Percutaneous Electrical Nerve Stimulation Research Articles

Effects of Adding Four Sessions of Ultrasound-Guided Percutaneous Electrical Nerve Stimulation to an Exercise Program in Patients with Shoulder Pain: A Randomized Controlled Trial

Objective: Percutaneous electrical nerve stimulation (PENS) appears to be effective for the treatment of musculoskeletal pain. The aim of this trial was to investigate the effects on disability and pain, as well as on the psychological aspects of adding PENS into an exercise program in patients with subacromial pain syndrome. Methods: A randomized, parallel-group clinical trial was conducted. Sixty patients with subacromial pain were allocated into exercise alone (n = 20), exercise plus PENS (n = 20), or exercise plus placebo PENS (n = 20) groups. Patients in all groups performed an exercise program twice daily for 3 weeks. Patients allocated to the PENS group also received four sessions of ultrasound-guided PENS targeting the axillar and suprascapular nerves. Patients allocated to the exercise plus placebo PENS received a sham PENS application. The primary outcome was related disability (Disabilities of the Arm, Shoulder, and Hand, DASH). Secondary outcomes included mean pain, anxiety levels, depressive symptoms, and sleep quality. They were assessed at baseline, one week after, and one and three months after. An analysis was performed using intention-to-treat with mixed-models ANCOVAs. Results: The results revealed no between-group differences for most outcomes (related disability: F = 0.292, p = 0.748, n2p = 0.011; anxiety: F = 0.780, p = 0.463, n2p = 0.027; depressive symptoms: F = 0.559, p = 0.575, n2p = 0.02; or sleep quality: F = 0.294, p = 0.747, n2p = 0.01); both groups experienced similar changes throughout the course of this study. Patients receiving exercise plus PENS exhibited greater improvement in shoulder pain at one month than those in the exercise (Δ −1.2, 95%CI −2.3 to −0.1) or the placebo (Δ −1.3, 95%CI −2.5 to −0.1) groups. Conclusions: The inclusion of four sessions of ultrasound-guided PENS targeting the axillar and suprascapular nerves into an exercise program did not result in better outcomes in our sample of patients with subacromial pain syndrome at one and three months after treatment.

Effectiveness of Percutaneous Electrical Nerve Stimulation Versus Conventional Therapy in Adults with Plantar Fasciitis

Background: Plantar Fasciitis is a degenerative condition of the heel. Percutaneous electrical nerve stimulationand conventional therapy was used as intervention treatment for heel pain.Purpose: The Purpose of this was to compare the efficacy of Pens and Conventional therapy in management ofplantar fasciitis.Materials and Methods: The experimental and control groups included 30 young males and females who wererandomly assigned to each group. The experimental group patients underwent Pens and conventional groupunderwent ultrasound treatment, plantar stretch, and exercise. Before and after four -week sessions of therapyeach participant was asked to score their morning pace using a numerical rating scale and functional foot indexas outcome measures.Result: The experimental group showed a substantial difference compared to the conventional group (p <0.0001),indicating a statistically significant outcome. When comparing both groups there was a statistically significantdifference after intervention.Conclusion: Patients treated for heel pain reacted well to the conventional strategy used in this study, but Pensfollowed by active stretching dramatically reduced pain severity and improved the quality of foot function.

Percutaneous electrical nerve field stimulation for adolescents with irritable bowel syndrome: Cost-benefit and cost-minimization analysis.

Abdominal pain drives significant cost for adolescents with irritable bowel syndrome (IBS). We performed an economic analysis to estimate cost-savings for patients' families and healthcare insurance, and health outcomes, based on abdominal pain improvement with percutaneous electrical nerve field stimulation (PENFS) with IB-Stim® (Neuraxis). We constructed a Markov model with a 1-year time horizon comparing outcomes and costs with PENFS versus usual care without PENFS. Clinical outcomes were derived from a sham-controlled double-blind trial of PENFS for adolescents with IBS. Costs/work-productivity impact for parents were derived from appropriate observational cohorts. PENFS was associated with 18 added healthy days over 1 year of follow-up, increased annual parental wages of $5,802 due to fewer missed work days to care for the child, and $4744 in cost-savings to insurance. Percutaneous electrical field nerve stimulation for adolescents with IBS appears to yield significant cost-savings to patients' families and insurance.

Effectiveness of physiotherapy interventions in alleviating symptoms and complications of diabetic peripheral neuropathy: A review of evidence

This review presents a comprehensive analysis of physiotherapy interventions for Diabetic Peripheral Neuropathy (DPN), summarizing key findings derived from an examination of approximately 654 studies, including randomized controlled trials, systematic reviews, meta-analyses, conducted up to September 2021. Ultimately, 19 studies met the inclusion and exclusion criteria. The findings affirm the effectiveness of physiotherapy interventions in enhancing the quality of life for individuals with DPN. Notable discoveries encompass the positive impact of various interventions, such as aerobic and resistance exercises, electrical stimulation modalities (e.g., transcutaneous electrical nerve stimulation, percutaneous electrical nerve stimulation, and functional electrical stimulation), as well as manual therapies (e.g., massage and joint mobilization). These interventions have demonstrated their ability to reduce pain, enhance balance, and improve sensory function. While acknowledging certain limitations, this review underscores the potential of evidence-based physiotherapy interventions to optimize DPN management and enhance patient outcomes.

The potent analgesia of intrathecal 2R, 6R-HNK via TRPA1 inhibition in LF-PENS-induced chronic primary pain model

BackgroundChronic primary pain (CPP) is an intractable pain of unknown cause with significant emotional distress and/or dysfunction that is a leading factor of disability globally. The lack of a suitable animal model that mimic CPP in humans has frustrated efforts to curb disease progression. 2R, 6R-hydroxynorketamine (2R, 6R-HNK) is the major antidepressant metabolite of ketamine and also exerts antinociceptive action. However, the analgesic mechanism and whether it is effective for CPP are still unknown.MethodsBased on nociplastic pain is evoked by long-term potentiation (LTP)-inducible high- or low-frequency electrical stimulation (HFS/LFS), we wanted to develop a novel CPP mouse model with mood and cognitive comorbidities by noninvasive low-frequency percutaneous electrical nerve stimulation (LF-PENS). Single/repeated 2R, 6R-HNK or other drug was intraperitoneally (i.p.) or intrathecally (i.t.) injected into naïve or CPP mice to investigate their analgesic effect in CPP model. A variety of behavioral tests were used to detect the changes in pain, mood and memory. Immunofluorescent staining, western blot, reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) and calcium imaging of in cultured dorsal root ganglia (DRG) neurons by Fluo-8-AM were used to elucidate the role and mechanisms of 2R, 6R-HNK in vivo or in vitro.ResultsIntrathecal 2R, 6R-HNK, rather than intraperitoneal 2R, 6R-HNK or intrathecal S-Ketamine, successfully mitigated HFS-induced pain. Importantly, intrathecal 2R, 6R-HNK displayed effective relief of bilateral pain hypersensitivity and depressive and cognitive comorbidities in a dose-dependent manner in LF-PENS-induced CPP model. Mechanically, 2R, 6R-HNK markedly attenuated neuronal hyperexcitability and the upregulation of calcitonin gene-related peptide (CGRP), transient receptor potential ankyrin 1 (TRPA1) or vanilloid-1 (TRPV1), and vesicular glutamate transporter-2 (VGLUT2) in peripheral nociceptive pathway. In addition, 2R, 6R-HNK suppressed calcium responses and CGRP overexpression in cultured DRG neurons elicited by the agonists of TRPA1 or/and TRPV1. Strikingly, the inhibitory effects of 2R, 6R-HNK on these pain-related molecules and mechanical allodynia were substantially occluded by TRPA1 antagonist menthol.ConclusionsIn the newly designed CPP model, our findings highlighted the potential utility of intrathecal 2R, 6R-HNK for preventing and therapeutic modality of CPP. TRPA1-mediated uprgulation of CGRP and neuronal hyperexcitability in nociceptive pathways may undertake both unique characteristics and solving process of CPP.

Retrospective analysis of the application of percutaneous electrical nerve stimulation and meta-analysis

After the stimulation of neurodermis, in the first stage, the relevant literature of each stage can be obtained through the relevant computer detection method. At the same time, also to the relevant database and scientific network research, and the influence of TENS tight comparison, the investigation is two years, using a series of score evaluation into the quality of the literature, in the process of inclusion if a certain funnel diagram analysis, the analysis results will be expressed according to the forest diagram, can get the final results in the review of many types of research, and then according to different types of research, delete the content of duplicate related reading topics. After reading the full text, if the content meets the inclusion criteria, it will show no significant difference between the effect of the control group and the pain effect of the experimental group, but the time of delivery is shorter than that of the control group, the pain intensity of TENS will decrease, thus shortening the labor time of each period.

Birds of a Feather Redux: Defining Ways to Stimulate the Peripheral Nervous System.

Peripheral nerve stimulation (PNS) has become an essential component in the pain management plan for individuals suffering from peripheral nerve-mediated pain. The recent surge in interest in PNS can be attributed to the advancements in imaging techniques and the availability of minimally invasive stimulation systems along with a deeper grasp of PNS physiology. These advancements have made PNS more accessible to clinicians and patients alike. However, it is important to note that PNS requires a different set of technical requirements and skills compared to other pain management procedures. The work, knowledge, and surgical and interventional skillset required for PNS are in a class of their own. This article aims to educate and clarify the differences between procedures that may have similar names but are vastly different in terms of technology, expertise, and skill sets necessary for their safe implementation. Some of the procedures that this article will cover include indirect peripheral nerve field stimulation (PNfS), indirect percutaneous electrical nerve stimulation (PENS), PENS-Field Stimulation (PENFS), and transcutaneous electrical nerve stimulation (TENS). By understanding the differences between these procedures, patients and health-care providers can make informed decisions about the best approach for managing pain.

Bibliometric and Visual Analysis of the Scientific Literature on Percutaneous Electrical Nerve Stimulation (PENS) for Pain Treatment

Background: Percutaneous electrical nerve stimulation (PENS) is a minimally invasive peripheral neuromodulation approach implemented against chronic neuropathic and mixed pain. This bibliometric study aims to quantitatively evaluate the output of PENS for pain treatment in the scientific literature. The main purpose is to stimulate research in the field and bridge potential scientific gaps. Methods: Articles were retrieved from the Web of Science (WOS) database. The search key term was “percutaneous electrical nerve stimulation (All Fields) and pain (All Fields)”. Year of publication, journal metrics (impact factor and quartile, Q), title, document type, topic, and citations were extracted. The join-point regression was implemented to assess differences in time points for the publication output. The software tool VOSviewer (version 1.6.17) was used for the visual analysis. Results: One thousand three hundred and eighteen articles were included in the knowledge visualization process. A linear upward trend for annual new publications was found. Almost two-thirds of the documents were published in top-ranked journals (Q1 and Q2). The topic “efficacy” was prevalent (12.81%). Concerning article type, the search strategy yielded 307 clinical investigations (23.3%). Articles were cited 36,610 times with a mean of 42.4 citations per article. Approximately one-half of the articles were cited less than 23 times in a range of 21 years. The semantic network analysis for keywords found eight clusters. The analysis of collaborative efforts among researchers showed five thematic clusters including 102 authors with a minimum of five documents produced in collaborations. Most partnerships involved the United States, England, and Germany. Conclusions: despite the upward trend in the number of publications on the subject and the publication of articles in top-ranked journals, there is a need to increase scientific collaborations between researchers and institutions from different countries.

An ultrasound-guided percutaneous electrical nerve stimulation regimen devised using finite element modeling promotes functional recovery after median nerve transection.

Percutaneous electrical nerve stimulation of an injured nerve can promote and accelerate peripheral nerve regeneration and improve function. When performing acupuncture and moxibustion, locating the injured nerve using ultrasound before percutaneous nerve stimulation can help prevent further injury to an already injured nerve. However, stimulation parameters have not been standardized. In this study, we constructed a multi-layer human forearm model using finite element modeling. Taking current density and activated function as optimization indicators, the optimal percutaneous nerve stimulation parameters were established. The optimal parameters were parallel placement located 3 cm apart with the injury site at the midpoint between the needles. To validate the efficacy of this regimen, we performed a randomized controlled trial in 23 patients with median nerve transection who underwent neurorrhaphy. Patients who received conventional rehabilitation combined with percutaneous electrical nerve stimulation experienced greater improvement in sensory function, motor function, and grip strength than those who received conventional rehabilitation combined with transcutaneous electrical nerve stimulation. These findings suggest that the percutaneous electrical nerve stimulation regimen established in this study can improve global median nerve function in patients with median nerve transection.

Effects of Percutaneous and Transcutaneous Electrical Nerve Stimulation on Endogenous Pain Mechanisms in Patients with Musculoskeletal Pain: A Systematic Review and Meta-Analysis.

The main aim was to determine the effects of percutaneous electrical nerve stimulation (PENS) and transcutaneous electrical nerve stimulation (TENS) on endogenous pain mechanisms in patients with musculoskeletal pain. A systematic review and meta-analysis. The search was conducted on March 1, 2022, in the EMBASE, CINAHL, PubMed, PEDro, Cochrane Library, Web of Science, Medline, and SCOPUS databases. Randomized controlled trials comparing the use of transcutaneous or percutaneous electrostimulation with a placebo, control group, or standard treatment in patients with musculoskeletal pain were included. Outcome measurements were quantitative sensory testing somatosensory variables like pressure pain threshold (PPT), conditioned pain modulation, and temporal summation of pain. The pooled data were evaluated in Review Manager 5.4. Twenty-four randomized controlled trials (n = 24) were included in the qualitative analysis and 23 in the meta-analysis. The immediate effects of PENS and TENS on local PPTs were significant, with a moderate effect size (standardized mean difference [SMD] 0.53; 95% confidence interval [CI]: 0.34 to 0.72; P < 0.00001). When only studies with a lower risk of bias were analyzed, the heterogeneity decreased from I2 = 58% (P < 0.00001) to I2 = 15% (P = 0.01), and a decrease in the overall effect was observed (SMD 0.33; 95% CI: 0.7 to 0.58). The short-term effects on local PPTs were not significant when compared with the control group (P = 0.13). The mid-term effects on local PPTs were significant, showing a large effect size (SMD 0.55; 95% CI: 0.9 to 1.00; P = 0.02). The immediate effects on conditioned pain modulation were significant, with a large effect size (SMD 0.94; 95% CI: 0.48 to 1.41; P < 0.0001). PENS and TENS have a mild-moderate immediate effect on local mechanical hyperalgesia in patients with musculoskeletal pain. It appears that these effects are not sustained over time. Analyses suggest an effect on central pain mechanisms producing a moderate increase in remote PPT, an increase in conditioned pain modulation, but further studies are needed to draw clearer conclusions.

Agreement between the visual analogue scale (VAS) and the dysfunctional voiding scoring system (DVSS) in the post-treatment evaluation of electrical nerve stimulation in children and adolescents with overactive bladder

Electrical nerve stimulation is one of the most commonly used and well-tolerated treatments for overactive bladder (OAB); however, different studies have used different instruments to assess patients' response to treatment. To analyze agreement between use of the visual analogue scale (VAS) and the Dysfunctional Voiding Scoring System (DVSS) for assessing improvement in urinary symptoms following electrical nerve stimulation treatment in children and adolescents with OAB. A cross-sectional analytical study including children and adolescents of 4-17 years of age diagnosed with OAB who underwent 20 sessions of transcutaneous (TENS) or percutaneous (PENS) electrical nerve stimulation. The DVSS and the VAS were used to assess daytime urinary symptoms before and following treatment. While the DVSS was always applied by a physician, the VAS was applied separately by a physiotherapist and then by a physician. Treatment was considered successful when the DVSS score was zero and the VAS score was ≥90%. Correlations between post-treatment VAS and DVSS scores were evaluated using the kappa coefficient. The VAS scores evaluated by the different professionals were compared for agreement using intraclass correlation and the Bland-Altman plot. Data from 49 cases were available for analysis. Of these, 27 (55.1%) were girls. Mean age was 7.1±2.6 years. There was agreement between the two instruments used, the DVSS and the VAS, in 36/49 patients (73.5%), with a moderate Kappa of 0.44. There was moderate agreement between the VAS scores applied by the two different professionals. imitations of the present study include the small sample size and the fact that the inter-observer evaluation was conducted following a single sequence, i.e. all the patients were first evaluated by the physiotherapist and then by the physician, which may have biased answers and the post-treatment VAS scores. Furthermore, although the child participated actively in completing the questionnaires, in cases of divergent answers, the questions were redirected to the responsible adult, and the final answer may not fully represent the patient's true situation. The present study found moderate agreement between the DVSS and the VAS, and moderate agreement between VAS scores when the instrument was applied by two different professionals. Although both tools appear to be important, and possibly complementary, a DVSS score of zero precludes the need to apply the VAS.

Effects of Ultrasound-Guided Nerve Stimulation Targeting Peripheral Nerve Tissue on Pain and Function: A Scoping Review.

This paper assesses the effects of percutaneous electrical nerve stimulation (PENS) on pain- and function-related outcomes by means of a scoping review of studies with single cases, case-series, quasi-experimental, and randomized or non-randomized trial designs. We consulted the PubMed, MEDLINE and EMBASE databases. Data were extracted by two reviewers. The methodological quality of studies was assessed using the Physiotherapy Evidence Database (PEDro) scale for experimental studies and the Joanna Briggs Institute (JBI) tool for case reports or cases series. Mapping of the results included: (1), description of included studies; (2), summary of results; and, (3), identification of gaps in the existing literature. Eighteen articles (five randomized controlled trials, one trial protocol, nine case series and three case reports) were included. The methodological quality of the papers was moderate to high. The conditions included in the studies were heterogeneous: chronic low back pain, lower limb pain after lumbar surgery, chronic post-amputation pain, rotator cuff repair, foot surgery, knee arthroplasty, knee pain, brachial plexus injury, elbow pain and ankle instability. In addition, one study included a healthy athletic population. Interventions were also highly heterogeneous in terms of sessions, electrical current parameters, or time of treatment. Most studies observed positive effects of PENS targeting nerve tissue against the control group; however, due to the heterogeneity in the populations, interventions, and follow-up periods, pooling analyses were not possible. Based on the available literature, PENS interventions targeting peripheral nerves might be considered as a potential therapeutic strategy for improving pain-related and functional outcomes. Nevertheless, further research considering important methodological quality issues (e.g., inclusion of control groups, larger sample sizes and comparatives between electric current parameters) are needed prior to recommending its use in clinical practice.

Novel Therapies for the Treatment of Neuropathic Pain: Potential and Pitfalls.

Neuropathic pain affects more than one million people across the globe. The quality of life of people suffering from neuropathic pain has been considerably declining due to the unavailability of appropriate therapeutics. Currently, available treatment options can only treat patients symptomatically, but they are associated with severe adverse side effects and the development of tolerance over prolonged use. In the past decade, researchers were able to gain a better understanding of the mechanisms involved in neuropathic pain; thus, continuous efforts are evident, aiming to develop novel interventions with better efficacy instead of symptomatic treatment. The current review discusses the latest interventional strategies used in the treatment and management of neuropathic pain. This review also provides insights into the present scenario of pain research, particularly various interventional techniques such as spinal cord stimulation, steroid injection, neural blockade, transcranial/epidural stimulation, deep brain stimulation, percutaneous electrical nerve stimulation, neuroablative procedures, opto/chemogenetics, gene therapy, etc. In a nutshell, most of the above techniques are at preclinical stage and facing difficulty in translation to clinical studies due to the non-availability of appropriate methodologies. Therefore, continuing research on these interventional strategies may help in the development of promising novel therapies that can improve the quality of life of patients suffering from neuropathic pain.

Updated review on overview of dry needling

Dry needling is a therapeutic method that involves inserting a filiform needle into a target area. Osteoarthritis is a degenerative joint disease that affects the articular cartilage, causes discomfort, and changes the biomechanics. ling is a component of conservative or comprehensive physiotherapeutic management. Increased blood flow, metabolic changes, spontaneous electrical activity, pain gating, and other mechanisms of action of dry needling may generate therapeutic advantages in osteoarthritis. The history of dry needling is extensively discussed. Needling can be defined as superficial or deep needling depending on the depth of the needle insertion, and it can also be classified as trigger point dry needling, fascial needling, scar tissue needling, and so on. The mechanism of Dry Needling is explained by a variety of ideas. The local effects of dry needling were also explored in this review, as well as the mechanism of analgesic effects. The needles can be utilized to provide therapeutic current to the tissues in a variety of ways. It can be done with PENS (Percutaneous Electrical Nerve Stimulation) or ETOIMS (Electro Transcutaneous Electrical Nerve Stimulation) (Electrical Twitch Obtaining Intramuscular Stimulation).

Percutaneous Versus Transcutaneous Electrical Nerve Stimulation for the Treatment of Musculoskeletal Pain. A Systematic Review and Meta-Analysis.

The justification for this review is the need for high-quality evidence to assist in the decision-making process when applying percutaneous electrical nerve stimulation (PENS) or transcutaneous electrical nerve stimulation (TENS) in a clinical setting. The main aim was to determine if the use of PENS is more effective and should be recommended when compared to TENS for the reduction of musculoskeletal pain intensity. A search for randomized controlled trials (RCTs) was performed. Studies published until 31/12/2020, comparing the effectiveness of PENS and TENS, were considered. The main outcome was pain assessed with a visual analog scale or numerical pain rating scale. Nine RCTs were included in the qualitative analysis, with seven of them in the quantitative analysis (n = 527). The overall effect of PENS on pain was statistically but not clinically superior to TENS (mean difference [MD]=-1.0 cm; 95% confidence interval [CI]: -1.5 to -0.4) with a high level of heterogeneity (I2=76%, P > .01). When only studies with a lower risk of bias (n = 3) were analyzed, the heterogeneity decreased to I = 0% (P = .06) and no difference was observed between TENS and PENS (MD=-0.81 cm; 95% CI:-1.6 to 0.02) with a moderate recommendation level according to GRADE. There were no data concerning adverse effects. There is low-quality of evidence for more pain intensity reduction with PENS, but the difference was not clinically significant. However, when only studies with low risk of bias are meta-analyzed, there is a moderate quality of evidence that there is no difference when TENS or PENS is applied for pain intensity.

The effect on handgrip strength of low-frequency percutaneous electric stimulation applied to the median and cubital nerves: A randomized, double-blind controlled trial.

Percutaneous electrical nerve stimulation (PENS) consists of applying an electric current of <1,000 Hz to different neuromuscular structures through acupuncture needles. Currently, there is controversy surrounding the effect of PENS on muscle strength in the scientific literature. The main objective was to assess the effect of PENS applied to the median and cubital nerves on the maximum handgrip strength (MHS) compared to sham stimulation, as well as to determine the safety of the intervention. A parallel, randomized, double-blind controlled trial in a sample of 20 healthy subjects. Participants were randomly allocated in the experimental (n=10) and control (n=10) groups. A blinded researcher measured MHS. Measurements of MHS of the dominant hand were taken at four time points: preintervention, immediately postintervention, 24 hr after the intervention, and at a 10-day follow-up. A 10-Hz percutaneous electrical current stimulation was employed. The control group also received the same puncture method but with no electric stimulation. Compared to baseline, the MHS decreased 10.4% (SEM=3.2, p=.02) in the PENS group at 24 hr postintervention, with no differences observed between baseline and at 10 days postintervention. No changes in grip strength were observed at any time point in the sham group. To sum up, PENS decreased MHS at 24 hr postintervention, which does not persist 10 days after the stimulation. PENS can be considered a safe technique. Trials with larger sample sizes are required to corroborate the findings of this study. Clinical Trials Registration: NCT, NCT04662229, filed on March 12th of 2020.

Nummular Headache Successfully Managed With Percutaneous Electrical Nerve Stimulation: A Case Report

Nummular Headache Successfully Managed With Percutaneous Electrical Nerve Stimulation: A Case Report

Percutaneous Electrical Nerve Stimulation (PENS) as a Rehabilitation Approach for Reducing Mixed Chronic Pain in Patients with Musculoskeletal Disorders

“Mixed pain” is a term recently introduced to define the overlapping of nociceptive, neuropathic and nociplastic pain. To date, it has been reported that pharmacological treatments might have a modest effectiveness on patients affected by mixed chronic pain, with detrimental consequences in terms of disability, physical function and health-related quality of life. In this scenario, Percutaneous Electrical Nerve Stimulation (PENS), a mini-invasive neuromodulation technique, has been recently suggested as a promising approach for the complex management of mixed pain in musculoskeletal disorders. Albeit PENS showed to be effective in reducing unspecified pain in several chronic pain conditions, there is still a lack of evidence in the literature about its role in the management of neuropathic or mixed pain not responsive to pharmacological treatments. Therefore, by the present scoping review, we portray the potential effects of PENS in the multidisciplinary and multidimensional management of mixed chronic pain in patients with musculoskeletal disorders.

Effectiveness of Dry Needling with Percutaneous Electrical Nerve Stimulation of High Frequency Versus Low Frequency in Patients with Myofascial Neck Pain

Percutaneous nerve electrical stimulation is a novel treatment modality for the management of acute and chronic myofascial pain syndrome. To compare the effectiveness of dry needling combined with percutaneous electrical nerve stimulation of low frequency versus high frequency, in patients with chronic myofascial neck pain. Randomized, single-blind trial. Laboratory in an academic institution. A total of 40 volunteer patients with chronic neck pain were randomly divided into 2 groups. All patients initially received deep dry needling in a myofascial trigger point of the upper trapezius. Then, one group received high frequency percutaneous electrical nerve stimulation while the other group received low frequency percutaneous electrical nerve stimulation. The primary outcomes were the visual analog scale and the pressure pain threshold, while Neck Disability Index and Kinesiophobia were secondary outcomes. We detected significant improvements in the visual analog scale score in both groups without differences between them. We did not observe significantly different statistics in either group during the evaluation of data on pressure pain threshold. Limitations of the study include (1) heterogeneity of the sample in relation to gender, with more women, (2) the small sample size (40 patients), (3) the absence of placebo group, and (4) the fact that the treatment is focused exclusively on the upper trapezium myofascial trigger point. . Low and high frequency percutaneous electrical nerve stimulation combined with deep dry needling showed similar effects, since no differences between groups were observed on any of the outcome measures. High and low frequency of percutaneous electrical nerve stimulation generates changes on pain intensity and disability, but not on pressure pain threshold or fear of movement.

Effects of Percutaneous Electrical Nerve Stimulation on Countermovement Jump and Squat Performance Speed in Male Soccer Players: A Pilot Randomized Clinical Trial.

It has been suggested that Percutaneous Electrical Nerve Stimulation (PENS) can increase muscle strength. No previous study has investigated changes in performance in semiprofessional soccer players. This study compares the effects of adding two sessions of PENS to a training program versus the single training program over sport performance attributes (e.g., jump height and squat speed) in healthy soccer players. A cluster-randomized controlled trial was conducted on twenty-three semiprofessional soccer players who were randomized into an experimental (PENS + training program) or control (single training program) group. The training program consisted of endurance and strength exercises separated by 15-min recovery period, three times/week. The experimental group received two single sessions of PENS one-week apart. Flight time and vertical jump height during the countermovement jump and squat performance speed were assessed before and after each session, and 30 days after the last session. Male soccer players receiving the PENS intervention before the training session experienced greater increases in the flight time, and therefore, in vertical jump height, after both sessions, but not one month after than those who did not receive the PENS intervention (F = 4.289, p = 0.003, η 2 p: 0.170). Similarly, soccer players receiving the PENS intervention experienced a greater increase in the squat performance speed after the second session, but not after the first session or one month after (F = 7.947, p < 0.001, η 2 p: 0.275). Adding two sessions of ultrasound-guided PENS before a training strength program improves countermovement jump and squat performance speed in soccer players.