Interferential Current Therapy Research Articles

Efficacy of Core Muscle Exercise Combined with Interferential Therapy in Alleviating Chronic Low Back Pain in High-Performance Fighter Pilots: A Randomized Controlled Trial

BackgroundChronic low back pain (LBP) related to flight is a prevalent health issue in military aviation, impacting pilots. The objective of this investigation was to ascertain if the application of core muscle training in conjunction with interferential current (IFC) therapy results in a reduction in pain severity and associated disability, consequently enhancing core muscle functionality in Chinese Air Force high-performance fighter pilots experiencing chronic LBP.MethodsFifty-three fighter pilots with chronic LBP were randomized into 3 groups: a core muscle exercise combined with IFC group (CG, n = 19), a core muscle exercise group (EG, n = 19), and an IFC group (IG, n = 15). The three groups underwent therapeutic intervention 5 times a week for 12 weeks. The primary outcomes were pain intensity, Oswestry Disability Index (ODI) score and SF-12 health-related quality of life (PCS and MCS) score. Secondary outcomes included evaluations of trunk muscle strength, endurance, and range of motion (ROM) during medial/lateral rotation to assess muscle functionality. Measurements were obtained both before and after the implementation of the intervention therapy.ResultsAfter 12 weeks of intervention therapy, all the health condition parameters significantly improved among the three groups. However, the CG had a significant improvement in pain intensity compared to the EG (MD = − 0.84 scores; 95% CI = − 1.54 to − 0.15; p = 0.013) and the IG (MD = − 1.22 scores; 95% CI = − 1.96 to − 0.48; p = 0.000). Additionally, the CG led to greater conservation of ODI and improved SF-12 PCS scores than did the IG (p < 0.05). Finally, compared with those at baseline, the core muscle function parameters in the CG and EG improved significantly at the end of the study, but no statistically significant differences were observed between the two groups (p > 0.05).ConclusionAmong participants with chronic LBP, three intervention therapies appear effective in reducing pain, diminishing disability, and enhancing quality of life. Also, combined therapy significantly improved pain and disability compared to the other two monotherapies; moreover, combined therapy and core muscle exercise provided similar benefits in terms of core muscle function after 12 weeks of intervention therapy.

Efficacy of Interferential Current Therapy in Patients Diagnosed with Subacromial Impingement Syndrome.

The objective of the study was to evaluate the effectiveness of interferential current treatment on a range of motion of joint and shoulder pain, functional status, and quality of life in patients with subacromial impingement syndrome and to compare interferential current with transcutaneous electrical nerve stimulation and sham interferential current. Patients complaining of shoulder discomfort participated in the present study. Diagnosis of subacromial impingement syndrome is based on anamnesis, clinical examinations, and shoulder magnetic resonance imaging. A total of 52 patients divided into 3 groups: Group 1 (17 patients, mean age 51.8 years) received interferential current, group 2 (18 patients, mean age 51.8 years) received transcutaneous electrical nerve stimulation, and group 3 (17 patients, mean age 49.1 years) received sham interferential current. Hot pack and exercise treatments were added to all groups. All groups were treated for 3 weeks, 5 times a week, for 15 sessions and 20 minutes for each session. Evaluations were made before treatment (T0), in the middle of treatment (T1; end of 8th session), and at the end of treatment (T2; end of 15th session) using active range of motion and visual analog scale for pain, the Arm, Shoulder, and Hand Problems Questionnaire for functional status, and Short Form-36 for quality of life. There were significant improvement effects on all of the range of motion, visual analog scale, and the Arm, Shoulder, and Hand Problems Questionnaire scores at T2 and on the scores in some subparameters of Short Form-36 in all groups (P < .05). However, there was no statistically significant difference at T2 between the groups (P > .05). Interferential current and transcutaneous electrical nerve stimulation exhibited equivalent results regarding range of motion, pain, function, and quality of life of patients with subacromial impingement syndrome, with no significant difference between interferential current and transcutaneous electrical nerve stimulation. Adding interferential current or transcutaneous electrical nerve stimulation treatments to hot pack +exercise therapy did not result in any extra benefits to the patients.

Transcutaneous electrical stimulation for gastrointestinal motility disorders.

Gastrointestinal (GI) dysmotility is categorized by muscle or nerve dysfunctions in any portion of the GI tract, which leads to abnormalities in GI motor and sensory function. Symptoms may vary depending on the organ affected and can be debilitating. Treatment usually involves diet and lifestyle changes. Pharmacotherapy is limited in effectiveness with various side effects. Transcutaneous electrical stimulation (TES), a noninvasive, needleless technique that provides electrical stimulation using cutaneous non-needle electrodes, has become increasingly popular. It has been shown to be beneficial in treating GI motility disorders. This review paper navigates through the different TES techniques, including transcutaneous peripheral nerve (vagal/sacral/tibial nerves) electrical stimulation, transcutaneous electrical acustimulation (stimulation via acupuncture point), transcutaneous interferential current therapy, and transcutaneous electrical nerve stimulation. As we delve deeper, we explore the promising effects of TES on dysphagia, gastroesophageal reflux disease, functional dyspepsia, gastroparesis, postoperative ileus, constipation, and irritable bowel syndrome. The literature at hand speaks volumes about the therapeutic prowess of this noninvasive technique. The time is ripe to evaluate further the full therapeutic potential of TES, a noninvasive, nonpharmaceutical, nonsurgical, and home-based self-administrative technique in managing GI motility disorders.

A Case Report: Korean Medicine Treatment for a Systemic Lupus Erythematosus Patient Persistently Complaining of Fatigue and Chest Tightness

Objective: This study reported the improved symptoms of integrative Korean medicine-based treatment in a patient diagnosed with Systemic Lupus Erythematosus (SLE) who persistently complained of fatigue and chest tightness.Methods: A 51-year-old female SLE patient persistently complaining of fatigue and chest tightness underwent an 18-day treatment with Kracie &lt;i&gt;Shihogayonggolmoryo-tang&lt;/i&gt;, Cheongpajeon-H, Gwanjeol-go, acupuncture, pharmacopuncture, cupping therapy, deep tissue meridian hot pack therapy, manual therapy, Interferential Current Therapy, and Extracorporeal Shock Wave Therapy. The Brief Fatigue Inventory (BFI) and Numeric Rating Scale (NRS) for each symptom were measured on admission, at one week, two weeks of hospitalization, and upon discharge. Clinical outcomes were assessed using these two figures.Results: After treatment, there was a reduction in the BFI score (7 to 3). The NRS score of chest tightness with hot flashes decreased from 8 to 5, neck pain lessened from 7 to 5, pain in both ankles diminished from 6 to 4, the cold hypersensitivity of both feet fell from 6 to 4, and heartburn decreased from 5 to 2. In order, the biggest clinical improvement was to heartburn, fatigue, and chest tightness with hot flashes.Conclusion: This case study shows that integrative Korean medicine-based treatment can improve symptoms of a Systemic Lupus Erythematosus patient persistently complaining of fatigue and chest tightness with hot flashes and suggests that &lt;i&gt;Shihogayonggolmoryo-tang&lt;/i&gt; may be an effective option for managing and treating SLE patients.

EVALUATION OF THE THERAPEUTIC EFFECTS OF TRANSCUTANEOUS INTERFERENTIAL CURRENT THERAPY AND THERAPEUTIC EXERCISES ON MUSCULOSKELETAL SYMPTOMS IN PATIENTS WITH POST COVID-19

The aim of this research was to investigate the therapeutic effectiveness of a multi-component rehabilitation program including: transcutaneous interferential current therapy and therapeutic exercises in patients with musculoskeletal symptoms in post COVID-19 syndrome. Materials and Methods: 62 patients, mean age 55.9(13.99), aged 21 to 79 years, with persistent musculoskeletal symptoms in the recovery phase after experiencing COVID-19 were included in this study. All patients underwent a ten-day treatment course in an outpatient setting, including transcutaneous application of interferential current with four electrodes. The therapeutic parameters were selected with analgesic, trophic and stimulating effects (90-100 Hz, 5min and 0-100 Hz, 15min). Immediately after electrotherapy, kinesitherapy was performed including: breathing exercises, aerobic training, active and resistance exercises for the limbs, postural control exercises and exercises to improve the mobility of the peripheral joints and the axial skeleton. Results were evaluated by: Visual Analogue Scale (VAS) for assessment of back pain, Numerical Rating Scale (NRS) for arthralgia and myalgia assessment, Brief Fatigue Inventory (BFI) – fatigue assessment, functional tests of mobility, Goniometry in the spine, Ott Sign- for measuring the range of motion (ROM) of the thoracic spine, Schober’s test to determine a lumbar spine range of motion (flexion), Tom Meyer’s test for total hip joint and spine flexion mobility. The results were reported before and after the rehabilitation. The statistical significance level was specified as (p&lt;0.05). Results: Musculoskeletal symptoms in the observed patients persisted for an average of 12 weeks, ranging from 7 to 20 weeks, and included: myalgia in 46.8% (29), arthralgia 29.0% (18), pain in various back departments 79.0% (49), fatigue 66.1% (41). Inpatient treatment for acute COVID-19 was performed in 35.5% (22) of patients, and home and outpatient treatment in 64.5% (40). There was a statistically significant reduction (Mean (SD)) after therapy in back pain (VAS) from 4.88(1.5) to 1.93(1.1), myalgia (NRS) from 3.66(1.2) to 1.29(1.1), arthralgia (NRS) from 3.27(1.2) to 0.89 (0.8), and fatigue index (BFI) showed a reduction from 5.73(1.4) to 3.22(1.4). There was an increase in mobility in Ott’s symptom from 2.24(1.2) to 2.86(0.9) cm, Schober’s test 1.41(1.2) to 2.38(0.9) cm, Tom Meyer’s test from - 8.23(6.5) to - 2.46(3.7) cm. Conclusion: In the recovery phase post COVID-19, some of the patients had long-time persistent musculoskeletal symptoms (fatigue, myalgia, arthralgia, back pain). These are a common reason for these patients to be referred for outpatient rehabilitation. In order to design a multi-component rehabilitation programme, it is necessary to take into account individual characteristics and comorbidities. The inclusion of physical modalities such as electrotherapy requires an accurate assessment of the rehabilitation potential and the presence of any counterindications. Therapeutic exercises have been proven to be effective in post COVID-19 patients. The results of this study show that the combination of interferential current therapy and therapeutic exercise can effectively reduce back pain, myalgia, arthralgia, and perception of fatigue. On the other hand, this multicomponent program resulted in improvement in functional tests in the studied patients. Due to the small sample size, it is advisable to continue the study in the future, covering a larger number of patients with long-standing musculoskeletal symptoms as part of post-COVID-19 syndrome, in order to design an effective strategy that can efficiently reduce negative health consequences and improve functional activity in these patients.

Neurophysiological Effects of Electrical Stimulation on a Patient with Neurogenic Bowel Dysfunction and Cauda Equina Syndrome after Spinal Anesthesia: A Case Report

Neurogenic bowel dysfunction (NBD) is common in patients with cauda equina syndrome (CES). Previous studies have reported that electrical stimulation (ES) improves NBD but more neurophysiologic evidence is required. This case report describes a patient who experienced difficulty with defecation as a result of cauda equina syndrome (CES) that developed after a cesarean section performed 12 years ago under spinal anesthesia. The neurophysiological effects were assessed using the bulbocavernosus reflex (BCR) and electromyography (EMG). Two ES treatments, interferential current therapy and transcutaneous electrical stimulation, were used to stimulate the intestine and the external anal sphincter, respectively. The BCR results showed right-side delayed latency and no response on the left side. Needle EMG revealed abnormal spontaneous activities of the bilateral bulbocavernosus (BC) muscles. Electrodiagnostic testing revealed chronic bilateral sacral polyradiculopathy, compatible with CES. After treatment, the patient reported an improved perianal sensation, less strain and time for defecation than before, and satisfaction with her bowel condition. At the follow-up electrodiagnosis, the BCR latency was normal on the right side-needle EMG revealed reductions in the abnormal spontaneous activities of both BC muscles and re-innervation of the right BC muscle. Electrodiagnostic testing can offer insight into the neurophysiological effects of ES, which can help in understanding the mechanism of action and optimizing the therapy for patients with NBD.

편측 안면경련의 한의치료에 대한 연구분석

Objectives The purpose of this study was to investigate Korean medicine treatment on hemifacial spasm and to suggest future research direction. Methods We used seven electronic databases to find articles on Korean medicine treatment of hemifacial spasm and by analyzing the title, abstract, and main text, articles elucidating on Korean medicine treatment on hemifacial spasms were included. Results A total of 68 articles were searched from seven electronic databases. Excluding duplicate articles and articles that satisfied the exclusion criteria, nine articles were included in this study. Acupuncture was used in nine cases, herbal medicine in five cases, physical therapy in three cases, and cupping therapy in one case. In acupuncture, general acupuncture was used in five cases, pharmacopuncture in three cases, and Meridian tendino-musculature acupuncture and thread-embedding therapy in two cases each. Gamigwibi-tang used in two cases was the most frequently used herbal medicine. In physical therapy, carbone, hot pack, interferential current therapy, and silver spike point were used in two cases each. Conclusions It was confirmed that Korean medicine treatment for hemifacial spasm was attempted in varying methods and nearly all cases included in this study showed improvement. However, because of the low level of evidence due to the nature of these case reports, further studies should be conducted for an objective comparison and analysis on the effect of Korean medicine treatment compared to existing treatments.

Improved abdomen muscle activity with interferential current therapy in cerebral palsy with constipation: a randomized controlled trial study

Background: Children with cerebral palsy (CP) often experience many comorbidities, such as constipation. Pain and discomfort that often accompany constipation have an impact on behavior and decrease quality of life. Abdominal muscle weakness can cause a low increase in intra-abdominal pressure so that the expulsive force during defecation is not adequate. The aim of this study was to evaluate the addition of interferential current (IFC) therapy on standard therapy (lactulose) on abdominal muscle activity in children with cerebral palsy (CP) with constipation. Methods: This research is a true experimental study with pre and post-test randomized control group design. Subjects were 18 children with CP who were constipated according to the ROMA IV criteria, which were divided into two groups, namely the control group who received standard therapy (lactulose) and the intervention group who received lactulose plus IFC therapy with a frequency of 4000-4100 Hz, duration 20 minutes, 3 times a week for 1 month. The parameters evaluated in this study were the value of abdominal muscle activity at rest and during contraction. Measurements were carried out twice, before and one week after the completion of the IFC therapy series. Data were analyzed computerized with SPSS v20.0. Results: There was a significant decrease in abdominal muscle activity at rest (P= .024) in the treatment group, while there was an insignificant increase in the control group (P= 0,266). The abdominal muscle activity during contraction in the treatment group showed a greater increase (P= 0.730) than in the control group (P= 0.831). The effect size in the treatment group is 0.2, which means it has a small effect, while in the control group is 0.1, which means it has no effect. Conclusion: The addition of IFC to standard therapy (lactulose) can improve abdominal muscle activity so that IFC can be an alternative supporting therapy in cerebral palsy with constipation to provide a good clinical response.

A partially averaged system to model neuron responses to interferential current stimulation.

The interferential current (IFC) therapy is a noninvasive electrical neurostimulation technique intended to activate deep neurons using surface electrodes. In IFC, two independent kilohertz-frequency currents purportedly intersect where an interference field is generated. However, the effects of IFC on neurons within and outside the interference field are not completely understood, and it is unclear whether this technique can reliable activate deep target neurons without side effects. In recent years, realistic computational models of IFC have been introduced to quantify the effects of IFC on brain cells, but they are often complex and computationally costly. Here, we introduce a simplified model of IFC based on the FitzHugh-Nagumo (FHN) model of a neuron. By considering a modified averaging method, we obtain a non-autonomous approximated system, with explicit representation of relevant IFC parameters. For this approximated system we determine conditions under which it reliably approximates the complete FHN system under IFC stimulation, and we mathematically prove its ability to predict nonspiking states. In addition, we perform numerical simulations that show that the interference effect is observed only for a narrow set of IFC parameters and, in particular, for a beat frequency no higher than about 100[Hz]. Our novel model tailored to the IFC technique contributes to the understanding of neurostimulation modalities using this type of signals, and can have implications in the design of noninvasive electrical stimulation therapies.

Epidural Steroid Injection Versus Conservative Measures in Treatment of Chronic Axial Low Back Pain, A Prospective Randomized Controlled Study

Chronic low back pain (CLBP) is a very common disorder with various management strategies. There is still debate regarding treatment alternatives for axial CLBP. This study aimed to compare the effect of epidural steroid injection (ESI), interferential current (IFC) therapy and core strengthening exercises in a prospective randomized controlled manner. Hence, sixty patients complaining of axial CLBP were included and randomly assigned into either a group of ESI and exercises (group A) or IFC and exercises (group B) or exercises only (group C); each group was of 20 patients. Outcomes were visual analogue scale (VAS) for pain, Oswestry disability index (ODI) for function and Beck's depression inventory (BDI) for depression, assessed at baseline and 3-, 6- and 12-week follow-ups. At the start of the study, there were no significant differences between the three groups in age, gender, cause and duration of CLBP, body mass index, abdominal muscle power, muscle spasm or tenderness (p &gt; 0.05). Significant improvement in VAS and ODI at 3-, 6- and 12-weeks was observed compared to baseline assessment in the three studied groups. The improvement was higher for group A compared to B and C. BDI was significantly improved in group A and C at 3 weeks, and in all groups at 6- and 12-weeks compared to baseline. However, at the end of the study, there was no significant difference in the BDI between the three groups. From this study and over a period of 3 months, all studied groups showed improvement in pain, function, and depression but the group who received epidural steroid injection with core strengthening exercises was statistically better than the other two groups, with significant improvement in pain and function, but not in depression. Early effective assessment and dealing with depression, even prophylactic treatment and cognitive behavioral therapy should be addressed. Trial registration: The Pan African Clinical Trial Registry (www.pactr.org) identification number is PACTR201901523042787 on 16 January 2019.

Effects of adding interferential current (IFC) in standard therapy (Lactulose) in cerebral palsy children with constipation

To determine the addition of interferential current (IFC) in treating constipation in children with cerebral palsy (CP), is more effective than standard therapy (lactulose). An experimental study with a single blind randomized controlled trial. Prior to receiving therapy, the subjects examined the baseline data regarding the Constipation Scoring System (CSS). The total subjects were 18 children with CP who had constipation according to ROME IV criteria, which were divided into two groups, the control group who received standard therapy (lactulose) and the intervention group who received lactulose plus IFC therapy with a frequency of 4000-4100 Hz, duration 20 minutes, 3 times a week for 1 month. A week after the last IFC, CSS was re-evaluated to assess outcomes. Data were analyzed computerized with SPSS v20.0. There was an improvement of CSS in CP with constipation who received additional IFC (P= .002) and lactulose P= .014). There was no significant difference of CSS between the two groups after therapy (P= .917).

Interferential current therapy improved constipation and pelvic floor muscle activity in cerebral palsy children

Background: Objective: The aim of this case report was to evaluate interferential current (IFC) therapy as adjuvant in treating constipation and abnormal pelvic floor muscle activity in cerebral palsy (CP) children. Study design: Nine CP children aged between 4,5 to 13 years old who had constipation according to ROME IV criteria received pre post test examination. At the baseline we collected data regarding the Pediatric Incontinence and Constipation Score (PICS), Pediatric Quality of Life (PedsQL), and pelvic floor muscle activity at rest and during contraction. They received standard lactulose therapy and IFC therapy with a frequency of 4000-4100 Hz, duration 20 minutes, 3 times a week for 4 weeks. A week after the last IFC series, the parameters were re-evaluated to assess outcomes. Data were analyzed with SPSS v20.0. Results: PICS for constipation improved (P= 0,005), PedsQL improved at pain parameter (p = 0,008), and the pelvic floor muscle activity reduced significantly at rest (P= 0,036) in CP with constipation after received additional IFC therapy.

Transcutaneous Electrical Stimulation, Interferential Current and Photobiomodulation May Lead to the Recurrence of Breast Cancer in Rats?

Introduction: Transcutaneous electrical nerve stimulation (TENS), interferential current therapy (IFC) and photobiomodulation therapy (PBMT) have been used in the management of cancer-related pain in adults. However, there are still some controversy regarding the effects of this therapy on tumor cells that may remain after cancer treatment. Objective: To evaluate the risk of recurrence of breast cancer in rats when using TENS, IFC or PBMT. Method: An experimental, randomized, controlled and cross-sectional study. With 90 days of age, 7,12-dimetylbenz(a)anthracene (7,12-DMBA) was administered to rats by gastric gavage to induce mammary cancer. After 120 days the mammary glands of the rats belonging to the group with mammary cancer were removed. Results: 39 female Sprague-Dawley rats were studied: 9 rats without induction of mammary carcinoma; 9 rats with induction of mammary carcinoma and without surgery; 9 rats with induction of mammary carcinoma with surgery and placebo application of TENS, IFC, PBMT; 9 rats with induction of mammary carcinoma, surgery and the application of TENS, IFC and PBMT. Conclusion: This study demonstrated that there was local recurrence of tumors in rats that were stimulated with TENS or IFC, however no evidence of local recurrence with PBMT.

Effectiveness of interferential current therapy in patients with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

We conducted a systematic review and meta-analysis to assess the effectiveness of interferential current therapy (IFC) in patients with knee osteoarthritis. We searched PubMed, Cochrane Library, Embase, ClinicalKey, and Scopus for relevant studies from their date of launch to March 22, 2022. We included randomized controlled trials (RCTs) in which IFC was applied to knee osteoarthritis patients and the outcomes of pain scores or functional scales were assessed. Ten RCTs with 493 patients met the inclusion criteria. Nine RCTs were included in the meta-analysis. The IFC groups exhibited significant improvements relative to the control groups for short-term pain scores (SMD = − 0.64, 95% CI − 1.04 to − 0.25, P = 0.001), long-term pain scores (SMD = − 0.36, 95% CI − 0.60 to − 0.11, P = 0.005), and short-term Western Ontario and McMaster Universities Osteoarthritis Index scores (SMD = − 0.39, 95% CI − 0.77 to − 0.02, P = 0.04). All included studies did not observe any obvious adverse effects of IFC. IFC can be recommended as a treatment for knee osteoarthritis because it improves short- and long-term pain and short-term function. However, large-scale and high-quality RCTs with longer follow-up are required to establish an appropriate standardized treatment.

Clinical Efficacy of Cervical Core Strengthening Exercise in the Treatment of Cervicogenic Headache

<bold>Objective</bold> To explore the clinical efficacy of cervical core strengthening exercise in the treatment of cervicogenic headache. <bold>Methods</bold> A total of 168 patients with cervicogenic headache who visited Rehabilitation Medicine Department of Beijing Jishuitan Hospital from January 2016 to December 2017 were randomly divided into control group and treatment group using a random number table sampling method, with 84 cases in each group. The patients in the control group were treated with conventional treatment, including taking rest, treating with therapeutic modalities, oral drugs. Therapeutic modalities included ultrashort wave, interferential current therapy, laser, magnetic therapy (15 minutes per time, once per day). On the other hand, drug therapy included nonsteroidal anti-inflammatory drugs, eperisone hydrochloride and gabapentin, etc. In addition of the conventional treatment, the treatment group also participated in strengthening exercise of anterior, posterior and lateral core muscles of cervical vertebra (each movement held for 10 seconds, 20 movements at a time, and 5 sets of exercise per day) for 4 weeks. Furthermore, it was changed to 2 sets of exercise per day for 12 months. In addition, visual analog scale (VAS) score, Hamilton's Depression Scale-17 (HAMD-17), Pittsburgh Sleep Quality Index (PSQI) and Patients' Global Impression of Change (PGIC) scale were evaluated before treatment and at 1 month, 3 months and 12 months of treatment. <bold>Results</bold> In terms of the intragroup comparison, the VAS score in control group improved at 1 month of treatment compared with that before treatment (<italic>P</italic>&lt;0.05). There were no significant changes in each index at each time point (<italic>P</italic>&gt;0.05). By contrast, the VAS, HAMD-17, PSQI and PGIC scores in the treatment group improved at 1 month, 3 months and 12 months of treatment compared with those before treatment (<italic>P</italic>&lt;0.05). The comparison between groups showed that no significant differences were found in VAS, HAMD-17, PSQI and PGIC scores between the two groups at 1 month of treatment (<italic>P</italic>&gt;0.05). Apart from that, the VAS, HAMD-17, PSQI and PGIC scores in the treatment group improved more than those in the control group at 3 months and 12 months of treatment (<italic>P</italic>&lt;0.05). Specifically, at 3 months of treatment, the scores of the treatment group were VAS (2.96±1.11), HAMD-17 (25.95±5.91), PSQI (4.55±0.81), and PGIC (4.87±1.47), while the scores of the control group were VAS (5.86±1.31), HAMD-17 (36.97±7.62), PSQI (6.97±1.21), and PGIC (2.36±0.74), and the difference was statistically significant respectively (<italic>P</italic>&lt;0.05). Last, at 12 months of treatment, the treatment group's VAS (1.92±0.91), HAMD-17 (21.94±7.52), PSQI (2.32±0.61), and PGIC (5.50±1.41) were better than the control group's VAS (6.97±1.01), HAMD-17 (41.38±9.02), PSQI (5.15±1.11), and PGIC (2.50±0.91), and the difference was statistically significant respectively (<italic>P</italic>&lt;0.05). <bold>Conclusion</bold> The cervical core strengthening exercise will relieve pain, improve scores of mood and sleep in patients with cervicogenic headache.

Analgesic Effects of Interferential Current Therapy: A Narrative Review.

Background and Objectives: Transcutaneous electrical stimulation of low- and medium-frequency currents is commonly used in pain management. Interferential current (IFC) therapy, a medium frequency alternating current therapy that reportedly reduces skin impedance, can reach deeper tissues. IFC therapy can provide several different treatment possibilities by adjusting its parameters (carrier frequency, amplitudemodulated frequency, sweep frequency, sweep mode or swing pattern, type of application (bipolar or quadripolar), time of application and intensity). The objective of this review article is to discuss the literature findings on the analgesic efficacy of IFC therapy. Conclusions: According to the literature, IFC therapy shows significant analgesic effects in patients with neck pain, low back pain, knee osteoarthritis and post-operative knee pain. Most of the IFC parameters seem not to influence its analgesic effects. We encourage further studies to investigate the mechanism of action of IFC therapy.

Detection of Changes on Parameters Related to Heart Rate Variability after Applying Current Interferential Therapy in Subjects with Non-Specific Low Back Pain.

Interferential current therapy (ICT) is an electrotherapeutic intervention that combines the advantages of high permeability from middle frequency currents and efficient tissue stimulation from low frequency currents, delivering the maximum current with high tissue permeability. The aim was to evaluate the effects of ICT on heart rate variability (HRV) and on pain perception in patients with non-specific chronic low back pain (NSCLBP). In the study, 49 patients with NSCLBP were randomly divided into an experimental (EG) and a sham group (SG). All participants received a single intervention, ICT, or simulated intervention. Outcome measures including baseline (sit-down position) and postintervention (prone position) pain, heart rate (HR), time domain parameter (rMSSD), diameters of the Poincaré plot (SD1, SD2), stress score (SS), and sympathetic/parasympathetic (S/PS) ratio were investigated. In both groups, significant statistical differences were found in perceived pain and in all HRV parameters except in HRmax. Between-group comparisons showed statistically significant differences in all variables except for HRmin and HRmean in favor of the experimental group. These changes reported an increase in parasympathetic activity (rMSSD) (p < 0.05) and a decrease in sympathetic activity (increase in SD2 and decrease in SS) (p < 0.001) and perceived pain (p < 0.001), with a greater size effect (η2 = 0.44) in favor of the experimental group. In conclusion, a single session of ICT can shift the autonomic balance towards increase parasympathetic dominance and decrease the sympathetic dominance and intensity of pain perceived by patients with NSCLBP.

The role of neuromodulation in chronic functional constipation: a systematic review.

Chronic functional constipation is a highly prevalent disorder in which, when conservative measures fail to relieve symptoms, surgical interventions are sometimes indicated. In recent years, neuromodulation for the treatment of functional constipation has gained interest but its role and effectiveness are still unclear. The purpose of this review is to provide a systematic overview on the current literature on the different modalities of neurostimulation and their effect on chronic functional constipation in adults as reported in the literature. A search in the literature for articles concerning the effect of different types of neuromodulation on constipation was performed in PubMed using extensive search terms for the different modalities of neuromodulation. Studies and trials were checked for eligibility. For all types of neuromodulation together, 27 articles were included. 17 studies were included on SNM (sacral nerve modulation). Although multiple studies show positive results on the effect of SNM in constipation, double-blind crossover RCT's (randomised controlled trials) showed no significant effect. 3 studies were included for tSNS (transcutaneous sacral nerve stimulation), 2 for PTNS (percutaneous tibial nerve stimulation) and 2 for TTNS (transcutaneous tibial nerve stimulation). Studies and trials on these modalities of neuromodulation reported ambiguous results on statistical significance of the effect. For transcutaneous IFC (interferential current therapy) 2 studies were included, which both reported a statistically significant effect on all outcomes. The beneficial effect of neuromodulation in chronic functional constipation remains questionable. However, neuro-modulation might be worth considering in patients refractory to treatment before turning to more invasive measures. Future research should shed more light on the effects of neuromodulation in constipation.

Immediate clinical benefits of combining therapeutic exercise and interferential therapy in adults with chronic neck pain: a randomized controlled trial.

Therapeutic exercise (TE) is highly recommended for the management of non-specific neck pain (NSNP) and has shown promising results combined with interferential current therapy. Yet, the clinical relevance of the pooled effect of these approaches remains uncertain. To investigate the immediate clinical effect size of combining TE and interferential therapy, compared with the isolated use of TE, in adults with chronic NSNP. Randomized, single-blinded, controlled, superiority trial. Outpatients, primary care center. Forty-nine adults with chronic NSNP. Participants with neck pain (grades I or II) lasting for more than 12 weeks were allocated to a TE plus interferential currents group (N.=25) or to a TE only group (N.=24). All individuals underwent treatment 5 times a week for 2 weeks. The primary outcome was current neck pain intensity (11-point Numeric Pain Rating Scale). Secondary outcomes included neck disability (Neck Disability Index) and active cervical range-of-movement (CROM device). Measurements were taken at baseline and immediately after treatment. An intention-to-treat analysis was carried out. To quantify the effect size of the interventions, the relative risk, the absolute and relative risk reduction, and the number needed to treat (NNT) were calculated. A significant time*group effect was found for pain intensity, disability, and neck flexion and right rotation (all, P<0.05). In the analysis for treatment benefit, the NNT was 2 (95% CI: 2 to 4, P<0.001) for neck pain and disability, and 3 (95% CI: 2 to 11, P=0.029) for neck flexion. Adding interferential therapy to TE is clinically more effective than TE alone to immediately improve neck pain and disability, but not active cervical range-of-movement, in adults with persistent neck pain. Our results suggest that this multimodal intervention can be a useful strategy for rehabilitation of patients with NSNP. This is the first study on this topic reporting findings in terms of clinical relevance, which is key to transfer research evidence into practice.

Long Term Lumbosacral Bracing and Its Adverse Effects on Low Back

Chronic low back pain CLBP is defined ldquoas the pain or stiffness localized below the costal margins and above the inferior gluteal folds which may be accompanied with sciatica and persist for ge 12 weeks.rdquo Most of these patients present with non-specific and gradually progressive back pain. Low back pain is found to be the most debilitating condition leading to low level of quality of life QOL and disability among women with this complaint. Usually it has been observed that in chronic cases of low back pain patients get used to wearing lumbar corset or brace or belt on long term basis which can have a lot of adverse effects on their back. This causes the soft tissues of the region to shorten adapt and restrict the motion further in the spinal segments. A 63-year-old female presented with disabling low back pain that inhibited her from bending forwards and backwards. Visual Analog Scale Oswestry Low Back Pain Disability Questionnaire and Fear Avoidance Beliefs questionnaire FABQ were taken as baseline information for outcome measures. Range of trunk forward flexion was measured using Schoberrsquos test and the difference was less than 1cm. She was treated in our physiotherapy department with Ultrasound UST and Interferential Current Therapy IFT over lower back region. The patient and her relatives were taught how to wean-off lumbosacral belt gradually by keeping it on for few hours a day initially. Forward-bending exercises in sitting position to stretch the back muscles and other home exercises like mobility exercises along with back muscle isometrics using the wall were taught. After seven days of treatment there was a significant improvement in VAS Oswestry Low Back Pain Disability Questionnaire and FABQ scores. From this it can be noted that back mobility exercises are the key to improve chronic back pain. Studies have highlighted the importance of strengthening especially of the lumbar spine extensors in CLBP patients and had also emphasized on abdominal strengthening to facilitate trunk stabilization. The patientsrsquo mobility in the lumbar region improved and her dependency on the belt reduced gradually. Based on this study we infer that prolonged use of lumbar corsets lumbosacral belts lead to lumbar immobility which further can lead to weakness of back and core muscles. Educating the patient regarding the same and emphasizing more on lumbar mobility exercises on a regular basis can reduce pain improve the range of motion along with decrease in fear avoidance behavior.