Transcranial direct current stimulation’s effect on exercise capacity, respiratory muscle strength, and physical performance in patients with chronic obstructive pulmonary disease: Randomized controlled trial

Background Chronic obstructive pulmonary disease (COPD) is associated with alterations in brain function that contribute to reduced respiratory and skeletal muscle strength, ultimately limiting exercise capacity. Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique, has demonstrated efficacy in enhancing lower extremity function in healthy older adults. Objective To evaluate the effects of a single session of anodal tDCS on exercise capacity, respiratory muscle strength, and physical performance in individuals with COPD. Methods In a randomized, double-blind, sham-controlled trial, 26 participants with COPD underwent baseline assessments of exercise capacity (Six-Minute Walk Distance, 6MWD), respiratory muscle strength (Maximum Inspiratory Pressure, MIP), and physical performance (4-m Gait Speed, 4MGS). Participants then received either active or sham tDCS, followed by reassessment 1 day post-intervention. Results Compared to sham, the active tDCS group showed significant improvements in physical performance, including increases of 46 ± 11.45 m in 6MWD ( p < 0.001), 12.54 ± 4.52 cm, H 2 O in MIP ( p < 0.01), and 0.24 ± 0.08 m/s in 4MGS ( p < 0.05). Conclusion A single session of anodal tDCS may enhance exercise capacity, inspiratory muscle strength, and gait speed in patients with COPD, suggesting its potential as a supportive intervention in pulmonary rehabilitation.