Potential Synergistic Effects of Single-Session tDCS and Guided Mindfulness on Balance and Pain in Athletes with Patellofemoral Pain: A Pilot Crossover Study

The objective of this study was to investigate the synergistic effect of a single-session combined transcranial direct current stimulation (tDCS) and mindfulness intervention on static and dynamic single-leg balance and pain intensity in athletes with patellofemoral pain syndrome (PFPS). Ten athletes with PFPS participated in a pilot randomized crossover study. Each participant received active tDCS-Mindfulness and Sham-Mindfulness in randomized order, with a one-week interval between sessions; participants were not informed of the condition. Both groups received a 20-minute intervention (anode over C3, 2 mA) while listening to brief guided mindfulness; in the Sham-Mindfulness group the current was discontinued after 30 seconds. Participants completed single-leg balance tests on the Biodex Balance System (BBS) and rated pain intensity on a 10-cm Visual Analogue Scale (VAS). Following initial assessments, covariance analysis was performed. Between-group comparisons showed that a single-session combined tDCS-Mindfulness produced improvements in overall static and dynamic single-leg balance and reduced pain intensity (p < 0.05). However, the intervention did not demonstrate a synergistic effect on the AP and ML subcomponents of either static or dynamic balance (p > 0.05). This study suggests that a brief, tDCS-mindfulness intervention can confer modest, immediate improvements in balance and reduce pain in athletes with PFPS. This approach could represent a promising option for practitioners in time-limited settings, pending confirmation in larger trials.