We thank the editors for the opportunity to respond to a letter by José, Gülser, and Julio regarding our systematic review and meta-analysis on the “effect of transcutaneous direct current stimulation on spasticity in upper motor neuron conditions”. We also thank the commentators for their intellectual contribution to our published systematic review and meta-analysis, however, it is important to respond to the valid issues they have raised.

We acknowledged including both transcutaneous spinal direct current stimulation (tsDCS) and transcutaneous spinal cord stimulation (tSCS) in our review as a limitation. However, the decision for the inclusion of the two non-invasive spinal cord stimulating techniques was based on the observed similarities between them in terms of the mechanism of action and the application protocol for the management of spasticity.