study completion, about 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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transcranial direct current stimulation, physical therapy, work retention