Abstract
Objective To evaluate the effect of transcutaneous electrical nerve stimulation (C-TENS) in the rehabilitation of rotator cuff injury. Methods A total of 60 patients diagnosed with mild to moderate rotator cuff injury were randomly divided into the control group and test group. Both groups received conventional rehabilitation treatment including physical therapy, joint mobilization, interventional therapy, and family recovery training. The test group additionally received TENS treatment on the upper area 4 or 5 of the wrist, based on the wrist-ankle acupuncture (WAA) theory. The results of the visual analogue scale (VAS), shoulder range of motion (ROM), and Constant-Murley score (CMs) were collected before and after the 1st treatment and after the 5th treatment. The differences of those indicators between the two groups were analyzed statistically. Results The VAS scores of measurement points after treatment were all improved compared with those at baseline. There was a significant difference between the two groups after the 1st and the 5th treatment (p < 0.05), and the improvements in the test group were better than those in the control group. The ROM of flexion, extension, abduction, adduction, internal rotation, and external rotation after the 1st treatment and 5th treatment in both groups were all improved compared with those at baseline. There was no significant difference between two groups. The CMs of the two groups after the 5th treatment were all improved compared with those at baseline. There was no significant difference between two groups. No adverse events occurred during the treatment. Conclusion Electrical stimulation on the wrist combined with conventional rehabilitation is more effective in relieving pain than the conventional rehabilitation alone. Electrical stimulation on the wrist combined with conventional rehabilitation has no obvious effect in improving shoulder joint mobility and shoulder function.
Highlights
Shoulder pain is a common clinical symptom that leads to limited shoulder joint movement and affects the quality of life
Diagnostic criteria were as follows: clinical symptoms such as shoulder pain and decreased range of motion; physical examination such as tenderness in the space between the anterior shoulder and the greater tuberosity and positive result in the painful arc test, impact test, Jobe test, Lag test, or lift-off test; and MRI: according to the Zlatkin classification, imaging findings were of grades 1–3, and conservative treatment or postoperative rehabilitation can be performed after medical evaluation
Ere was a significant difference between the two groups after the 1st and the 5th treatment (p < 0.05), and the scores of the test group were better than those of the control group (Table 2)
Summary
Shoulder pain is a common clinical symptom that leads to limited shoulder joint movement and affects the quality of life. Common causes of shoulder pain are adhesive arthritis and acromioclavicular joint disease [2], and about 70% of should pain cases are caused by rotator cuff injury [3]. Rehabilitation physiotherapy is often adopted in the treatment of mild to moderate rotator cuff injuries, by means of electrical stimulation, manual therapy, functional exercise, local pain closure, and acupuncture, to reduce pain and inflammation. With different frequencies and intensities, the electrical stimulation can be divided into electrical stimulation on the sensory level and electrical stimulation on the motor level. Conventional TENS (C-TENS) is defined as sensory level stimulation, which can inhibit the nociceptor induced dorsal horn response by stimulating large-diameter primary afferent fibers so as to produce the analgesic effect [8].
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