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ABSTRACT BACKGROUND AND OBJECTIVES: Neuropathic pain (NP) affects the afferent somatosensory pathways, generating various symptoms, however, there is difficulty in terms of diagnosis and in the formation of treatment protocols. There is a need to search the current literature for effective resources for the treatment of peripheral neuropathy in rehabilitation. The objective of this study was to describe reproducible assessment and treatment approaches capable of reducing NP. CONTENTS: Full articles produced between 2018 and 2022, found in the Pubmed, Scielo, Medline, Embase and Cochrane databases were included. Fifteen Boolean descriptors were used, and data were cross-referenced with the words "AND" or "OR". The selected articles went through the Methodi Ordinatio of classification and organization of studies. Eleven articles were selected and used in this review, two from 2018, five from 2020, and three from 2021. Regarding the type of study, five review articles, one case study, and six intervention studies were obtained. Of these 11 studies, only three used quality of life (QoL) indicators. Most studies used combined interventions, and in more than half of the publications transcranial direct current stimulation (tDCS) was present. The somatosensory rehabilitation method was able to redeem neuropathy through specific techniques. CONCLUSION: The implications of the neuropathic pain treatment in terms of QoL were left in the background by the bibliometric survey carried out. It is suggested that new studies could associate analgesia techniques with rehabilitation methods, including and measuring the effects on the QoL of these patients.
RESUMO JUSTIFICATIVA E OBJETIVOS: A dor neuropática (DN) acomete as vias somatossensoriais aferentes, gerando diversos sintomas, entretanto há dificuldades em termos de diagnóstico e na formação de protocolos de tratamento. Há a necessidade de buscar, na literatura atual, recursos eficazes para o tratamento da neuropatia periférica na área da reabilitação. O objetivo deste estudo foi descrever abordagens reprodutíveis de avaliação e tratamento capazes de diminuir a DN. CONTEÚDO: Foram incluídos artigos completos produzidos entre os anos de 2018 e 2022, encontrados nos bancos de dados Pubmed, Scielo, Medline, Embase e Cochrane. Foram usados 15 descritores booleanos, e os dados foram cruzados com as palavras "AND" ou "OR". Os artigos passaram pelo Methodi Ordinatio de classificação e organização de estudos. Foram selecionados e utilizados 11 artigos, sendo dois de 2018, cinco de 2020 e três de 2021. Acerca do tipo de estudo, foram obtidos cinco artigos de revisão, um estudo de caso e seis estudos de intervenção. Desses 11 estudos, apenas três utilizaram indicadores de qualidade de vida (QV). A maioria dos estudos utilizou intervenções combinadas, e em mais da metade das publicações a estimulação transcraniana por corrente contínua (ETCC) estava presente. O método de reabilitação somatossensorial foi capaz de redimir a neuropatia por meio de técnicas específicas. CONCLUSÃO: As implicações do tratamento da dor neuropática no quesito QV ficaram em segundo plano pelo levantamento bibliométrico realizado. Sugere-se que novos estudos possam associar técnicas de analgesia a métodos de reabilitação, incluindo e mensurando os efeitos sobre a QV desses pacientes.
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ABSTRACT BACKGROUND AND OBJECTIVES: Despite the widespread use of mid-frequency currents in reducing pain in chronic low back pain (CLBP), there is still no consensus on the optimal parameters for treatment. The aim of this study was to compare the immediate analgesic effects of interferential (IC) and Aussie (AC) currents in CLBP. METHODS: This is a five-arm double-blind randomized controlled trial. Patients aged between 18 and 60 years with CLBP were randomly divided into 5 groups: CI4kHz/100Hz, CI4kHz/2Hz, CA4kHz/100Hz, CA4kHz/2Hz and placebo (PG). Participants received a single application of Interferential current or Aussie current for 30 min. Main outcome measures were pain intensity by numeric pain scale (NPS), McGill pain questionnaire (MPQ) and pressure pain threshold. The secondary outcomes assessed were: abdominal strength test (AST), lumbar flexion test (modified Schober test), trunk and lower limb mobility (sit and reach test and finger tip test). RESULTS: There was a significant difference in NPS and MPQ groups (with the exception of the affective component) (p<0.05) in IC 4 kHz/100 Hz and IC 4 kHz/2 Hz groups in relation to PG. Regarding secondary outcomes, a difference was found only between IC 4kHz/2Hz and PG in AET. CONCLUSION: Interferential current, regardless of frequency modulation, provided immediate analgesic effect in individuals with CLBP, being superior to the effects of Aussie current.
RESUMO JUSTIFICATIVA E OBJETIVOS: Apesar da grande utilização das correntes de média frequência na diminuição do quadro álgico na dor lombar crônica (DLC), ainda não existe consenso sobre os parâmetros ideais para tratamento. O objetivo deste estudo foi comparar os efeitos analgésicos imediatos das correntes interferencial (CI) e Aussie (CA) na DLC. MÉTODOS: Trata-se de um ensaio clínico randomizado controlado duplo-cego de cinco braços. Foram selecionados pacientes com idades entre 18 e 60 anos, com DLC, que foram divididos aleatoriamente em 5 grupos: CI4kHz/100Hz, CI4kHz/2Hz, CA4kHz/100Hz, CA4kHz/2Hz e placebo (GP). Os participantes receberam uma única aplicação da corrente Interferencial ou corrente Aussie durante 30 min. As principais medidas de desfechos foram: intensidade da dor pela escala numérica da dor (END), questionário de dor McGill (QDM) e limiar de dor por pressão. Os desfechos secundários avaliados foram: teste de resistência abdominal (TRA), teste de flexão da lombar (teste de Schober modificado), mobilidade de tronco e membros inferiores (teste de sentar e alcançar e teste de distância do terceiro dedo ao solo). RESULTADOS: Houve diferença significativa nos grupos END e QDM (com exceção do componente afetivo) (p<0,05) nos grupos CI 4 kHz/100 Hz e CI 4 kHz/2 Hz em relação ao GP. Com relação aos desfechos secundários foi encontrada diferença somente entre CI 4kHz/2Hz e GP no TRA. CONCLUSÃO: A corrente interferencial, independente da modulação da frequência, proporcionou efeito analgésico imediato em indivíduos com DLC, sendo superior aos efeitos da corrente Aussie.
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Abstract Introduction Temporomandibular joint disorders (TMD) present with a multitude of symptoms that can range from headaches to shoulder pain. Patients frequently present with pain in the ear, dizziness, and vertigo. It is noted that some patients who report TMDs also have a history of sleep disturbances, which is noted in cone beam computed tomography (CBCT) as a reduction in the oropharyngeal airway volume. Objective To evaluate the airway volume in pre- and posttreatment of TMD with the use of neuromuscular orthotics made with ultra-low frequency transcutaneous electrical nerve stimulation (ULF-TENS). Methods A total of 15 patients were evaluated for TMDs using the related criteria. Those included were treated with ULF-TENS with evaluation of the airway volume both pre- and posttreatment using CBCT and the Dolphin 3D volume analysis software. Results While the symptoms were shown to be significantly reduced in patients who were treated with this particular modality, the airway volume varied in those who reported a reduction after a period of 3 months and those that reported after a period of 6 months. Conclusion Posttreatment evaluation of the airway should be done after a period of 6 months for a more objective evaluation. A multidisciplinary evaluation of the patient is required in such cases.
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Pain is considered as one of the most debilitating symptoms of cancer and its treatment. Owing to the limited efficacy of traditional pharmacological interventions to address cancer pain in its entirety, an avenue exists for exploration into nonpharmacological therapies. Analgesia using non?invasive electrotherapeutic modalities such as transcutaneous electrical nerve stimulation (TENS) and scrambler therapy emerges as a viable option to address cancer pain. The inability of these modalities to find a place within the recommended clinical guidelines has possibly resulted in the paucity of application of the same within the clinical setup. This perspective article aims at stimulating a discussion surrounding the inclusion of non?invasive neuromodulatory treatment techniques such as TENS and scrambler therapy to combat cancer pain and explore the benefits and pitfalls of using these techniques as an adjunct to the pre?existing treatment strategies. It is envisioned that this opinion piece will open a dialogue about a possible home for non?invasive electroanalgesia within the clinical treatment pathway for cancer pain.
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Background:Myofascial pain syndrome is defined as sensory, motor and autonomic symptoms that are caused trigger points (MTrP). It is defined as a hyperirritable spot in skeletal muscle, which is associated with hypersensitive palpable nodule in a taut band. Objectives: Present study was undertaken to add on to available treatment methods for myofascial Trigger points and to find out the effectiveness of dry needling and Transcutaneous Electrical Nerve Stimulation (TENS) therapy for treating myofascial trigger point. Material And Methods:In this study, 32 participants were recruited based on inclusion and exclusion criteria. Dry Needling and TENS therapy was administered to them for a period of 2 weeks, 6 sessions in 2 weeks. Pre and post assessme nt were taken using following outcome measures-Pain Pressure Threshold, Numerical Pain Rating Scale (NPRS), Functional Assessment Scale for Acute Hamstring Injuries (FASH)Result:There was significant decrease in Pain due to hamstring injury on NPRS, agility score and increase in Pain Pressure threshold in patients which is suggestive of decrease in pain and improve functional independency. The outcome of Pressure Algometer, Agility score and NPRS were statistically analyzed. It was found to be effective with significant P value<0.000. Conclusion:Statistically both Dry Needling and TENS are competent enough to alleviate pain but clinically TENS having better response in pain depletion and in increase in functional independency compared to Dry Needling.
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ABSTRACT Objective: To analyze the immediate effect of amplitude modulation frequencies (AMFs) of 4kHz interferential current (IFC) on chronic low back pain (CLBP). Method: This is a randomized controlled clinical trial. Sixty-three subjects with CLBP were recruited. The subjects were randomized into 3 groups: the placebo group (PG, n=21) and 2 intervention groups (IG), IG4kHz/2Hz (n=21) and IG4kHz/100Hz (n=21). All groups were submitted to a single session of 30 minutes. Pain was evaluated using a numerical rating scale (NRS), the McGill Pain Questionnaire (MPQ), and pressure algometry. Flexibility was evaluated using the Modified Schober Test (MST), the Sit-and-Reach Test (SRT), the Fingertip-to-Floor Test (FTF), and the Passive Straight-Leg Raise Test (PSLR). Results: Comparing IG4kHz/100Hz with PG, we found a significant difference (p<0.05) in NRS in the total and in the MPQ categories, whereas in the comparison between IG4kHz/2Hz and PG, we found a significant difference only in the sensory and evaluative categories of MPQ. Regarding the flexibility tests, we observed a significant difference of both IG4kHz/100Hz and IG4kHz/2Hz in comparison to PG in MST and PSLR, and of IG4kHz/2Hz in comparison to PG in SRT. The 4kHz IFC was effective in immediately reducing CLBP and, consequently, in increasing the flexibility of the lumbar spine and lower limbs. Conclusion: Conclusion: There was a greater number of significant positive outcomes when the 100Hz AMF was adopted. Level of Evidence I; High quality randomized clinical trial with or without statistically significant differences, but with narrow confidence intervals.
RESUMO: Objetivo: Analisar o efeito imediato das frequências de modulação de amplitude (AMF) da corrente interferencial (IFC) de 4 kHz sobre dor lombar crônica (DLC). Métodos: Este é um ensaio clínico controlado randomizado. Foram recrutados 63 participantes com DLC. Esses participantes foram randomizados em três grupos: grupo placebo (PG, n = 21) e dois grupos de intervenção (IG), IG4kHz/2 Hz (n = 21) e IG4kHz/100 Hz (n = 21). Todos os grupos foram submetidos a uma única sessão de 30 minutos. A dor foi avaliada por meio de uma escala numérica de classificação (NRS), o questionário de McGill (MPQ) e algometria de pressão. A flexibilidade foi avaliada pelo Teste de Schober Modificado (MST), Teste de sentar e alcançar (SRT), Teste do terceiro dedo ao solo (FTF) e Teste passivo de Elevação de Perna Reta (PSLR). Resultados: Comparando IG4kHz/100 Hz com PG, encontramos diferença significativa (p < 0,05) em NRS nas categorias total e MPQ, enquanto na comparação entre IG4kHz/2Hz e PG, encontramos uma diferença significativa apenas nas categorias sensoriais e de avaliação do MPQ. Com relação aos testes de flexibilidade, observamos diferença significativa tanto do IG4kHz/100 Hz quanto do IG4kHz/2 Hz em comparação com o PG em MST e PSLR, e do IG4kHz/2 Hz em comparação com o PG no SRT. A IFC de 4kHz foi eficaz na redução imediata da DLC e, consequentemente, no aumento da flexibilidade da coluna lombar e dos membros inferiores. Conclusões: Houve maior número de desfechos positivos significativos quando a AMF de 100 Hz foi adotada. Nível de Evidência I; Estudo clínico randomizado de alta qualidade com ou sem diferença estatisticamente significante, mas com intervalos de confiança estreitos.
RESUMEN: Objetivo: Analizar el efecto inmediato de las frecuencias de modulación de amplitud (AMF) de la corriente interferencial (ICF) de 4 kHz sobre el dolor lumbar crónico (DLC). Métodos: Se trata de un ensayo clínico controlad y aleatorizado. Se reclutaron 63 participantes con DLC. Los mismos fueron distribuidos aleatoriamente en 3 grupos: grupo placebo (PG, n=21) y 2 grupos de intervención (IG), IG4kHz/ 2Hz (n=21) e IG4kHz/100 Hz (n=21). Todos los grupos fueron sometidos a una sola sesión de 30 minutos. El dolor se evaluó mediante una escala de clasificación numérica (NRS), el cuestionario de McGill (MPQ) y algometría de presión. La flexibilidad se evaluó mediante el test de Schober modificado (MST), el test de sit-and-reach (SRT), el test de distancia dedos-suelo (FTF) y la prueba pasiva de elevación de la pierna recta (PSLR). Resultados: Al compararIGI4kHz/100 Hz con PG, encontramos una diferencia significativa (p<0,05) en el NRS en las categorías total y MPQ, mientras que en la comparación entre IG4kHz/2 Hz y PG, encontramos una diferencia significativa sólo en las categorías sensoriales y evaluativas de MPQ. En cuanto a las pruebas de flexibilidad, observamos una diferencia significativa tanto de IG4kHz /100 Hz como de IG4kHz/2 Hz en comparación con PG en MST y PSLR, y de IG4kHz/2 Hz en comparación con PG en SRT. La ICF de 4kHz fue eficaz en la reducción inmediata del DLC y, en consecuencia, en el aumento de la flexibilidad de la columna lumbar y los miembros inferiores. Conclusión: Hubo un mayor número de resultados positivos significativos cuando se adoptó la AMF de 100 Hz. Nivel de Evidencia I; Ensayo clínico aleatorizado de alta calidad con o sin diferencia estadísticamente significativa, pero con intervalos de confianza estrechos.
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Humans , OrthopedicsABSTRACT
Objective: To examine the effect of acupuncture-like transcutaneous electrical nerve stimulation (ACUTENS) on labor pain in nulliparous women. Methods: This randomized clinical trial was conducted at Razi Hospital in Qazvin, Iran between January and July 2018. After the screening process, 144 out of 184 pregnant women were selected by convenience sampling and assigned to an intervention group or a control group by the block randomization method. The intervention group received ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) during various stages of delivery in addition to routine labor care at the delivery room. For the control group, the same routine labor care was performed alone. The severity of pain was assessed in the two groups using the visual analog scale (VAS). The data were analyzed using R software (ver. 4.0.2) and repeated measurement analysis of variance. Results: ACUTENS reduced the mean score of pain intensity in the first stage of labor in the intervention group more than that in the control group (P<0.001). Also, the mean scores of pain intensity in the second stage of labor, episiotomy, and one hour after delivery in the intervention group were significantly lower than those in the control group (P<0.001). Conclusion: ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) can decrease the intensity of labor pain in nulliparous women. It can be used as a non-pharmacological method for reducing pain in and after labor.
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A dismenorreia primária é uma dor na região inferior do abdômen, antes ou durante a menstruação e independente de patologias pélvicas. Tratamentos fisioterapêuticos são alternativas para a melhora dos sintomas, dentre esses recursos, a estimulação elétrica nervosa transcutânea (TENS). O objetivo deste estudo foi comparar o efeito terapêutico e analgésico da TENS interativa e convencional na dor secundária à dismenorreia primária. A aplicação da TENS, em ambos os grupos, foi realizada no primeiro dia do período menstrual por 35 minutos. Na TENS interativa todas as voluntárias optaram pelos seguintes parâmetros: frequência de 250 Hz, duração de pulso de 25 µs e intensidade conforme nível sensorial, sendo essa ou a duração do pulso reajustado, a cada 5 minutos, conforme houvesse necessidade. Na TENS convencional foi utilizado os seguintes parâmetros: frequência de 100 Hz, duração de pulso de 50 µs e com a intensidade conforme grupo anterior. A análise estatística foi realizada por meio do software GraphPadPrism®, versão 5.0, sendo empregado o teste t de Student e com nível de significância de p < 0,05. Obteve-se como resultado uma redução da dor entre as participantes de ambos os grupos logo após o tratamento. Porém não houve diferença na analgesia promovida pelos dois métodos de tratamento. (AU)
Primary dysmenorrhea (PD) is a lower region of the abdomen pain, before or during menstruation and independent of pathologies. Physical therapy treatments are alternatives to improve symptoms, among these resources, transcutaneous electrical nerve stimulation (TENS). The aim of this study was to compare the therapeutic and analytical effect of interactive and conventional TENS in high school in PD. The application of TENS, in both groups, was performed on the first day of the menstrual period for 35 minutes. In the interactive TENS all the volunteers chose the following parameters: frequency of 250 Hz, pulse duration of 25 µs and intensity according to sensory level, whether this or the duration of the readjustment of the pulse, every 5 minutes, according to the need for use. In conventional TENS, the following parameters were used: frequency of 100 Hz, pulse duration of 50 µs and intensity according to the previous group. A statistical analysis was performed using the GraphPadPrism® software, version 5.0, being employed Student's test with a significance level of p < 0.05. The result is a reduction in pain among participants in both groups right after treatment. However, there was no difference in the analgesia promoted by the two treatment methods. (AU)
Subject(s)
Humans , Female , Transcutaneous Electric Nerve Stimulation , Dysmenorrhea , Physical Therapy Modalities , Visual Analog ScaleABSTRACT
INTRODUÇÃO: Dismenorreia é a condição dolorosa mais frequente em adolescentes e mulheres jovens causando absenteísmo e presenteísmo no trabalho e na escola. É caracterizada por um quadro álgico leve, moderado ou severo na região pélvica anterior do tipo cólica, o qual pode acontecer antes, durante ou depois do fluxo menstrual. OBJETIVO: Comparar a influência da Estimulação Elétrica Nervosa Transcutânea (TENS) na dor pélvica causada pela dismenorreia primária com os eletrodos aplicados na região pélvica anterior e posterior. MÉTODOS: 50 universitárias foram aleatoriamente distribuídas em dois grupos de 25 voluntárias: Grupo Região Pélvica Anterior (GA) e Grupo Região Pélvica Posterior (GP), que foram submetidas a TENS durante 30 minutos tendo a intensidade aumentada a cada 10 minutos e avaliadas pela Escala Visual Analógica de Dor antes, depois e duas horas após o término do tratamento. As participantes do GA tiveram os eletrodos aplicados na região pélvica anterior e as do GB na região pélvica posterior. RESULTADOS: Houve uma diminuição do quadro álgico nos momentos antes e após o tratamento (GA e GP p<0,0001) e antes e duas horas após o tratamento (GA e GP p<0,0001). Nos momentos depois do tratamento e duas horas após o seu término foi possível observar aumento do quadro álgico no GA (p=1,0000) e diminuição no GP, porém os valores não foram estatisticamente significativos (p=0,8443). CONCLUSÃO: O uso da TENS contribuiu para a redução do quadro álgico das mulheres de ambos os grupos, sem diferença estatística entre estes. Registro Brasileiro de Ensaios Clínicos: RBR-67cjv5.
INTRODUCTION: Dysmenorrhea is the most frequent painful condition in adolescents and young women that causes absenteeism and presenteeism at work and school. It is characterized by a mild, moderate, or severe pain in the anterior pelvic region of the colic type, which can happen before, during, or after menstrual flow. OBJECTIVE: To compare the influence of Transcutaneous Electrical Nerve Stimulation (TENS) in pelvic pain caused by primary dysmenorrhea with the electrodes applied in the anterior and posterior pelvic region. METHODS: 50 university students were randomly assigned to two groups of 25 volunteers: Anterior Pelvic Region Group (GA) and Posterior Pelvic Region Group (GP), who were submitted to TENS for 30 minutes and the intensity increased every 10 minutes and evaluated by the Visual Analog Pain Scale before, after and two hours after the end of treatment. GA participants had the electrodes applied in the anterior pelvic region and GB in the posterior pelvic region. RESULTS: There was a decrease in the pain in the moments before and after treatment (GA and GP p<0.0001) and before and two hours after treatment (GA and GP p <0.0001). In the moments after the treatment and two hours after its end, it was possible to observe an increase in the pain in GA (p=1.0000) and a decrease in the GP, however, the values were not statistically significant (p=0.8443). CONCLUSION: The use of TENS contributed to the reduction of pain in women in both groups, without statistical difference between them. Brazilian Registry of Clinical Trials: RBR-67cjv5.
Subject(s)
Dysmenorrhea , Transcutaneous Electric Nerve Stimulation , Physical Therapy ModalitiesABSTRACT
ABSTRACT BACKGROUND AND OBJECTIVES Among the main non-pharmacological analgesic techniques are physical therapies such as electrotherapy and cognitive-behavioral techniques, such as hypnosis. The objective of this study was to compare the analgesic effect of transcutaneous electrical nerve stimulation (TENS) and hypnosis in the control of chronic low back pain. METHODS A crossover study that included 19 young adults of both genders with chronic low back pain who underwent TENS and hypnosis, and pain education as a control group. The quality of pain was assessed by the McGill's questionnaire; pain intensity and threshold were assessed by the visual analog scale. The intensity of spontaneous pain, the threshold and intensity of pain induced by cold and the pressure pain threshold before the interventions, immediately after the interventions and 30 minutes after the end of the interventions were evaluated. Statistical analysis was performed with Generalized Mixed Linear Models, with 5% significance, and Cohen's G effect sizes. RESULTS There was a statistically significant decrease in the intensity of spontaneous and cold induced pain in the hypnosis and TENS groups compared to the pain education group. There was a statistically significant reduction of pain in the sensory and evaluation categories in the intervention groups compared to the control group. There was no significant difference for the pressure pain threshold and latency time for cold induced pain. CONCLUSION Hypnosis and TENS decreased the intensity of chronic low back pain with no statistically significant difference between them, but statistically different from the pain education control group.
RESUMO JUSTIFICATIVA E OBJETIVOS Entre as principais técnicas analgésicas não farmacológicas estão as terapias físicas como a eletroterapia e técnicas cognitivo-comportamentais, como a hipnose. O objetivo deste estudo foi comparar o efeito analgésico da estimulação elétrica nervosa transcutânea (TENS) e hipnose no controle da dor lombar crônica. MÉTODOS Estudo do tipo cruzado que incluiu 19 adultos jovens de ambos os sexos portadores de dor lombar crônica, submetidos a TENS, hipnose e educação em dor como grupo controle. A qualidade da dor foi avaliada pelo questionário de McGill, a intensidade e o limiar da dor pela escala analógica visual. Foi avaliada a intensidade da dor espontânea, o limiar e a intensidade de dor ao frio e o limiar da dor à pressão, imediatamente após as intervenções e 30 minutos depois do final das intervenções. A análise estatística foi realizada com modelos lineares generalizados mistos, com 5% de significância, e tamanhos de efeito G de Cohen. RESULTADOS Houve diminuição estatisticamente significativa da intensidade da dor espontânea e ao frio nos grupos hipnose e TENS comparados ao grupo de educação em dor. Ocorreu redução do quadro álgico estatisticamente significativo nas categorias sensorial e avaliativa nos grupos intervenção comparados ao grupo controle. Não houve diferença significativa para o limiar de dor à pressão e o tempo de latência para a dor ao frio. CONCLUSÃO A hipnose e a TENS diminuíram a intensidade da dor lombar crônica sem diferença estatisticamente significativa entre si, porém estatisticamente diferentes em relação ao grupo controle.
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Literatures on pain intervention with transcutaneous electrical acupoint stimulation (TEAS) were collected by searching the databases both in Chinese and English, and summarized to understand the research progress of TEAS effects on pain mediators in recent years. This will provide a more objective and scientific theoretical basis for clinical practice of TEAS to treat pain syndrome, thus promoting the clinical application of TEAS. Our literature analysis indicated that TEAS effectively regulated the release levels of various pain factors such as prostaglandin, 5-hydroxytryptamine, interleukins, substance P and tumor necrosis factor-α to achieve the analgesic effects by affecting the conduction pathways. TEAS is a safe, non-invasive and effective treatment for pain syndrome. However, further research is necessary due to the lack of rigor of the current clinical trial design.
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Objective:To analyze the feasibility of applying transcutaneous electrical nerve stimulator and high-frequency ultrasound in superficial nerve positioning for detection anatomical location in the area of lateral lip of the iliac crest by lateral cutaneous branch of subcostal nerve(LCSN). The significance of using the nerve as a free sensory superficial circumflex iliac artery perforator flap was discussed.Methods:The data of patients who underwent the repair of defects on limbs with free perforator flap or composite flap of superficial iliac circumflex artery carrying sensory nerve and the volunteers who agreed to have the location of the LCSN measured between October, 2018 and October, 2020 were collected. The LCSN were located by percutaneous electrical nerve stimulation and ultrasound, and the patients were measured and located during surgery. Using Passing-Bablok regression and Bland-Altman graph to evaluated the consistency between transcutaneous electrical nerve stimulation, ultrasound and the surgical positioning.Results:A total of 43 subjects, including 22 patients and 21 volunteers, were selected for locating the LCSN. Thirty-nine males and 4 females, with an average age of 39 years old and an average BMI of 24.08. The operation time of percutaneous nerve electrical stimulation was(6±1) min, and the detection distance was(80.7±5.9) mm. The high-frequency ultrasound was(23±4) min, and the distance was(81.2± 6.6) mm. The average operation time of surgical measured distance was(80.9±8.2)(65-100) mm, the diameter of nerve was(2.3±0.8)(1.0-4.0) mm, and the operation time was(5±1) min. A 95% CI of Passing-Bablok regression intercept and slope of operation, percutaneous electrical nerve stimulation and ultrasoundincluded 0 and 1, respectively. The points on Bland-Altman plot were distributed on both sides, and 95% CI of total mean difference, total intercept and slope included 0. Therefore, it was can be considered that the application of percutaneous electrical nerve stimulation and ultrasound in LCSN localization has good consistency.Conclusion:The location point of the LCSN crossing the iliac crest which detected by transcutaneous electrical nerve stimulation and high-frequency ultrasound detection was close to the measurement taken during the operation. It was also showed that both of them can be used for preoperative locationing of the sensory branch of the sensory nerve flap, optimizing the design of the flap, shortening the operation time, and reducing the unnecessary injury in operation.
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OBJECTIVE: To compare the effectiveness of tibial nerve transcutaneous electrical nerve stimulation (TENS) for an overactive bladder, considering the sites of application and frequency of attendance. METHODS: This multi-arm randomized controlled trial enrolled 137 adult women (61.0±9.0 years) with overactive bladder from a university hospital. They underwent 12 sessions of 30-min TENS application and were assigned to five groups: one leg, once a week (n=26); one leg, twice a week (n=27); two legs, once a week (n=26); two legs, twice a week (n=28); and placebo (n=30). Symptoms of overactive bladder and its impact on quality of life were evaluated before and after 6 or 12 weeks of treatment using the Overactive Bladder Questionnaire-V8 and voiding diary. ClinicalTrials.gov: NCT01912885. RESULTS: The use of one leg, once a week TENS application reduced the frequency of urgency episodes compared with the placebo (1.0±1.6 vs. 1.4±1.9; p=0.046) and frequency of incontinence episodes compared with the placebo (0.7±1.4 vs.1.4±2.2; p<0.0001). The one-leg, twice a week protocol decreased the urinary frequency compared with the two legs, once a week protocol (8.2±3.5 vs. 9.0±5.1; p=0.026) and placebo (8.2±3.5 vs. 7.9±2.7; p=0.02). Nocturia improved using the two legs, once a week protocol (1.5±1.8) when compared with the one leg, twice a week protocol (1.9±2.0) and placebo (1.7±1.6) (p=0.005 and p=0.027, respectively). Nocturia also improved using the two legs, twice a week protocol when compared with the one leg, twice a week protocol (1.3±1.2 vs.1.9±2.0; p=0.011). CONCLUSION: One-leg stimulation improved the daily urinary frequency, urgency, and incontinence, and the two-leg stimulation once and twice weekly improved nocturia.
Subject(s)
Humans , Female , Adult , Urinary Incontinence , Transcutaneous Electric Nerve Stimulation , Urinary Bladder, Overactive/therapy , Quality of Life , Tibial Nerve , Treatment OutcomeABSTRACT
A esternotomia na cirurgia cardíaca é marcada por dor pós-operatória. Os medicamentos analgésicos são amplamente utilizados para aliviar esse sintoma, no entanto, apresentam vários efeitos adversos que variam de acordo com a classe terapêutica do medicamento utilizado. Portanto, o uso da Estimulação Elétrica Nervosa Transcutânea (TENS) aparece como uma alternativa não invasiva e de fácil aplicação para reduzir o uso de drogas em pacientes submetidos à cirurgia cardíaca. OBJETIVOS: Revisar sistematicamente os efeitos da TENS no tratamento da dor em pacientes no pós-operatório de cirurgia cardíaca e sua repercussão nos parâmetros respiratórios. METODOLOGIA: Revisão sistemática utilizando a metodologia PICO e palavras-chave (TENS, dor, pacientes no pós-operatório, cirurgia cardíaca). Foram incluídos estudos publicados que abordaram os efeitos da TENS na dor de pacientes após cirurgia cardíaca e, como variável secundária, seu impacto nos parâmetros respiratórios, publicados em português ou inglês, nos anos de 2008 a 2019. Estudos não randomizados excluídos, relatos de casos , observações clínicas e revisões. Além disso, os operadores booleanos "and" e "or" foram utilizados. RESULTADOS: A busca resultou inicialmente em 265 artigos, dos quais 253 foram excluídos, restando 12 artigos. Ao final, foram incluídos 5 artigos. As amostras variaram de 20 a 120 participantes. Dos cinco estudos selecionados, quatro demonstraram redução no nível de dor após cirurgia cardíaca, variando sua aplicação do primeiro dia ao terceiro dia de pós-operatório. Essa redução da dor favoreceu uma diminuição no uso de drogas como a morfina. Além disso, com a redução da dor, houve uma melhora na força muscular ventilatória e nos volumes e capacidades pulmonares. CONCLUSÃO: Conclui-se que a TENS é uma opção não medicamentosa que pode ser utilizada como adjuvante na redução da dor e, consequentemente, na melhoria da força muscular respiratória, volume e capacidade pulmonar, entre outros parâmetros, em pacientes submetidos à cirurgia cardíaca.
Sternotomy in cardiac surgery is marked by postoperative pain. Analgesic drugs are widely used to relieve this symptom, however, with several adverse effects that vary according to the drug therapeutic class used. Therefore, the use of Transcutaneous Electrical Nerve Stimulation (TENS) appears as a noninvasive and easily applicable alternative for reducing the use of drugs in patients undergoing cardiac surgery. OBJECTIVE: To systematically review the effects of TENS in the treatment of pain in patients in the postoperative cardiac surgery and its repercussion on respiratory parameters. METHODOLOGY: Systematic review using the PICO methodology and keywords (TENS, pain, patients in the postoperative,cardiac surgery). Published studies that addressed the effects of TENS on the pain of patients after cardiac surgery were included and, as a secondary variable, its impact on respiratory parameters, published in Portuguese or English, in the years 2008 to 2019. Excluded nonrandomized studies, case reports, clinical observations and reviews. In addition, the Boolean operators "and" and "or" were used. RESULTS: The search initially resulted in 265 articles, of which 253 were excluded, 12 articles remained. At the end, 5 articles were included. The search initially resulted in 2165 articles. Of these, 2160 were excluded, of which 5 were selected. The samples ranged from 20 to 120 participants. Of the five studies selected, four demonstrated a reduction in the level of pain after cardiac surgery, varying its application from the first day to the third postoperative day. This reduction in pain favored a decrease in the use of drugs such as morphine. In addition, with the reduction of pain, there was an improvement in ventilatory muscle strength and lung volumes and capacities. CONCLUSION: It is concluded that TENS is a non-drug option that can be used as an adjunct in pain reduction and, consequently , improving respiratory muscle strength, lung volume and capacity , among other parameters, in patients undergoing cardiac surgery.
Subject(s)
Transcutaneous Electric Nerve Stimulation , Pain , Thoracic SurgeryABSTRACT
Objective @#To evaluate the effects of transcutaneous electrical nerve stimulation ( TENS ) and waterbirth with Doula services on the outcome of delivery. @*Methods@#From July 2018 to December 2019, 150 primiparas in Hangzhou Women's Hospital were randomly divided into three groups: TENS, waterbirth and control groups. They were given TENS, waterbirth and conventional midwifery, accompanied by Doula services. The visual analogue scores ( VAS ) , length of labor stages and neonatal asphyxia were compared.@*Results@#It finally included 45 cases in the TENS group, 45 cases in the waterbirth group and 44 cases in the control group. There were no significant differences in gestational weeks, age, height, weight, fetal biparietal diameter and newborn birth weight among the three groups ( P>0.05 ) . The VAS scores of TENS group and waterbirth group were lower than those of the control group ( P<0.05 ) , but there were no significant differences between the two groups ( P>0.05 ) with the cervix open to 2.5-3 cm, 5-7 cm ( 0.5 hours later ) and 10 cm. There was no interaction between the analgesia methods and cervix diameter ( P>0.05 ) . The duration of the first stage of labor in the TENS group and the waterbirth group was less than that in the control group ( P<0.05 ) , and there was no significant difference between the TENS group and the waterbirth group ( P>0.05 ) . The asphyxia rate of neonates in TENS group, waterbirth group and control group were 2.22%, 2.22% and 4.55%, respectively, with no significant difference ( P>0.05 ) . @*Conclusion@#Under Doula services, both TENS and waterbirth can effectively relieve the pain of delivery and shorten the first stage of labor, without obvious differences.
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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.
RESUMO JUSTIFICATIVA E OBJETIVOS: Há uma variedade de formas de aplicação de estimulação elétrica nervosa transcutânea (TENS), sem que haja uma forma definida com melhores resultados no tratamento para a dor lombar inespecífica. O objetivo deste estudo foi avaliar qual aplicação de TENS tem melhor efeito sobre a redução imediata da intensidade da dor espontânea e provocada, em universitários com lombalgia inespecífica. MÉTODOS: Estudo quantitativo, aleatorizado e cruzado. Vinte indivíduos jovens foram distribuídos em quatro grupos e realizaram uma intervenção diferente por semana, totalizando quatro semanas. Grupos TENS convencional com frequência de 100Hz, duração de pulso de 200µs; TENS variação de frequência e intensidade com variação de frequência e duração de pulso automática, TENS Burst com frequência modulada em 2Hz, duração de pulso 250µs; e placebo em que os indivíduos foram submetidos a um protocolo de estimulação sem nenhuma sensação de formigamento ou contração muscular. Todas as sessões tiveram uma aplicação total de 20 minutos. Foram avaliados pela dor espontânea por meio da aplicação da escala analógica visual (EAV), e dor provocada pelo dolorímetro e dor ao frio por meio da aplicação de gelo sólido diretamente na pele, e EAV para intensidade de dor ao frio, todos realizados antes e após cada aplicação de eletroterapia. RESULTADOS: Apenas a escala analógica visual de dor espontânea apresentou resultados significativos (p<0,05) quando comparado intragrupos, nas três correntes aplicadas. CONCLUSÃO: As três formas utilizadas no presente estudo foram capazes de reduzir a dor espontânea após a intervenção por eletroestimulação.
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Objective：The purpose of this study was to determine whether combination therapy has an effect on extrapersonal neglect (EP).Methods：The subject, who was capable of walking without the help of a cane or an orthosis, had right brain damage with left unilateral spatial neglect. We used a single-case study (BAB) design, consisting of a 2-week intervention phase, a 2-week baseline phase, and another 2-week intervention phase. The subject was trained seven times a week. Period A (baseline) included normal visual scanning training during walking, while Period B (intervention) included both normal visual scanning training with transcutaneous electrical nerve stimulation (TENS) for neck muscles and video feedback (VF) with a smartphone during walking. The primary outcomes used Behavioral Inattention Test (BIT), and the Catherine Bergego Scale (CBS).Results：Both BIT and CBS improved in Period B. In particular, the CBS sub-items “Collides with people or objects on the left side” and “Experiences difficulty in finding his way towards the left when traveling in familiar places or in the rehabilitation unit” during walking improved, showing improvement in the results of CBS observation scores and anosognosia scores.Conclusion：In this study, we suggested that combination therapy has a beneficial effect on EP and awareness. We also reported the safety and feasibility of the combination therapy.
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Objective：The purpose of this study was to determine whether combination therapy has an effect on extrapersonal neglect (EP).Methods：The subject, who was capable of walking without the help of a cane or an orthosis, had right brain damage with left unilateral spatial neglect. We used a single-case study (BAB) design, consisting of a 2-week intervention phase, a 2-week baseline phase, and another 2-week intervention phase. The subject was trained seven times a week. Period A (baseline) included normal visual scanning training during walking, while Period B (intervention) included both normal visual scanning training with transcutaneous electrical nerve stimulation (TENS) for neck muscles and video feedback (VF) with a smartphone during walking. The primary outcomes used Behavioral Inattention Test (BIT), and the Catherine Bergego Scale (CBS).Results：Both BIT and CBS improved in Period B. In particular, the CBS sub-items“Collides with people or objects on the left side”and“Experiences difficulty in finding his way towards the left when traveling in familiar places or in the rehabilitation unit”during walking improved, showing improvement in the results of CBS observation scores and anosognosia scores.Conclusion：In this study, we suggested that combination therapy has a beneficial effect on EP and awareness. We also reported the safety and feasibility of the combination therapy.
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ABSTRACT Objective: The purpose of this study was to investigate the effects of neuromuscular electrical stimulation (NMES) in different frequencies on the quadriceps femoris. A randomized, controlled, blind cross-sectional study. Methods: Thirty subjects (12 men and 18 women), with an average age of 24.67 years, weight of 65.62 kg and height of 1.69 m were evaluated. Three random test conditions were applied: maximum voluntary isometric contraction (MVIC), maximum voluntary isometric contraction with medium frequency current (MVIC-MF) and maximum voluntary isometric contraction with low frequency current (MVIC-LF). Four MVICs were applied in each situation. The time between different isometric contraction types was 90 seconds while the time between the same conditions of contraction was 10 seconds. Results: Two-way ANOVA test showed that MVIC-MF had higher values for peak torque than MVIC-LF (p=0.02). Significant statistical results were found when comparing MVIC-MF and MVIC (p=0.03), but not for MVIC and MVIC-LF (p=0.52). Conclusion: Maximum voluntary isometric contraction associated with medium-frequency electrical stimulation was more effective than other NMES conditions. Level of Evidence II, Therapeutic Studies - Investigation of treatment results.
RESUMO Objetivo: A finalidade deste estudo foi investigar os efeitos da estimulação elétrica neuromuscular (EENM) em diferentes frequências sobre o músculo quadríceps femoral. Estudo randomizado, transversal, controlado e cego. Métodos: Foram avaliados trinta indivíduos de ambos os sexos (12 homens e 18 mulheres) com média de idade de 24,67 anos, peso 65,62 kg e altura 1,69 m. Os indivíduos foram submetidos a três condições de testes randomizados: contração voluntária isométrica máxima (CVIM), contração voluntária isométrica máxima associada à corrente de média frequência (CVIMMF) e contração voluntária isométrica máxima associada à baixa frequência (CVIMBF), sendo realizadas quatro repetições de CVIM em cada situação. O tempo entre as diferentes condições de contrações isométricas foi de 90 segundos e o tempo entre as contrações isométricas das mesmas condições foi de 10 segundos. Resultados: O teste ANOVA mostrou que a CVIMMF obteve valores de pico de torque maiores do que a CVIMBF (p = 0,02), com diferença significativa. Foram encontrados resultados com significância estatística ao comparar CVIMMF e CVIM (p = 0,03), mas não entre CVIM e CVIMBF (p = 0,52). Conclusões: A contração voluntária isométrica máxima associada a EENM de média frequência foi mais efetiva do que as outras situações de EENM. Nível de evidência II, Estudos Terapêuticos - Investigação dos resultados do tratamento.
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ABSTRACT BACKGROUND AND OBJECTIVES: Cryotherapy and transcutaneous electrical nerve stimulation are physiotherapeutic resources widely used for the treatment of pain, due to their analgesic actions proved by scientific evidence. The concomitant use of these two therapeutic modalities in clinical practice is becoming more and more recurrent, justified by the assumption of boosting the analgesic effect. However, some physiotherapists disagree with this practice and believe that the simultaneous use of cryotherapy and transcutaneous electrical nerve stimulation nullifies its effects. The objective of this study was to carry out a bibliographic review of studies on the effects of the simultaneous use of cryotherapy and transcutaneous electrical nerve stimulation in pain treatments. CONTENTS: We selected articles published between 2006-2018 in the databases Scielo, LILACS, Medline and Pubmed. The selection was based on the crossing of the keywords: transcutaneous electrical nerve stimulation, cryotherapy and analgesia. The final sample consisted of 6 articles. CONCLUSION: The results of the analysis of the selected articles showed that, as already scientifically proved, the effects of cryotherapy and transcutaneous electrical nerve stimulation alone have their analgesic efficacy. However, most of the studies did not demonstrate a significant improvement in pain with the associated use of transcutaneous electrical nerve stimulation and cryotherapy compared to the isolated use of these physiotherapeutic resources, reinforcing the need for further research to elucidate the issue.
RESUMO JUSTIFICATIVA E OBJETIVOS: Crioterapia e estimulação elétrica nervosa transcutânea são recursos fisioterapêuticos amplamente utilizados para o tratamento da dor, devido a suas ações analgésicas comprovadas por evidências científicas. Torna-se cada vez mais recorrente o uso concomitante dessas duas modalidades terapêuticas na prática clínica, justificando-se com o pressuposto de potencialização do efeito analgésico. No entanto, alguns fisioterapeutas discordam dessa prática e acreditam que o uso simultâneo da crioterapia com a estimulação elétrica nervosa transcutânea leva à anulação dos seus efeitos. O objetivo deste estudo foi realizar uma revisão bibliográfica de estudos sobre os efeitos do uso simultâneo da crioterapia e da estimulação elétrica nervosa transcutânea nos tratamentos para dor. CONTEÚDO: Foram selecionados artigos publicados entre os anos 2006-2018 nas seguintes bibliotecas e bases de dados: Scielo, LILACS, Medline e Pubmed. A seleção foi baseada no cruzamento dos descritores: estimulação elétrica nervosa transcutânea, crioterapia e analgesia. A amostra final foi composta por 6 artigos. CONCLUSÃO: O resultado da análise dos artigos selecionados mostrou que, como já comprovado cientificamente, os efeitos da crioterapia e da estimulação elétrica nervosa transcutânea isoladamente têm sua eficácia analgésica. Entretanto, a maioria dos estudos não demonstrou melhora significativa da dor com o uso associado da crioterapia com estimulação elétrica nervosa transcutânea comparado ao uso isolado dos recursos fisioterapêuticos, reforçando a necessidade de mais pesquisas que elucidem a questão.