HOME-BASED TRANSCRANIAL DIRECT CURRENT STIMULATION AND EXERCISE FOR FIBROMYALGIA: FEASIBILITY, LEARNING, AND SAFETY IN A RANDOMIZED TRIAL

Fibromyalgia is a chronic pain syndrome associated with sensory dysfunctions, fatigue, functional impairment, and changes in cortical excitability. Strategies such as transcranial direct current stimulation (tDCS) and physical exercise (PE) have shown promise in the rehabilitation of these patients, especially when applied in an accessible format with remote supervision Objective: To evaluate the feasibility, safety, and learning of a home-based tDCS protocol associated with PE, synchronously and remotely supervised, in women with fibromyalgia. Methods: Randomized clinical trial including 62 women with fibromyalgia, allocated into five groups: PE, tDCS, PE+tDCS, sham PE, and sham PE+tDCS. The 20-day protocol combined daily anodal tDCS (2 mA, 20 min; M1/Fp2) with PE 3 times per week. Feasibility was assessed by adherence/retention, safety by Comfort Rating Questionnaire (CRQ) reported adverse effects, and learning by the number of sessions needed to achieve autonomous execution. Results: Recruitment was 66% (62/94). Adherence was 100% (all 62 completed 20 sessions), and dropout was minimal (retention = 98.4%, 61/62). Reported adverse effects were mild and transient, with no serious events. Most participants reached proficiency within ≤5 sessions, indicating an efficient learning curve. These findings support the safe, feasible, and straightforward home implementation of the protocol. Conclusion: This study shows that a remotely supervised, home-based tDCS associated with physical exercise protocol for fibromyalgia is feasible, safe, and rapidly learned, supporting scalable telehealth delivery.