Transcutaneous Electrical Acupuncture Research Articles

Central and Peripheral Effects of Transcutaneous Acupuncture Treatment for Nausea in Patients With Diabetic Gastroparesis

Background/Aims Nausea, an unpleasant symptom of diabetic gastroparesis (DMGP), has been reported to be alleviated by needleless transcutaneous electrical acupuncture (TEA). Our study was designed to utilize electroencephalography (EEG) and electrogastrography (EGG) recordings to investigate the central and peripheral responses of TEA in the treatment of nausea in DMGP patients. Methods Eleven DMGP subjects underwent simultaneous EEG and EGG testing while grading the severity of nausea following 30-minute intervals of: (1) baseline, (2) visual stimulation (VS) to provoke more nausea, (3) active VS together with TEA, and (4) TEA alone, and a final 15-minute recording without any intervention. Results The nausea score was increased to 5.9 ± 1.5 with VS (P < 0.05, vs 3.5 ± 1.0 at baseline), then reduced to 3.5 ± 1.2 with VS plus TEA, and to 2.5 ± 1.3 with TEA alone, while it continued at a score of 2.9 ± 1.0 post TEA (all significant, P < 0.05, vs VS without TEA). The mean percentage of normal gastric slow waves was decreased to 60.0 ± 5.7% with VS (P < 0.05, vs 66.6 ± 4.5% at baseline), then improved to 69.2 ± 4.8% with VS plus TEA, and maintained at 70 ± 3.6% with TEA alone. During initial VS, EEG signals showed right inferior frontal activity as the prominent finding, but during VS with TEA, left inferior frontal activity predominated. Conclusions In DMGP, TEA improves gastric dysrhythmia and ameliorates nausea. TEA treatment of nausea provoked by VS resulted in a change of dominance from right to left inferior frontal lobe activity. These data provide new understandings of peripheral and central mechanisms for nausea, and potential future directions for DMGP treatment approaches.

Comparison of the effectiveness between transcutaneous electrical nerve stimulation, manual acupuncture, and electroacupuncture on tinnitus: study protocol for a randomized controlled trial

BackgroundTranscutaneous electrical nerve stimulation (TENS) involves a neuromodulatory effect using electrical stimulation and has been widely used due to its safety and convenience. It has been used for treating tinnitus for decades. Acupuncture has also been used for tinnitus and several research studies have shown that acupuncture can improve a certain kind of tinnitus by stimulating the somatosensory system. Moreover, several studies have shown the efficacy of electroacupuncture, which is a combination of acupuncture and electrical stimulation, for tinnitus. However, the comparative effectiveness of TENS, manual acupuncture, and electroacupuncture for the treatment of tinnitus has not been determined previously. Herein, we design a randomized, non-blind clinical trial to investigate and compare the effects and safety of TENS, manual acupuncture, and electroacupuncture for tinnitus.MethodsAfter screening, 45 patients are randomly assigned to three groups: (1) patients in the TENS group are treated at four sites (tender points of masseter and the sternocleidomastoid muscle, in front of tragus, and mastoid process); (2) the manual acupuncture group patients are treated at 11 acupoints (TE21, SI19, GB2, TE22, ST7, TE17, GB20 of tinnitus affected side, and GB20, TE05, KI3 of both sides); (3) electroacupuncture group patients are treated by using acupuncture as in the manual acupuncture group and electrical stimulation at TE21, SI19, TE17, and GB20. Patients are treated for ten sessions, twice a week. The primary outcome measurement is the change of Tinnitus Handicap Inventory (THI) score between visit 1 and visit 10. The secondary outcome measurements are the response rate of THI, change in visual analogue scale associated with the loudness and annoyance of tinnitus, pure-tone audiometry and speech discrimination, and changes in parameters of heart rate variability.DiscussionThe purpose of this study is to compare the effect of TENS, manual acupuncture, and electroacupuncture in the auricular area on tinnitus. If the specific treatment shows a significant effect compared to other treatments, it could have potential for use in clinical practice as a primary treatment.Trial registrationClinical Research Information Service (CRIS), KCT0002117. Registered October 21, 2016. Retrospectively registered.

Central and Peripheral Effects of Transcutaneous Acupuncture Treatment for Nausea in Patients with Diabetic Gastroparesis

Background/AimsNausea, an unpleasant symptom of diabetic gastroparesis (DMGP), has been reported to be alleviated by needleless transcutaneous electrical acupuncture (TEA). Our study was designed to utilize electroencephalography (EEG) and electrogastrography (EGG) recordings to investigate the central and peripheral responses of TEA in the treatment of nausea in DMGP patients.MethodsEleven DMGP subjects underwent simultaneous EEG and EGG testing while grading the severity of nausea following 30-minute intervals of: (1) baseline, (2) visual stimulation (VS) to provoke more nausea, (3) active VS together with TEA, and (4) TEA alone, and a final 15-minute recording without any intervention.ResultsThe nausea score was increased to 5.9 ± 1.5 with VS (P < 0.05, vs 3.5 ± 1.0 at baseline), then reduced to 3.5 ± 1.2 with VS plus TEA, and to 2.5 ± 1.3 with TEA alone, while it continued at a score of 2.9 ± 1.0 post TEA (all significant, P < 0.05, vs VS without TEA). The mean percentage of normal gastric slow waves was decreased to 60.0 ± 5.7% with VS (P < 0.05, vs 66.6 ± 4.5% at baseline), then improved to 69.2 ± 4.8% with VS plus TEA, and maintained at 70 ± 3.6% with TEA alone. During initial VS, EEG signals showed right inferior frontal activity as the prominent finding, but during VS with TEA, left inferior frontal activity predominated.ConclusionsIn DMGP, TEA improves gastric dysrhythmia and ameliorates nausea. TEA treatment of nausea provoked by VS resulted in a change of dominance from right to left inferior frontal lobe activity. These data provide new understandings of peripheral and central mechanisms for nausea, and potential future directions for DMGP treatment approaches.

BokSmart: Preventive rehabilitation for rugby injuries to the lower back and core

Background. The low back is an integral part of the entire movement chain as it functions as part of a complex network of the skeletal, muscular and nervous system. Eighty to 90% of acute low back pain episodes dissipate within 8 - 12 weeks regardless of any intervention, but 5 - 10% regress into chronic low back pain. As a result of its undistinguished aetiology, the treatment for low back pain remains controversial. Treatment options for low back pain include the following: analgesics, muscle relaxants, antidepressants, nonsteroidal anti-inflammatory drugs, epidural steroid injections, manipulation, back schools, electromyographic biofeedback, traction, orthoses, behaviour therapy, transcutaneous electrical nerve stimulation, acupuncture, and exercise therapy. Results. Therapeutic exercises for low back pain have been shown in 6 different randomised controlled trials to be beneficial in reducing pain by up to 60% and improving functional ability by up to 47%. Furthermore, a Cochrane review on low back pain found strong evidence that exercise therapy is an effective intervention in the treatment of low back pain. When prescribing exercises for an individual with low back pain the following goals need to be considered: (i) improve performance in endurance activities; (ii) improve muscular strength around the spine; (iii) eliminate any impairments in spinal flexibility; (iv) reduce the intensity of the pain being experienced by the individual; and (v) reduce back pain-related disability. A rugby player will have increased core stability/strength and a reduced risk of injury if the internal support mechanisms of the spine have been conditioned to resist distortion or injury from external forces. Not only will improved core stability benefit players on the field during matches or practices, it will also assist in preventing unnecessary injuries during weight training and pre-season conditioning. Conclusion. Exercise programmes which combine core stability with general strength training should be prescribed for rugby players to prepare them for the level of impact involved in the game, as well as for sport-related weight training and non-sport-related daily activities.

BokSmart: Preventive rehabilitation for rugby injuries to the lower back and core

Background. The low back is an integral part of the entire movement chain as it functions as part of a complex network of the skeletal, muscular and nervous system. Eighty to 90% of acute low back pain episodes dissipate within 8 - 12 weeks regardless of any intervention, but 5 - 10% regress into chronic low back pain. As a result of its undistinguished aetiology, the treatment for low back pain remains controversial. Treatment options for low back pain include the following: analgesics, muscle relaxants, antidepressants, nonsteroidal anti-inflammatory drugs, epidural steroid injections, manipulation, back schools, electromyographic biofeedback, traction, orthoses, behaviour therapy, transcutaneous electrical nerve stimulation, acupuncture, and exercise therapy. Results. Therapeutic exercises for low back pain have been shown in 6 different randomised controlled trials to be beneficial in reducing pain by up to 60% and improving functional ability by up to 47%. Furthermore, a Cochrane review on low back pain found strong evidence that exercise therapy is an effective intervention in the treatment of low back pain. When prescribing exercises for an individual with low back pain the following goals need to be considered: (i) improve performance in endurance activities; (ii) improve muscular strength around the spine; (iii) eliminate any impairments in spinal flexibility; (iv) reduce the intensity of the pain being experienced by the individual; and (v) reduce back pain-related disability. A rugby player will have increased core stability/strength and a reduced risk of injury if the internal support mechanisms of the spine have been conditioned to resist distortion or injury from external forces. Not only will improved core stability benefit players on the field during matches or practices, it will also assist in preventing unnecessary injuries during weight training and pre-season conditioning. Conclusion. Exercise programmes which combine core stability with general strength training should be prescribed for rugby players to prepare them for the level of impact involved in the game, as well as for sport-related weight training and non-sport-related daily activities.

Managing Pain—the Canadian Healthcare Professional's Reference, 2nd Edition

Managing Pain—the Canadian Healthcare Professional's Reference, 2nd Edition

Timeliness of TENS

To the Editor: I would like to commend the authors of “Effect of Transcutaneous Electrical Nerve Stimulation on Human Blood β-Endorphin Levels,” for their ambitious undertaking.1 It is necessary that studies like this one be undertaken. It is unfortunate, however, that the plethora of transcutaneous electrical nerve stimulation (TENS) and acupuncture literature was largely ignored by the authors and the study suffered for it. As a professor of electrotherapy, I come across very little literature suggesting that conventional TENS works at all through an endorphin-mediated pain pathway.2 Nor has this claim been made regarding low-rate TENS in general. Rather, strong, low-rate2 or acupuncture-like TENS has been hypothesized to work in this manner.3,4 Unfortunately, by ignoring this important distinction, the authors have emerged with a less than valuable study. The operative word in strong, low-rate is “strong.”… [ ARTICLE][1] [1]: /lookup/volpage/64/1367?iss=9

Transcutaneous electrical nerve stimulation (TENS) and acupuncture: comparison of therapy for low-back pain

Transcutaneous electrical nerve stimulation (TENS) and acupuncture: comparison of therapy for low-back pain