Application Of Transcutaneous Electrical Nerve Stimulation Research Articles

Temporal Variability in Stride Kinematics during the Application of TENS: A Machine Learning Analysis.

The purpose of our report was to use a Random Forest classification approach to predict the association between transcutaneous electrical nerve stimulation (TENS) and walking kinematics at the stride level when middle-aged and older adults performed the 6-min test of walking endurance. Data from 41 participants (aged 64.6 ± 9.7 years) acquired in two previously published studies were analyzed with a Random Forest algorithm that focused on upper and lower limb, lumbar, and trunk kinematics. The four most predictive kinematic features were identified and utilized in separate models to distinguish between three walking conditions: burst TENS, continuous TENS, and control. SHAP analysis and linear mixed models were used to characterize the differences among these conditions. Modulation of four key kinematic features - toe-out angle, toe-off angle, and lumbar range of motion (ROM) in coronal and sagittal planes - accurately predicted walking conditions for the burst (82% accuracy) and continuous (77% accuracy) TENS conditions compared with control. Linear mixed models detected a significant difference in lumbar sagittal ROM between the TENS conditions. SHAP analysis revealed that burst TENS was positively associated with greater lumbar coronal ROM, smaller toe-off angle, and less lumbar sagittal ROM. Conversely, continuous TENS was associated with less lumbar coronal ROM and greater lumbar sagittal ROM. Our approach identified four kinematic features at the stride level that could distinguish between the three walking conditions. These distinctions were not evident in average values across strides.

The Effects Of Transcutaneous Electrical Nerve Stimulation Applied in the Early Postpartum Period After Cesarean Birth on Healing, Pain, and Comfort.

This study was conducted to determine the effects of transcutaneous electrical nerve stimulation (TENS) applied in the early postpartum period after cesarean birth on incision site healing, postoperative recovery, pain, and comfort. This randomized, single-blind, placebo-controlled study was conducted with 138 women (TENS group n = 46, placebo group n = 46, control group n = 46) who gave birth by cesarean between January and September 2023. TENS was applied twice at a frequency of 100 Hz with a pulse width of 100 microseconds, at 10 to 12 and 14 to 16 hours after birth, for 30 minutes each. Outcomes were measured with the Postoperative Recovery Index; Redness, Edema, Ecchymosis, Discharge, and Approximation Scale; Visual Analogue Scale; and Postpartum Comfort Questionnaire. Outcomes between groups were compared postintervention, correcting for baseline using analysis of covariance. The study was registered at www. gov (NCT05991921). Mean scores for postoperative recovery were significantly lower (improved) in the TENS group (113.58) compared with the placebo and control groups (134.67, 136.61; P <.001). The postoperative recovery subscales (psychological symptoms, physical activities, appetite symptoms, bowel symptoms, general symptoms) were also significantly decreased in the TENS group compared with the placebo and control groups. Similarly, mean scores for postpartum comfort, and the corresponding physical comfort, psychospiritual comfort, and sociocultural comfort subscales, were significantly improved in the TENS group (110.26) compared with the placebo and control group (83.80, 81.19; P <.05). TENS application can be preferred as an alternative method to increase pain control, recovery, and patient comfort after cesarean birth.

Duration of the preemptive analgesic effects of low- and high-frequency transcutaneous electrical nerve stimulation in rats with acute inflammatory pain.

Transcutaneous electrical nerve stimulation (TENS) activates various pathways to induce antinociceptive effects, based on the frequencies used. This study evaluates the preemptive analgesic effects and their duration of low- (LT: 4 Hz) and high-frequency TENS (HT: 100 Hz) using a rat model of acute inflammatory pain. Acute inflammation was induced by injecting 1% formalin into the hind paws of rats. LT or HT was applied for 30 min before formalin injection. Pain-related behaviors, such as licking, flinching, and lifting, were recorded for 60 min postinjection. Immunohistochemistry was used to assess the number of phosphorylated extracellular signal-regulated kinase (pERK)- and c-fos-positive cells in the spinal cord. Naloxone, a μ-opioid receptors (MORs) antagonist, and naltrindole, a δ-opioid receptors (DORs) antagonist, were administered before TENS application. Pain behavior duration and pERK- and c-fos-positive cell expression were then measured. LT and HT pretreatment significantly reduced both pain behaviors and the number of pERK- and c-fos-positive cells postformalin injection. Naloxone and naltrindole partially reversed the effects of LT and HT, respectively. Notably, HT's analgesic effect lasted up to 120 min whereas that of LT persisted for 90 min. LT and HT effectively exerted their preemptive analgesic effects on acute inflammatory pain by inhibiting pERK and c-fos expression in the spinal cord. HT presented a longer-lasting effect compared to LT. MOR and DOR activation may contribute to LT and HT's analgesic mechanisms, respectively.

Evaluation of Pain Perception During Orthodontic Debonding of Metallic Brackets with Simultaneous Application of TENS Therapy.

The objective of the present study was to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on pain during the debonding procedure. A placebo-controlled, randomized split - mouth study was conducted on 30 orthodontic patients. The right and left anterior teeth in the maxilla and mandible were randomly allocated to the control and experimental groups (EG) and were stimulated. TENS application was made through a modified electrode probe that was used from an ammeter. The control group (CG) received the mechanical application of the device with no current, whereas the EG received progressively increasing current from 0.1 mA to the point where the patient experienced a mild tingling sensation for 60 s for each tooth. This was followed by a debonding procedure using an orthodontic debonding plier. Pain perception was recorded on a numerical rating scale after debonding each tooth. The mean pain score was higher in the CG than in the EG, and the difference between the two groups was significant (p=0.001). The pain score was higher in the mandibular teeth than in the maxillary teeth, and the difference between the two groups was also significant (p=0.021). Pain score was higher in female subjects than in male subjects, and the difference between the two groups was significant (p=0.015). The application of TENS therapy results in pain reduction during the debonding procedure. The female subjects experienced more pain. Higher pain scores were recorded for the mandibular anterior teeth than for the maxillary teeth.

Comparison of the efficiency of transcutaneous electrical nerve stimulation and manual therapy in children with cerebral palsy with lower urinary system dysfunction- a randomized prospective trial

Neurological defects in children with cerebral palsy (CP) not only affect their motor skills but also lead to bladder and bowel problems. Although most children with CP have achieved urinary control, more than 50% of cases experience lower urinary tract symptoms (LUTS). Common LUTS complaints observed in CP include delayed toilet training, urinary incontinence, increased frequency of urination, urgency, urinary hesitancy, and recurrent urinary tract infections. This study aimed to prospectively evaluate and compare the effectiveness of two different physiotherapy approaches, sacral Transcutaneous Electrical Nerve Stimulation (TENS) and massage, on lower urinary tract dysfunction in children with CP. A total of 54 children with CP who had the Dysfunctional Voiding Scoring System (DVISS) of 8.5 or higher were included in the study. Children were randomized to the TENS (TG; n=27) and Manual Therapy (MG; n=27) groups. TENS application was performed 2 sessions in a week for 20min for a total of 12 weeks. The electrodes used during the application were adhered bilaterally to the parasacral region (S2-S4). 4 electrodes of 5×5cm were used. Classical bowel massage was applied to the MG with the friction massage technique twice a week for 12 weeks. Manual therapy applications were performed in the form of abdominal, colon, and friction massage, twice a week for 20min by the physiotherapist. Massage was applied to the abdominal region between the lower subcostal border and the anterior superior iliac spine. Questionnaires were applied before and after treatment interventions: DVISS, functional bladder capacity (FBC), frequency of voiding, and urinary incontinence episodes evaluated by bladder diary, Bristol Gaita Scale, and Pediatric Incontinence Quality of Life Scale (PIN-Q) used. The decrease in the episodes of incontinence was higher in the TG (p=0.037; p<0.05). FBC increased after treatment in both groups, but there was no statistically significant difference between the groups (p=0.683; p>0.05). Manual therapy was more effective in improving constipation symptoms. In both groups, DVISS and PIN-Q values decreased after treatment, but the decrease in TG was statistically significant in the evaluation made between groups (p=0.001; p<0.01). Both parasacral TENS and massage provided a significant improvement in LUTS, constipation, and quality of life but TENS showed a bigger improvement. We suggest adding these interventions to the treatment of bladder and bowel problems in CP children.

Effect of cold application versus transcutaneous nerve stimulation on chemotherapy induced diabetic peripheral neuropathy post mastectomy.

The adverse effects of chemotherapy-induced diabetic peripheral neuropathy (CIDPN) are rather prevalent. There is no known pharmaceutical treatment that can stop CIDPN. This study compared the effects of cold application and transcutaneous nerve stimulation (Transcutaneous electrical nerve stimulation (TENS)) on individuals who had undergone mastectomy following CIDPN. Between Mars 2021 and September 2021, a randomised controlled experiment was carried out at physical therapy clinics at the Modern University for Technology and Information. 30 patients were randomly split into two equal groups (A and B). Both lower limbs received cold application (Group A) three times per week for 12 weeks and TENS application (Group B) three times each week for 12 weeks. The Visual Analogue Scale and nerve conduction velocity for the sural nerve were used to assess patients before and after 12 weeks of therapy. The results showed that Group A significantly (p<0.05) decreased pain intensity after treatment by 70.83% compared with Group B by 55.17%. Moreover, Group A improved significantly (p<0.05) the sural nerve amplitude by 44.12% compared with group B which recorded 26.87%. After treatment, both pain intensity and sural nerve amplitude significantly (p<0.05) changed between Group A versus Group B. Cold application has a better effect on pain in CIDPN post mastectomy.

Change in Pain Perception and TENS Pulse Amplitude, and Progression in Aerobic and Resistance Exercises over a Series of Ten-session Rehabilitation for Anterior Knee Pain

OBJECTIVES The purpose of this study was to report changes in pain perception and the transcutaneous electrical nerve stimulation (TENS) pulse amplitude, and progressions in aerobic and resistance exercise at each session during a ten-session rehabilitation programme for patients with anterior knee pain.METHODS Eleven patients with anterior knee pain (4 females and 7 males: 20.8 ± 2.8 years, 169.7 ± 8.1 cm, 72.9 ± 25.0 kg, painful duration: 51.3 ± 42.0 months, Kujala anterior knee pain scale: 73.4 out of 100) participated in the rehabilitation programme. Each session of rehabilitation consisted of a 30-min simultaneous application of TENS and focal knee joint cooling, followed by a 30-min of therapeutic exercises (aerobic, flexibility, and strengthening exercise). Pain perception (using a 10-cm visual analogue scale) before and after each session, transcutaneous electrical nerve stimulation pulse amplitude (mA), treadmill jogging speed (km/h), and external load during resistance exercises (knee extensions, squats, and lunges in kg/kg) at each session were recorded.RESULTS Overall pain perception was reduced (49%, &lt;i&gt;p&lt;/i&gt;=0.0008) and the TENS pulse amplitude was increased (20%, &lt;i&gt;p&lt;/i&gt;=0.002) at the fourth session. The jogging speed increased at the third (9%, &lt;i&gt;p&lt;/i&gt;=0.008), fifth (7%, &lt;i&gt;p&lt;/i&gt;=0.03), and ninth (9%, &lt;i&gt;p&lt;/i&gt;=0.0007) session. External loads in resistance exercises were increased every session that the total improvement was 98% in lunges (&lt;i&gt;p&lt;/i&gt;&lt;0.0001), 95% in knee extensions (&lt;i&gt;p&lt;/i&gt;&lt;0.007), 105% in squats (&lt;i&gt;p&lt;/i&gt;&lt;0.0001).CONCLUSIONS The observed changes and progressions could be used as general guidelines for the establishment and implementation of a short-term conservative treatment of anterior knee pain.

Influence of transcutaneous electrical nerve stimulation on walking kinematics and standing balance of older adults who differ in walking speed.

The purpose was to determine the impact of transcutaneous electrical nerve stimulation (TENS) on measures of walking kinematics and standing balance of healthy older adults who were stratified into two groups based on differences in the distance walked during the 6-min test of walking endurance. Regression models were developed to explain the variance in the 6-min distance and to assess the predictive power of balance metrics to categorize the 26 older adults (72 ± 5.4 yrs) as either slow or fast walkers. Walking kinematics were measured during 6- and 2-min walk tests that were performed with and without the concurrent application of TENS to the hip flexor and ankle dorsiflexor muscles. Participants walked briskly during the 6-min test and at a preferred pace during the 2-min test. The supplementary sensory stimulation provided by TENS did not alter the power of the models to explain the variance in the Baseline 6-min distance: Baseline, R2 = 0.85; TENS, R2 = 0.83. In contrast, TENS improved the explanatory power of the data obtained during the 2-min walk to account for the variance in the Baseline 6-min distance: no TENS, R2 = 0.40; TENS, R2 = 0.64. Logistic regression models based on force-plate and kinematic data obtained during the balance tasks were able to discriminate between the two groups with excellent certainty. The impact of TENS was greatest when older adults walked at a preferred speed but not when they walked at a brisk pace or performed tests of standing balance.

The Effects of Electrode Placement on Analgesia Using Transcutaneous Electrical Nerve Stimulation for Primary Dysmenorrhea: A Single-Blind Randomized Controlled Clinical Trial.

Background Primary dysmenorrhea (PD) refers to the occurrence of painful menstrual crampswithout pathological involvement of the pelvic organs, with considerable morbidity and high prevalence among females of reproductive age. Objective The objective of this study is to present and test the efficacy of an innovative method of interactive transcutaneous electrical nerve stimulation (iTENS) for PD. Methods and materials This study is a single-blind controlled clinical trial. This was conducted at the outpatient clinic of the faculty of physical therapy. Females with PD (n=124) were divided into the treated group (transcutaneous electrical nerve stimulation {TENS} group {TG}, n=62) and the placebo group (PG, n=62). A single session of either iTENS or placebo intervention was used for 35 minutes. Pain, the duration of analgesia, and the use of pain medication were assessed before and after the intervention. Data from before and after the treatment were compared between groups (Student's t-test). The level of significance was set at 5%. Results A significant decrease in pain (p<0.001) was observed after the intervention for the TG, with a more long-lasting analgesia (p<0.001) and decreased need for pain medication (p<0.001). Conclusions The proposed method of transcutaneous electrical nerve stimulation (TENS) application showed positive results for pain management on females with PD, with no reported adverse effects. The new proposed TENS application takes into account the preferences of the patient regarding positioning and the number of channels needed to cause analgesia. This application was able to promote almost complete analgesia in females with primary dysmenorrhea, and the analgesia persisted for more than one menstrual cycle.

A new use of transcutaneous electrical nerve stimulation: Role of bioelectric technology in resistant hypertension (Review).

Hypertension is an important risk factor for cardiovascular and cerebrovascular disease-associated death. Hypertension and its complications are the main problems that have an impact on public health at present. A portion of adults with hypertension fail to meet the recommended blood pressure (BP) treatment goals, despite strict clinical management. Those individuals requiring at least three types of antihypertensive drugs to achieve their BP goal may be classified as patients with resistant hypertension (RH). Bioelectric technology is an emerging method that functions with the help of the human body's own bioelectric system. It is widely used in auxiliary examination, pain relief and organ function rehabilitation. Bioelectrical technology, as an effective treatment for RH, has developed rapidly in recent years and mainly includes renal sympathetic denervation, carotid baroreflex activation therapy, Traditional Chinese Medicine electroacupuncture and transcutaneous electrical nerve stimulation (TENS). The present review describes the pathogenesis of hypertension and provides an understanding of bioelectrical technology as a treatment. In particular, the development of the application of TENS in RH is introduced. The aim is to provide a basis for the clinical treatment of RH and a new idea for further clinical trials in this field.

The dose-dependent effects of transcutaneous electrical nerve stimulation for pain relief in individuals with fibromyalgia: a systematic review and meta-analysis.

Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological modality widely used to manage pain; however, its effectiveness for individuals with fibromyalgia (FM) has been questioned. In previous studies and systematic reviews, variables related to dose of TENS application have not been considered. The objectives of this meta-analysis were (1) to determine the effect of TENS on pain in individuals with FM and (2) determine the dose-dependent effect of TENS dose parameters on pain relief in individuals with FM. We searched the PubMed, PEDro, Cochrane, and EMBASE databases for relevant manuscripts. Data were extracted from 11 of the 1575 studies. The quality of the studies was assessed using the PEDro scale and RoB-2 assessment. This meta-analysis was performed using a random-effects model that, when not considering the TENS dosage applied, showed that the treatment had no overall effect on pain (d+ = 0.51, P > 0.050, k = 14). However, the moderator analyses, which were performed assuming a mixed-effect model, revealed that 3 of the categorical variables were significantly associated with effect sizes: the number of sessions ( P = 0.005), the frequency ( P = 0.014), and the intensity ( P = 0.047). The electrode placement was not significantly associated with any effect sizes. Thus, there is evidence that TENS can effectively reduce pain in individuals with FM when applied at high or at mixed frequencies, a high intensity, or in long-term interventions involving 10 or more sessions. This review protocol was registered at PROSPERO (CRD42021252113).

Effects of Transcutaneous Electrical Nerve Stimulation on Chronic Pelvic Pain in Women: A Systematic Review and Meta-Analysis

Introduction: The study aimed to identify the effects of transcutaneous electrical nerve stimulation (TENS) in women with chronic pelvic pain (CPP) by conducting a systematic review and meta-analysis of randomized controlled trials. Methods: We used five international databases from 2000 to 2020 and selected the clinical trials that reported the effects of TENS on CPP. We excluded the case reports, acute pelvic pain reports, men-related, animal-related, and intravaginal and intrarectal electrical stimulation articles. The level of pain (based on the visual analog scale) was considered for pooling data through the meta-analysis. Results: Ten studies met the inclusion criteria, and three articles were included in the meta-analysis. The results showed that TENS application mildly reduced pain in women with primary dysmenorrhea (mean difference = −1.29; 95% CI: −2.57 to −0.01; Z = 1.98, p = 0.05). Also, to reduce pain in patients with CPP, the TENS must be applied at least for 20 min, with a pulse duration of 50–400 μs, at a frequency of 2–120 Hz. The meta-analysis was followed by assessing the risk of bias, including publication bias. Based on the Cochrane risk of bias evaluation, the majority of the included trials were assessed with moderate methodological quality. Conclusion: TENS application can mildly improve the level of pain in patients with CPP caused by primary dysmenorrhea. Although no distinct agreement was observed among the effective parameters, the high-frequency mode with maximum tolerated intensity was more effective compared to the low-frequency mode.

The influence of the low-frequency transcutaneous electrical nerve stimulation application moment in vocal quality of dysphonic women

Objective: to compare the immediate effects of low-frequency TENS employment on vocal quality in women with behavioral dysphonia before and after vocal exercises. Methodology: 30 women (mean = 31.3 years old), diagnosed with behavioral dysphonia received low-frequency TENS before (TENS + VE Group) and after vocal exercises (VE + TENS Group) with a 1-week washout. They had their sustained vowel/a/and running speech recorded before and after each procedure for auditory-perceptual analysis and acoustic measures. The low-frequency TENS parameters applied were symmetrical biphasic quadratic pulse, 200 µs phase, 10 Hz frequency, intensity on the motor threshold, and the electrodes were positioned on the submandibular and superior fibers of the trapezius muscle region. The vocal exercises: tongue trill, humming, finger kazoo, and water resistance therapy were performed totalizing 20 min. Results: intragroup analysis of sustained vowel/a/showed reduction in both groups of strain parameter and increased the breathiness; only VE + TENS Group increased the instability parameter, decreased fundamental frequency, and increased in SPI values; the running speech analysis showed an increase in the overall degree, roughness, and breathiness parameters. However, in VE + TENS Group, there was a statistically significant decrease in the intensity of the strain and an increase in breathiness. The acoustic measures showed that VE + TENS Group had a higher variation than TENS + VE Group regarding NHR. Conclusion: vocal exercises followed by low-frequency TENS have more immediate positive effects on voice quality than the low-frequency TENS followed by vocal exercises. This is a preliminary immediate effects study, and these effects could be verified through long-term assessments.

Can Vocal Therapy With Transcutaneous Electrical Nerve Stimulation (TENS) Followed by Vocal Exercises Reduce Benign Laryngeal Lesions in Dysphonic Women?: Randomized, Blind Clinical Trial

To investigate the effectiveness of vocal therapy with the use of low-frequency transcutaneous electrical nerve stimulation (TENS) followed by voice exercises on vocal fold lesion size, vocal quality and quality of life in dysphonic women. 27 women with vocal nodules participated, randomized into to: experimental group (EG)-13 women who received vocal therapy with 12 sessions of 20 min of TENS application (pulse:200μs, frequency:10Hz, motor threshold intensity, electrodes positioned in the trapezius muscle [descending fibers and submandibular region, bilaterally]). Each TENS session was followed by 30 min of vocal exercises; and the Control Group (CG)- 14 women who received 12 sessions with 20 min of application of placebo TENS (same conditions EG, but without receiving the stimulus electric), followed by 30 min of vocal exercise. Before, immediately after and one month after vocal therapy, participants underwent vocal recording for acoustic analysis, vocal self-assessment, laryngological examination and answered voice-related quality of life (V-RQOL) protocol. There was reduction in the size of vocal fold lesions only in the EG, immediately after treatment and one month after treatment. Acoustic analysis showed decreases in SPI values immediately after and one month after treatment in both groups. There was improvement in voice self-perception in both groups after treatment and one month after, but no significant difference in V-RQOL values. TENS followed by vocal exercises produced results similar to vocal therapy without TENS regarding voice quality, self-perception and quality of life in voice. However, vocal therapy with low-frequency TENS followed by vocal exercise was effective in reducing vocal fold lesion size in dysphonic women.

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.

Transcutaneous electrical neurostimulation relieves primary dysmenorrhea: A randomized, double-blind clinical study versus placebo.

This randomized, crossover, double-blind, controlled trial evaluates the efficacy and safety of a preprogrammed transcutaneous electrical nerve stimulation (TENS) device versus placebo (SHAM) in women with primary dysmenorrhea (PD). Forty women suffering from significant dysmenorrhea requiring the use of analgesics and/or non-steroidal anti-inflammatory drugs self-apply to the abdominal or lumbar region depending on the location of the pain, alternately according to randomization, the TENS device then the SHAM (dummy device) or conversely SHAM then TENS. The primary endpoint compares the evolution of pain intensity before and after application of TENS and SHAM. The speed of action, the persistence of the analgesic effect and the therapeutic savings are also evaluated. Adverse events (AEs) are collected. A statistically and clinically significant decrease in the pain of 53% (P<0.0001) is observed during the first 2 applications of TENS versus no analgesic effect (-5%, P=0.318) with SHAM. Over all 197 applications of TENS, the reduction of menstrual pain intensity by more than half is confirmed. The rapid relief, less than 20 minutes in 74% of cases, lasts on average more than 7 hours. A difference in analgesic consumption of -93% is observed in favor of TENS (P<0.01). Seven participants reported 10 non-serious AEs, 2 of which were possibly related to TENS. The TENS device tested represents a well-tolerated, rapidly and lastingly effective non-pharmacological analgesic solution, capable of replacing or being combined with analgesics in the management of PD.

Use of Transcutaneous Electrical Nerve Stimulation (TENS) for the Recovery of Oral Function after Orthognathic Surgery.

The oral functions of patients are markedly diminished immediately after orthognathic surgery, and novel approaches are needed to accelerate their recovery. The aim of this study was to examine the usefulness of weekly applications of transcutaneous electrical nerve stimulation (TENS) for this purpose, based on the evidence of its effectiveness in other types of patients with muscle alterations. Maximum jaw opening, bite force, pain, and facial inflammation were compared between patients receiving TENS and those receiving sham-TENS for 30 min at baseline and weekly over a four-week period after orthognathic surgery and were also compared between the before and after of each procedure. TENS was applied at 220 Hz, applying the maximum intensity tolerated by each individual patient. The TENS procedure was identical for all patients, but the device was not turned on in the sham-TENS group. Patients were blinded to their group membership. Results were analyzed separately in skeletal class II and III patients. Improvements in jaw opening and inflammation were significantly greater in the TENS than in the sham-TENS group, attributable to the muscle relaxation achieved with the procedure. Research is warranted on the benefits of a more frequent application of TENS.

Role of Transcutaneous Electric Nerve Stimulation in Pain and Pulmonary Function in Patients after Bariatric Surgery.

Background Changes in lifestyle, a carbohydrate-rich diet, and decreased physical activity are part of the context that led to an obesity pandemic. Treating obesity is a task that requires multidisciplinary care; however, in many cases, conventional therapy has no effect, requiring surgical intervention. This, in turn, is not without risks and causes important changes in lung function. Therefore, the aim of this study is to evaluate the effect of electroanalgesia through conventional transcutaneous electrical nerve stimulation (TENS) on the pain and lung function in the postoperative period of bariatric surgery. Methods This is a controlled and blinded clinical trial with 66 subjects who underwent bariatric surgery. The participants were randomized into 2 groups as follows: an intervention group treated with TENS (n = 33) and a placebo group (n = 33). The participants underwent 4 TENS sessions, and the effect on pain was assessed using a visual analogue scale (VAS pain). Lung function was measured by spirometry. Results There were no differences between the 2 groups regarding time of surgery and time of mechanical ventilation. Compared to placebo, TENS reduced pain in the intervention group (p = 0.001). Regarding the effect of electroanalgesia on pulmonary function, the spirometric parameters were similar between the groups. However, regarding muscle strength between the preoperative and postoperative periods, maximal inspiratory pressure (MIP) was maintained in the intervention group and decreased in the placebo group (p = 0.03). Compared with that in the intervention group, the respiratory rate in the placebo group increased during the application of TENS (p = 0.003). Conclusion Electroanalgesia reduces pain in patients who underwent bariatric surgery. Importantly, in these patients, the MIP is maintained between the preoperative and postoperative periods. However, electroanalgesia does not contribute to improvements in spirometric data. This trial is registered with NCT04800640.

Effects of transcutaneous electrical nerve stimulation applied at different frequencies during labor on hormone levels, labor pain perception, and anxiety: A randomized placebo-controlled single-blind clinical trial

There are various non- pharmacological methods for decreasing labor pain which is acute and severe. One method is Transcutaneous Electrical Nerve Stimulation (TENS). This study investigated the effects of TENS applied at different frequencies during labor on hormone levels, labor pain perception and anxiety. The overall aim was to determining the most effective TENS frequency and pulse width. This randomized-controlled single-blind experimental study included 56 pregnant women who were hospitalized in the delivery unit of a public hospital in Adana, Turkey between 20th of June 2020 and 19th of August 2020. Women were randomized into 4 groups: active TENS 1 (100 Hz and 100 μs) (n = 14); active TENS 2 (80–100 Hz and 350 μs) (n = 14); placebo group (n = 14); control group (n = 14). TENS therapy was initiated at the active phase of the first stage of labor, when cervical dilation was 4 cm, and administered for 30 min. Data were collected using the Personal Information Form, the Labor Monitoring Form, the Visual Analogue Scale (VAS), the State Anxiety Scale (STAI-S), and Biochemical Hormone Tests. The participants in the active TENS 2 group demonstrated a significant increase in their oxytocin and endorphin levels (p<0.01) and a significant decrease in post-test plasma cortisol, labor pain perception, and anxiety levels (p<0.01) compared to active TENS 1, placebo, and control groups. High-frequency TENS application decreased labor pain perception and anxiety levels more significantly than stable frequency TENS, via effects on the release of oxytocin, endorphin and cortisol, which have positive contributions to labor. ClinicalTrials.gov.ID: NCT04851938 was registered on the 2nd of March 2020.

Immediate effects of transcutaneous electrical nerve stimulation on gait patterns in chronic stroke survivors: A single group, pretest-posttest clinical trial.

Transcutaneous electrical nerve stimulation (TENS) has been used to reduce muscle spasticity and improve locomotion in stroke survivors. We speculate that acute changes in gait performance after TENS mediate functional improvement in the long-term. However, no previous study has investigated the effect of TENS on ankle kinetics and kinematics during walking in stroke survivors. We aimed to investigate whether TENS applied over the paretic leg could rapidly improve the plantar flexion moment and ankle kinematics in chronic stroke survivors with lower limb paresis. Twenty chronic stroke survivors were recruited. They underwent 30min of TENS over the area innervated by the common peroneal nerve on the paretic leg. Three-dimensional (3D) motion capture was performed and ankle plantar flexor spasticity was assessed before and immediately after stimulation. Ankle kinematics and kinetic and spatiotemporal data were collected using 3D motion capture. Ankle plantar flexor spasticity was assessed using the Modified Tardieu Scale. A significant increase in the ankle plantar flexion moment of the paretic side during the pre-swing phase was observed immediately after stimulation (p=0.009, maximal mean difference=0.035, 95%CI=0.0125 to 0.0575). The step length of the paretic limb also increased significantly after stimulation (p=0.023, mean difference=-0.02, 95%CI=-0.04 to -0.004). TENS had no immediate effect on paretic ankle spasticity, as measured by the Modified Tardieu Scale, or on other temporo-spatial parameters. The findings support the use of TENS to improve the motor function and gait pattern in chronic stroke survivors. The study indicated that the application of TENS to the paretic leg before gait training might improve rehabilitation outcomes. Future studies investigating the effects of TENS on functional outcomes, the optimal stimulation duration, and assessing spasticity using more sensitive measures are warranted.