Application Of Transcutaneous Electrical Nerve Stimulation Research Articles

Transcutaneous electrical nerve stimulation improves fatigue performance of the treated and contralateral knee extensors.

Transcutaneous electrical nerve stimulation (TENS) can reduce acute and chronic pain. Unilateral fatigue can produce discomfort in the affected limb and force and activation deficits in contralateral non-exercised muscles. TENS-induced local pain analgesia effects on non-local fatigue performance are unknown. Hence, the aim of the study was to determine if TENS-induced pain suppression would augment force output during a fatiguing protocol in the treated and contralateral muscles. Three experiments were integrated for this article. Following pre-tests, each experiment involved 20min of TENS, sham, or a control condition on the dominant quadriceps. Then either the TENS-treated quadriceps (TENS_Treated) or the contralateral quadriceps (TENS_Contra) was tested. In a third experiment, the TENS and sham conditions involved two\; 100-s isometric maximal voluntary contractions (MVC) (30-s recovery) followed by testing of the contralateral quadriceps (TENS_Contra-Fatigue). Testing involved single knee extensors (KE) MVCs (pre- and post-test) and a post-test 30% MVC to task failure. The TENS-treated study induced greater (p = 0.03; 11.0%) time to KE (treated leg) failure versus control. The TENS_Contra-Fatigue induced significant (p = 0.04; 11.7%) and near-significant (p = 0.1; 7.1%) greater time to contralateral KE failure versus sham and control, respectively. There was a 14.5% (p = 0.02) higher fatigue index with the TENS (36.2 ± 10.1%) versus sham (31.6 ± 10.6%) conditions in the second fatigue intervention set (treated leg). There was no significant post-fatigue KE fatigue interaction with the TENS_Contra. Unilateral TENS application to the dominant KE prolonged time to failure in the treated and contralateral KE suggesting a global pain modulatory response.

The effect of transcutaneous electrical nerve stimulation on pain, muscle strength, balance, and gait in individuals with dementia: A double blind, pilot randomized controlled trial

IntroductionThe effect of transcutaneous electrical nerve stimulation (TENS) for functional management in patients with dementia has not been reported yet. Thus, the aim of present study was to investigate the effect of TENS on pain, muscle strength, balance, and gait ability in patients with dementia who have difficulty exercising independently. MethodsThirty-two subjects with dementia were randomly allocated into either a TENS group (n = 16) or a placebo-TENS group (n = 16). TENS (4 Hz), above motor threshold intensity, was applied to both calf muscles for 20 min, 2 times per day. Placebo-TENS was applied for 30 s and then ramped down to zero for 15 s at the same location. The intervention was performed 5 days per week for 2 weeks. Pain was quantified with pain pressure threshold (PPT). Strength of the calf muscles was assessed using a hand-held dynamometer. To assess balance and gait, functional reach test (FRT), 10-m walk test (10MWT), and timed-up and go test (TUG) were used. ResultsThere were significant differences in PPT (p = 0.001) after TENS application, and the PPT was significantly increased in TENS group compared with placebo-TENS group (p = 0.0495). TENS group showed significant improvements of plantarflexor strength (p = 0.008). Balance and gait were also significantly affected in TENS group, as assessed by 10MWT (p = 0.018) and TUG (p = 0.007). The placebo-TENS group did not show significant improvements for any outcome measures. ConclusionsThese results suggest that TENS application can be used for functional maintenance of patients with dementia. Further research is needed to underpin these preliminary results.

Application of High-Frequency Transcutaneous Electrical Nerve Stimulation in Muscle Tension Dysphonia Patients With the Pain Complaint: The Immediate Effect

The aim of the present study was to investigate the immediate effect of the application of high-frequency Transcutaneous electrical nerve stimulation (TENS) in muscle tension dysphonia (MTD) patients with the pain complaint. Thirty patients with MTD, 10 men and 20 women with a mean age of 36.40 ± 5.76 years, participated in the study. The patients were randomized into two groups: (1) Treatment group (TENS) (10 women and 5 men) and (2) Sham TENS group (10 women and 5 men). The treatment group (TENS) received a unique 20-minute session of high-frequency TENS. The sham TENS group was treated in the same condition as the treatment group and received a unique 20-minute session of high-frequency TENS, but no stimulation was given. Auditory-perceptual assessments, acoustic voice analysis, vocal tract discomfort (VTD), and musculoskeletal pain were used to compare the patients pre- and post-treatment. There was a significant improvement in the asthenia parameter of auditory-perceptual assessment in the TENS group. This improvement in asthenia was significant when comparing the TENS group with the sham TENS group. These differences in the asthenia were not significant after using Holm-Bonferroni correction. A comparison of the VTD before and after the TENS application showed there was a significant reduction in the severity of the symptoms (burning, tight, dry, pain, tickling, sore, irritable, and lump in the throat). When comparing the TENS group with the sham TENS group, improvements in burn, tight, dry, pain, and irritable items of VTD were observed. However, after applying the Holm-Bonferroni correction, only reductions in dry and pain items remain significantly different between the groups. After the TENS application, the pain intensity was significantly reduced in the anterior and posterior neck, larynx, submandibular, masseter, temporal region, and upper back. After applying the Holm-Bonferroni correction, pain intensity reduction was significant in the anterior neck and larynx. When comparing the TENS group with the sham TENS group, pain intensity was reduced significantly in the larynx of the TENS group. This difference between the two groups was not significant after using Holm-Bonferroni correction. The pain and VTD assessments in the present study were performed using valid and reliable self-reported scales (NMSQ-E and VTD). High-frequency TENS can be used in the voice treatment program of patients with MTD. MTD patients with pain complaint reported that their vocal tract discomfort and pain were decreased following the high-frequency TENS. Notably, these positive effects were obtained after a single session of high-frequency TENS application.

Randomized controlled trial of transcutaneous electrical nerve stimulation for pain relief during transvaginal oocyte retrieval using conscious sedation: study protocol for a randomized controlled trial

BackgroundTransvaginal oocytes retrieval is an essential step in in-vitro fertilization treatment. There are different pain relief methods, but none has been shown to be superior than the others. Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological and non-invasive pain relief method. This study aims to compare the pain levels experienced by the women using the conscious sedation and those who had TENS in addition to conscious sedation.Methods and analysisThis is a double-blinded randomized trial that will be carried out in a university-assisted conception unit. Women who will undergo oocyte retrieval under conscious sedation will be recruited. After randomization, women will be allocated to either the active TENS group or placebo TENS group (the TENS machine will not emit active impulse), in addition to the paracervical block and conscious sedation. The primary outcome is pain levels of women during the retrieval assessed by the visual analog scale. Secondary outcomes include satisfaction of women and postoperative side effects.DiscussionTENS is an effective non-pharmacological and non-invasive method for pain relief in a number of clinical conditions. Both women and assisted conception unit can benefit if the addition of non-invasive, simple, and low-cost TENS application is proven to be superior than using conscious sedation and paracervical block alone.Trial registrationClinicalTrials.gov, NCT03472430. Registered on 3 May 2018.

Efficacy of transcutaneous electrical nerve stimulation combined with therapeutic exercise on hand function in children with hemiplegic cerebral palsy

Purpose: Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological method used to reduce spasticity. It was also assumed that TENS reduces pain and therefore improves limb function. Most of the previous studies about the effect of TENS were done in the lower limb and in stroke patients. There is a lack of enough literature about the direct and indirect effects of TENS in the upper limb. Hence, our study aimed to determine whether TENS combined with therapeutic exercises helps to improves hand function by reducing spasticity in children with hemiplegic cerebral palsy (CP).Materials and methods: Twenty-nine children with hemiplegic CP were randomly assigned to the TENS group (n = 15) or the control group (n = 14). The TENS group received traditional physical therapy with the adjunct application of conventional TENS for 30 minutes (pulse duration, 250 µs; pulse rate, 100 Hz) on the wrist extensors, once daily, 3 days a week, for 8 weeks, while the control group received traditional physical therapy.Results: The results showed a significant intergroup difference in handgrip strength over the 8-week period. The time to accomplish the Jebsen Taylor Hand Function Test (JTHFT) task decreased by 48% and the ABILHAND-Kids questionnaire scores improved by 23% in the TENS group.Conclusions: The use of TENS in combination with therapeutic exercise may improve strength and hand function.

Effects of transcutaneous electrical nerve stimulation on pain after impacted third molar surgery.

BackgroundThe aim of this study was to assess the therapeutic effects of Transcutaneous Electrical Nerve Stimulation (TENS) on pain after the impacted third molar surgery.Material and MethodsThe study was carried out on 30 patients attending the outpatient department of the oral and maxillofacial surgery. Both sides’ impacted mandibular third molars were taken into consideration, and a total of 60 impacted third molars were undergone surgical extraction. After the first surgery, patients were given analgesic, antibiotics, and mouthwash as a routine treatment procedure. Following the second surgery, TENS was applied over the painful area of the cheek for patients in addition to routine treatment procedure. Pain was evaluated with Visual Analog Scale (VAS) at the postoperative 6, 8, 24 hours and 2,3,4 and 5 days. The Student t test was applied to compare pain levels between groups. P<0.05 and p<0.001 were considered significant in all statistical analyses.ResultsThe study was carried out in 30 patients 15 (50%) female and 15 (50%) male, aged between 20 and 31 years. The mean age of the patients was 24.60 ± 4.76. There was a statistically significant difference in the evaluation of VAS levels in postoperative 6, 8, 24 hours and 2, 3, 4, and 5 days between the routine treatment group and the TENS application group.ConclusionsTENS activates a complex neuronal network to result in a reduction in pain. In conclusion, TENS application was highly effective in pain modulation following the third molar surgery. Therefore, TENS, which is one of the non-pharmacological pain control methods after such surgeries, can be used safely in reducing postoperative pain. Key words:Impacted teeth, third molar, pain, transcutaneous electrical nerve stimulation.

Comparative analysis between three forms of application of transcutaneous electrical nerve stimulation and its effect in college students with non-specific low back pain

ABSTRACT BACKGROUND AND OBJECTIVES: There are a variety of ways to apply the transcutaneous electrical nerve stimulation (TENS) without an established way that provides better results in the treatment of nonspecific low back pain. The objective of this study was to evaluate which application of TENS has a better effect on the immediate reduction of the intensity of spontaneous and provoked pain in college students with nonspecific low back pain. METHODS: Quantitative, randomized and cross-sectional study. Twenty young individuals were divided into four groups and received a different intervention per week, totaling four weeks. The groups were Conventional TENS with the frequency of 100Hz, a pulse duration of 200µs; TENS with frequency and intensity variation with frequency variation and automatic pulse duration, TENS Burst with frequency modulated at 2Hz, pulse duration of 250µs; and placebo in which the subjects underwent a pacing protocol with no tingling sensation or muscle contraction. All sessions had a total application time of 20 minutes. They were evaluated for spontaneous pain through the application of the visual analog scale (VAS), and pain provoked by the algometer and cold pain through the application of solid ice directly to the skin, and VAS for the intensity of cold pain, all performed before and after each application of the electrotherapy. RESULTS: Only the visual analog scale of spontaneous pain showed significant results (p<0.05) when compared intragroups, in the three applied currents. CONCLUSION: The three forms used in the present study were able to reduce spontaneous pain after the intervention by electrostimulation.

Role of Transcutaneous Electrical Nerve Stimulation (Tens) in Management of Pain in Osteoarthritis (OA) of Knee

Context: Osteoarthritis is primarily a disease of cartilage as it is characterized by the degradation of hyaline cartilage in the joints. It is believed to be a dynamic disease that reflects the balance between destruction and repair. Clinically, there is pain, swelling of joints and limitation of motion. Pathological disease is characterized by focal erosive lesions, cartilage destruction, subchondral sclerosis, cyst formation and large osteophyte at the margin of the joints. The objectives of management of osteoarthritis (OA) of the knee are to relieve pain, maintain or improve mobility, and minimize disability. Treatment options include non -pharmacologic intervention, drug therapy, and surgery. Different modalities of physical therapy have been shown to help improve clinical symptoms and function of knee OA with fewer adverse effects. Transcutaneous electrical nerve stimulation (TENS) is among these non invasive therapies which have been used to treat a variety of painful acute and chronic conditions including osteoarthritis.&#x0D; Material and Methods: This randomized clinical trial was conducted on 60 (sixty) patients attending in Physical Medicine and Rehabilitation department of Dhaka Medical College Hospital, who were suffering from knee osteoarthritis. The patients were randomly divided into two groups, Group-A and Group-B. The patients were evaluated clinically and data was collected from both groups in a pre designed data collection sheet for visual analogue scale (VAS) on Pain, 50 feet walking time in seconds and tenderness index in every two weeks interval from the first visit for up to 6 weeks. All the data were analyzed by SPSS version 16.1.&#x0D; Result : The present study showed pain, tenderness and walking time were significantly improved in Group A who were treated with TENS, NSAID &amp; ADL instructions than in Group B who were treated with NSAID &amp; ADL instructions after 6 weeks( P&lt;0.05).&#x0D; Conclusion: The results of this study suggest that application of TENS along with NSAIDs and ADL instructions is more effective in reduction of pain and improving functional performances in patients with knee osteoarthritis than the drug only treatment.&#x0D; J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 62-67

ACUTE EFFECTS OF GANGLION ELECTRICAL STIMULATION ON AUTONOMIC MODULATION AND ENDOTHELIAL FUNCTION IN HEART FAILURE PATIENTS WITH CHAGAS DISEASE: A CONTROLLED AND RANDOMIZED STUDY

Transcutaneous electrical nerve stimulation (TENS) has been used as a complementary treatment to improve peripheral blood flow through autonomic modulation. Chagas Disease usually replaces myocardial fibers by fibrosis but usually do not present a severe vascular impairment such as in ischemic etiology, also presents a compensatory overload of the autonomic system. We hypothesized that TENS may reduce sympathetic activity and improve peripheral vascular endothelial function. This study sought to assess sympathetic activity through heart rate variability (HRV) and endothelial function through flow-mediated vasodilation (FMD%) in patients with Chagas disease. Intervention (TENS or placebo) was applied over stellate ganglion region in 20 subjects (10 healthy and 10 chagasic men) for 30 minutes. The HRV were continuously monitored and brachial artery images (FMD) was recorded during at baseline following five minutes after cuff release. The effects of the intervention were compared using ANOVA with Tukey post-hoc test considering a p <0.05. Flow mediated dilation (FMD%) increased from 6.32 ± 2.39% to 10.74 ± 2.52% in healthy men and 8.33 ± 2.44% to 10.7 ± 1.98% in Chagas patients. Heart rate variability (HRV) showed no significant alteration in both sympathetic and parasympathetic modulations. Despite of the no effect over HRV, TENS application over the ganglion region improved peripheral endothelial function measured on brachial artery. This result ratifies the vascular effect of TENS applied over the stellate ganglion and demonstrate the preserved dilatation capacity of the Chagas Disease.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Does High Frequency Transcutaneous Electrical Nerve Stimulation (TENS) Affect EEG Gamma Band Activity?

Transcutaneous electrical nerve stimulation (TENS) is a noninvasive, inexpensive and safe analgesic technique used for relieving acute and chronic pain. However, despite all these advantages, there has been very little research into the therapeutic effects of TENS on brain activity. To the best of our knowledge, there is no evidence on the effect of high frequency TENS on the gamma band activity. Investigation of the effect of high frequency TENS on the electroencephalographic (EEG) gamma band activity after inducing ischemic pain in healthy volunteers is considered. The modified version of Submaximal effort tourniquet test was carried out to induce tonic pain in 15 right-handed healthy volunteers. The high frequency TENS (150µs in duration, frequency of 100 Hz) was applied for 20 minutes. Pain intensity was assessed at using Visual Analog Scale (VAS) in two conditions (after-pain, after-TENS). EEG gamma band activity was recorded by a 19-channel EEG in three conditions (baseline, after-pain and after- TENS). The repeated measure ANOVA and paired-sample T- tests were used for data analysis. EEG analysis showed an increase in gamma total power after inducing pain as compared to baseline and a decrease after the application of TENS (mean±SD: .043±.029 to .088±.042 to .038±.022 μV2 ).The analysis of VAS values demonstrated that the intensity of induced pain (mean±SD: 51.53±9.86) decreased after the application of TENS (mean±SD: 18.66±10.28). All these differences were statistically significant (p<.001). The results of this study revealed that the high frequency TENS can reduce the enhanced gamma band activity after the induction of tonic pain in healthy volunteers. This finding might help as a functional brain biomarker which could be useful for pain treatment, specifically for EEG-based neurofeedback approaches.

Effects of Transcutaneous Electrical Nerve Stimulation in Autonomic Nervous System of Hypertensive Patients: A Randomized Controlled Trial.

Patients with hypertension have altered autonomic nervous system function, which are increased sympathetic activity. Transcutaneous Electrical Nerve Stimulation (TENS) is a useful modality for pain control and has also been shown to be effective in the reduction of sympathetic activity in healthy subjects and individuals with cardiovascular diseases. The aim of this study was to verify the effects of transcutaneous electrical nerve stimulation by the evaluation of heart rate variability (HRV) in patients with essential hypertension. Twenty-eight patients received an application of low-frequency TENS(4 Hz) n=8, highfrequency TENS (100 Hz) n=10 or placebo TENS n=10 in paravertebral ganglionar region during thirty minutes. After 4 Hz TENS, there was a decrease in the low-frequency (LFn.u.) component (57.71±9.46 vs 45.58±13.51, p<0.026) and an increase in the high-frequency (HFn.u.) component (33.03±13.83 vs 45.83±20.19, p <0.05) of HRV. After 100 Hz TENS and placebo, there were no changes in the LF and HF components. No significant differences were found in systolic blood pressure with low-frequency TENS (129.37± 15.48 vs 126.69 ± 15.21, p<0.490). There was an increase, although not significant, with high-frequency TENS (131.00 ± 15.97 vs 138.75 ± 25.79, p<0.121) and placebo (133.80 ± 29.85 vs 134.80 ± 29.72, p< 0.800). No differences were found in the diastolic blood pressure with low-frequency TENS and placebo, but there was a significant increase in high-frequency TENS (81.00 ± 11.78 vs 85.65 ± 13.68, p< 0.018). Low-frequency TENS decreases sympathetic nervous system activity and increases parasympathetic nervous system activity and high-frequency TENS increases diastolic blood pressure, when applied on the paravertebral ganglionar region in the hypertensive patients.

Efeito agudo da Transcutaneous Electric Nerve Stimulation (TENS) sobre a hipossalivação induzida pela radioterapia na região de cabeça e pescoço: um estudo preliminar

To verify the acute effect of electrostimulation on the salivary flow of patients with hyposalivation. Uncontrolled clinical trial evaluating 15 patients with hyposalivation induced by radiotherapy (RT) used for head and neck cancer treatment. Mean age of the patients was 56.8 ± 6.46 years. Males outnumbered females (73%). Transcutaneous Electrical Nerve Stimulation (TENS) was adjusted with 50Hz of frequency and 250μs of pulse width. Intensity was adjusted over a 20-minute period according to maximum tolerance. The electrodes were attached bilaterally on the region of the salivary glands. Evaluation of the salivary flow was performed through sialometry before and immediately after application of TENS. The most prevalent region for RT was the oropharynx (80.0% of cases). The mean dose used in RT was 64.6 ± 7.27 Gy. After TENS, salivary flow increased significantly (p = 0.0051) from 0.05 (0.00; 0.40) mL/min to 0.10 (0.07: 0.40) mL/min. The response to TENS was directly correlated with the intensity of the tolerated electric current (r = 0.553; p = 0.032) and the dose used in RT (r = -0.514; p = 0.050). TENS was able to increase the salivary flow rate of patients with RT-induced hyposalivation.

Transcutaneous nerve stimulation for pain relief during chest tube removal following cardiac surgery.

Background and Aims:In patients undergoing open heart surgery, chest tubes are removed postoperatively when patients are well awake and stable. Pain during chest tube removal can be moderate to severe and can be the worst experience of hospitalization. Various modalities of pain relief during chest tube removal have been tried with variable results. We sought to examine the effect of transcutaneous electrical nerve stimulation (TENS) as an intervention for pain relief during chest tube removal after cardiac surgery.Material and Methods:In a tertiary care center, fifty patients undergoing open heart surgery were randomized into two groups. Group TENS (n = 25) received TENS from 30 min before and continued up to 30 min after chest tube removal. Control Group (n = 25) did not receive TENS. In both the groups, additional analgesic medication was provided on demand, besides the standard analgesic regime which was injection ketorolac 30 mg intramuscularly every 8 h. Patients were studied for pain during chest drain removal and pain related nausea, vomiting, and sense of well-being.Results:Mean visual analog pain score assessed for chest tube removal was significantly less 4.1 ± 1.2 (P < 0.05) in TENS Group as compared to 6.1 ± 0.8 in Control Group. Significantly greater number of patients (n = 14) (P < 0.05) in Control Group demanded additional analgesia as compared to TENS Group (n = 5). Feeling of well-being, improvement in appetite, and sleep was better in TENS Group as compared to Control Group.Conclusion:We conclude that TENS might not replace the conventional analgesics but has definite adjuvant role in decreasing pain scores and improves sense of well-being during chest tube removal after cardiac surgery.

Effectiveness of transcutaneous electrical nerve stimulation in management of neuropathic pain in patients with post traumatic incomplete spinal cord injuries

Objective:To determine the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) in management of neuropathic pain in post-traumatic incomplete spinal cord injury patients.Methods:A quasi-experimental study was conducted at from January 2017 to June 2017 at Paraplegic Center Hayatabad, Peshawar. Total 60 incomplete spinal cord injured patients with diagnosis of neuropathic pain were subjected to high frequency TENS of 80 HZ. One session was of 45 minutes while there were two sessions per day. TENS was applied for four days in a week and all patients were followed for eight week duration. Pain intensity was measured by using VAS (Visual analogue scale).Results:Mean pain intensity on VAS at baseline was 6.45 which was decreased to 4.77 post intervention at day-1 while it was decreased to 3.48 at day-4 of week one. After application of TENS for 8 weeks, mean pain intensity was decreased to 2.80 ± 1.74. During the consecutive sessions of the TENS application, the pain intensity decreases in a linear fashion and there were significant difference (p<0.05) between pre and post treatment sessions.Conclusion:TENS is useful and safe adjuvant in spinal cord injury patients for the management of neuropathic pain.

Transcutaneous electrical nerve stimulation improves walking capacity and reduces spasticity in stroke survivors: a systematic review and meta-analysis

Objective: To evaluate (1) the effectiveness of transcutaneous electrical nerve stimulation (TENS) at improving lower extremity motor recovery in stroke survivors and (2) the optimal stimulation parameters for TENS. Review methods: A systematic search was conducted for studies published up to October 2017 using eight electronic databases (CINAHL, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, PEDro, PubMed and Web of Science). Randomized controlled trials that evaluated the effectiveness of the application of TENS at improving lower extremity motor recovery in stroke survivors were assessed for inclusion. Outcomes of interest included plantar flexor spasticity, muscle strength, walking capacity and balance. Results: In all, 11 studies met the inclusion criteria which involved 439 stroke survivors. The meta-analysis showed that TENS improved walking capacity, as measured by either gait speed or the Timed Up and Go Test (Hedges’ g = 0.392; 95% confidence interval (CI) = 0.178 to 0.606) compared to the placebo or no-treatment control groups. TENS also reduced paretic plantar flexor spasticity, as measured using the Modified Ashworth Scale and Composite Spasticity Scale (Hedges’ g = –0.884; 95% CI = –1.140 to −0.625). The effect of TENS on walking capacity in studies involving 60 minutes per sessions was significant (Hedges’ g = 0.468; 95% CI = 0.201–0.734) but not in study with shorter sessions (20 or 30 minutes) (Hedges’ g = 0.254; 95% CI = –0.106–0.614). Conclusion: The results support the use of repeated applications of TENS as an adjunct therapy for improving walking capacity and reducing spasticity in stroke survivors.

Adjusting Pulse Amplitude During Transcutaneous Electrical Nerve Stimulation Does Not Provide Greater Hypoalgesia.

Transcutaneous electrical nerve stimulation (TENS) is an electrotherapeutic modality commonly used in rehabilitation to relieve pain. Adjusting pulse amplitude (intensity) during TENS treatment has been suggested to overcome nerve habituation. However, it is still unclear if this procedure leads to greater hypoalgesia. The aim of this study was to determine if the hypoalgesic effect of TENS is greater when pulse amplitude is adjusted throughout the TENS treatment session in chronic low-back pain patients. Randomized double-blind crossover study. Recruitment and assessment were conducted at the Clinique universitaire de réadaptation de l'Estrie (CURE) of the Faculty of Medicine and Health Sciences of the Université de Sherbrooke. Twenty-one volunteers with chronic low-back pain were enrolled and completed this investigation. Each patient received two high-frequency TENS treatments on two separate sessions: (1) with adjustment of pulse amplitude and (2) without pulse amplitude adjustment. Pain intensity and unpleasantness were assessed before, during, and after TENS application with a 10 cm visual analog scale. Both TENS conditions (with and without adjustment of intensity) decreased pain intensity and unpleasantness when compared with baseline. No difference was observed between the two stimulation conditions for both pain intensity and unpleasantness. The current results suggest that adjustment of pulse amplitude during TENS application does not provide greater hypoalgesia in individuals with chronic low-back pain. Future studies are needed to confirm these findings in other pain populations.

Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults

Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults

Dose postural control improve following application of transcutaneous electrical nerve stimulation in diabetic peripheral neuropathic patients? A randomized placebo control trial

Backgroundperipheral neuropathy is the most common problem of diabetes. Neuropathy leads to lower extremity somatosensory deficits and postural instability in these patients. However, there are not sufficient evidences for improving postural control in these patients. AimTo investigate the effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with diabetic neuropathy. MethodsTwenty eighth patients with diabetic neuropathy (40–55 Y/O) participated in this RCT study. Fourteen patients in case group received TENS and sham TENS was used for control group. Force plate platform was used to extract sway velocity and COP displacement parameters for postural control evaluation. ResultsThe mean sway velocity and center of pressure displacement along the mediolateral and anteroposterior axes were not significantly different between two groups after TENS application (p>0.05). ConclusionApplication of 5min high frequency TENS on the knee joint could not improve postural control in patients with diabetic neuropathy.

The influence of Task-Related Training combined with Transcutaneous Electrical Nerve Stimulation on paretic upper limb muscle activation in patients with chronic stroke.

This study investigated the efficacy of Task-Related Training (TRT) Combined with Transcutaneous Electrical Nerve Stimulation (TENS) on the improvement of upper limb muscle activation in chronic stroke survivors with mild or moderate paresis. A single-blind, randomized clinical trial was conducted with 46stroke survivors with chronic paresis. They were randomly allocated two groups: the TRT+TENS group (n = 23) and the TRT+ placebo TENS (TRT+PLBO) group (n = 23). The TRT+TENS group received 30 minutes of high-frequency TENS on wrist and elbow extensors, while the TRT+PLBO group received placebo TENS that was not real ES. Both groups did 30 minutes of TRT after TENS application. Intervention was given five days a week for four weeks. The primary outcomes of upper limb muscle activation were measured by integrated EMG (IEMG), a digital manual muscle tester for muscle strength, active range of motion (AROM) and Fugl-Meyer Assessment of the upper extremity (FMA-UE). The measurements were performed before and after the 4 weeks intervention period. Both groups demonstrated significant improvements of outcomes in IEMG, AROM, muscle strength and FMA-UE during intervention period. When compared with the TRT+PLBO group, the TRT+TENS group showed significantly greater improvement in muscle activation (wrist extensors, P = 0.045; elbow extensors, P = 0.004), muscle strength (wrist extensors, P = 0.044; elbow extensors, P = 0.012), AROM (wrist extension, P = 0.042; elbow extensors, P = 0.040) and FMA-UE (total, P < 0.001; shoulder/elbow/forearm, P = 0.001; wrist, P = 0.002; coordination, P = 0.008) at the end of intervention. Our findings indicate that TRT Combined with TENS can improve paretic muscle activity in upper limb paresis, highlighting the benefits of somatosensory stimulation from TENS.

Stretching Combined With Tens Or Self-massage Has Differential Effects On Ankle Flexibility

Many studies evaluating the effect of stretching conclude that gains in flexibility are primarily due to improved stretch tolerance (discomfort). Under this rationale, use of pain reduction therapies while stretching should provide greater improvements in flexibility than stretching alone. Transcutaneous electrical nerve stimulation (TENS) is a modality commonly used to mitigate pain. Self-massage with a foam roller, which may modulate the mechanical properties of connective tissues, has been shown to improve flexibility. PURPOSE: To compare the influence of TENS and self-massage on ankle joint flexibility and force capacity of the plantar flexor muscles after a stretching intervention. METHODS: 20 healthy young adults (10M, 10F, mean (SD) age 25 (3) y) underwent 3 sessions of ankle plantar flexor stretching: stretching alone (SS), stretching with concurrent application of TENS (TS), and stretching after self-massage using yoga therapy balls (BS). Each visit was separated by one week. All subjects performed SS at the first visit; the remaining 2 visits were counterbalanced. At every visit, subjects performed isometric maximum voluntary contractions (MVCs) for the plantar flexors before and after the intervention. Stretching involved three 30-s standing calf stretches, separated by 30-s rest. TENS was applied at a comfortable current without muscle contraction for 1-min prior to, and for the duration of stretching. Massage with yoga balls was performed for 60-s immediately prior to each of the 3 stretches. Ankle dorsiflexion range of motion (ROM) was assessed before, immediately after, and at 1, 5, 10, and 15 min after the intervention. RESULTS: All 3 interventions significantly increased ankle dorsiflexion ROM (all p=0.00). The mean (SD) change in ROM was 13 (9)%, 9 (7)%, and 25 (17)% for SS, TS, and BS, respectively. The mean (SD) change in ankle torque was -1(13)%, -3 (10)%, and 16 (11)% for SS, TS, and BS, respectively. In contrast to TENS (TS), the use of yoga therapy balls significantly increased ROM and MVC torque (both p=0.00, effect size 0.40, 0.58 for ROM, torque). CONCLUSION: The addition of TENS to a stretch intervention did not improve ankle joint range of motion or alter MVC force. In contrast, self-massage with yoga therapy balls prior to stretching significantly improved range of motion and MVC force.