Foundational Research Could Improve Future Transcutaneous Electrical Nerve Stimulation Evaluations (original) (raw)
Related papers
Physiotherapy, 2019
Background There is no consensus regarding the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) for chronic musculoskeletal or low back pain. A review of previous trial methodology identified problems with treatment fidelity. Qualitative research with experienced TENS users identified specific contexts for TENS use, leading to individualised outcomes. There is little information available to guide the selection of Patient Reported Outcome Measures (PROMs) appropriate for TENS evaluation. Objective To determine the capability of previously used PROMs to capture the perceived benefits of TENS reported by secondary care Pain Clinic patients who successfully used TENS to manage chronic musculoskeletal pain. Design The World Health Organisation International Classification of Functioning, Disability and Health (ICF) was used to match the perceived benefits of TENS against previously used PROMS. Methods Semi-structured interviews conducted with nine patients (6 women) as well as three other qualitative datasets (88 patients in total) generated patient-reported benefits which were matched against previously used PROMs using the ICF. Findings There were 18 items in the final list of benefits, and none of the four functional outcome measures used in previous RCTs captured more than 8 of these 18 items. The data analysis complemented the inductive thematic analysis but could not replace it, indicating the value of both forms of analysis. Conclusions This study highlights a low level of match between outcome measures used in previous TENS studies, and the benefits perceived by experienced TENS users. This suggests that further work is required if the patient-reported benefits of TENS are to be evaluated.
Physical Therapy, 2015
Background There is no consensus regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for management of chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of patient-reported outcome measures appropriate for TENS evaluation. Objectives The purpose of this study was to explore the experiences of patients at a secondary care pain clinic who successfully used TENS to help manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. Design A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Methods A mini focus group informed the development of a discussion guide for semistructured interview...
Scholars journal of applied medical sciences, 2022
Original Research Article The management of low back pain (LBP) encompasses a diverse range of possible interventions including drug therapy, surgery, exercise, patient education, physiotherapy, cognitive-behavioral therapy and various other nonpharmacological therapies. Acute and chronic LBP warrant separate consideration as they may respond differently to the same interventions. Transcutaneous electrical nerve stimulation (TENS) is widely used as a therapeutic adjunct in the management of low back pain. It is relatively safe, non-invasive and easy to use modality that makes it an attractive treatment option. For more than four decades, TENS has been applied in the treatment of acute and chronic pain syndromes. Hence there is still uncertainty about the most effective therapeutic approach in chronic non-specific low back pain. Methods: This randomized controlled clinical trial was conducted in the department of Physical Medicine and Rehabilitation, Chatto gram from 13/01/2019 to 13/06//2019. The aim of the study was to evaluate the effects of Transcutaneous Electrical Nerve Stimulation on Chronic Non-specific Low Back Pain Patients. 120 patients with chronic low back pain were treated according to inclusion & exclusion criteria. Patients were equally distributed in three groups. Group-A patients (n=40) treated with NSAID+ADL, and Group-B patients (n=40) treated with NSAID+ADL+TENS and Group-C patients (n=40) treated with NSAID+ ADL+ Back extension exercise. Written informed consent was obtained from all patients. Data were calculated and analyzed by computer based software SPSS (Statistical Package for social Science) windows 16.0 version. Main Outcome Measure (S): Age, Sex, Occupational status, Socioeconomic status, Subjective pain intensity score, Visual Analogue Scale, Tenderness index, Disability due to pain, Spinal mobility index, Oswestry disability Index. Results: The mean age was found 41.82±11.95 years in group A and 42.7±12.52 years in group B and 40.52±13.40 in group C.Majority patients (55-60%) came from middle class family in all groups. Mean duration of pain was found 23.90±2.57 months in group A, 21.0+1.50 months in group B and 22.1±1.89 months in group C. Visual analogue score was improved individually in group-A, group B and group C after treatment, which was statistically significant (P<0.05). Oswestry disability questionnaire score was also improved individually in group-A, group B and group C after treatment, which was statistically significant (P<0.05). And in case of comparison between group-B and Group-C this was not statistically significant (P>0.05). Discussion: In this current study it was observed that the entire variable individually improved in Group-A, Group-B and Group-C. So, all the three treatment groups were benefited from drugs and therapy. But these were not statistically significant (P>0.05) in between Group-B and Group-C. All therapies were helpful. But there was no significant difference in improvement between TENS and NSAID. Conclusion: Beneficial effects of TENS were seen in the study population but no firm conclusion could be drawn.
Transcutaneous Electrical Nerve Stimulation Uptake in Lowering Low Back Pain
Indonesian Journal of Medicine
Background: Low Back Pain (LBP) is a generalized pain from the second lumbar vertebra to the sacroiliac joint, and is generally a lifelong health disorder. LBP is often the cause of people feeling a decrease in ability in daily functional activities. Patients often complain of symptoms of pain, muscle spasms and impaired function. One of the interventions that can be used to reduce LBP is therapy using transcutaneous electrical nerve stimulation (TENS). TENS is a device used to relieve pain by stimulating nerves through electrodes transcutaneously. TENS is one of the modalities that can improve neuromuscular function or reduce pain and is very useful for patients with complaints of low back pain who experience pain and muscle weakness around the pelvis, trunk, and lower legs. LBP patient. Subject and Method: This study was a meta-analysis with the following PICO, population: low back pain patients. Intervention: administration of TENS. Comparison: not given TENS. Result: decreased pain. The articles used in this study were obtained from three databases, namely Google Scholar, Pubmed, and Science Direct. Keywords to search for articles "transcutaneous electrical nerve stimulation" OR "TENS" AND "reduction pain" OR "pain relief" AND "low back pain". The articles included are full-text English with a randomized control trial study design from 2007 to 2022. Article selection was carried out using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3. application. Results: A total of 12 case studies from continental Europe, America and Asia were selected for systematic review and meta-analysis. It was found that giving TENS-0.67 times reduced pain in complaints of low back pain compared to not given TENS significantly (SMD =-0.67; 95% CI =-1.03 to-0.32; p = 0.002). Conclusion: Transcutaneous Electrical Nerve Stimulation reduces pain in low back pain patients.
Effects Of Transcutaneous Electrical Nerve Stimulation (Tens) On Patients With Acute Low Back Pain
Journal of Armed Forces Medical College, Bangladesh, 2012
Background: Acute low back pain (LBP) affects a significant proportion of the population. Transcutaneous electrical nerve stimulation (TENS) was introduced more than 30 years ago as an adjunct to the pharmacological management of pain. However, despite its widespread use, the usefulness of TENS in LBP is still controversial. Introduction: LBP is a common problem in Bangladesh. Acute LBP is usually defined by a period of complaints of LBP of six weeks or shorter. TENS may improve acute LBP. Objective: To evaluate the effectiveness of TENS on acute LBP and also to ensure the patients wellbeing by shortening recovery time who have acute LBP. Methods: A prospective study was carried out in the Department of Physical Medicine and Rehabilitation, Bangubandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July 2008 to December 2008. The patients were divided into two groups (A and B). Patients of Group A (30 patients) were treated with TENS, Non-steroidal anti-inflammator...
Physical Therapy, 2013
Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological treatment for control of pain. It has come under much scrutiny lately with the Center for Medicare Services rendering a recent decision stating that "TENS is not reasonable and necessary for the treatment of CLBP [chronic low back pain]." When reading and analyzing the existing literature for which systematic reviews show that TENS is inconclusive or ineffective, it is clear that a number of variables related to TENS application have not been considered. Although many of the trials were designed with the highest of standards, recent evidence suggests that factors related to TENS application need to be considered in an assessment of efficacy. These factors include dosing of TENS, negative interactions with long-term opioid use, the population and outcome assessed, timing of outcome measurement, and comparison groups. The purpose of this perspective is to highlight and interpret recent evidence to help improve the design of clinical trials and the efficacy of TENS in the clinical setting.
Physical Therapy Reviews, 2008
Background: Chronic orchialgia is defined as testicular pain, which may be either unilateral or bilateral, lasting for more than 3 months. It disturbs a patient's daily activities and quality of life (QoL), inciting the patient to search for treatments to alleviate the pain. It is estimated that 25% of chronic orchialgia cases are idiopathic. Purpose: The purpose of this study was to investigate how effective transcutaneous electrical nerve stimulation (TENS) is in pain reduction and how it consequently affects the QoL in patients with idiopathic chronic orchialgia (ICO). Patients and methods: Seventy-one patients were randomly assigned to group A (study group), which included 36 patients who received TENS and analgesia, and group B (control group), which included 35 patients who received analgesia only. The outcome measures were the participants' demographic data and results of the visual analog scale (VAS) and QoL questionnaire. These outcomes were measured before and after 4 weeks of treatment and at 2-month follow-up. Results: The results showed that compared to pretreatment, there was a significant reduction in pain postintervention and at 2-month follow-up in group A (P<0.0001 and <0.001, respectively; F=7.1) as well as a significant improvement in QoL at these time points (P<0.0001 and <0.0001, respectively). There were no significant differences in the VAS score and QoL in group B at different time points of evaluation. Conclusion: The findings indicate that TENS is effective in reducing pain and improving patients' QoL in cases of ICO. TENS is an easy-to-use, effective, noninvasive, and simple method for ICO-associated pain control and QoL improvement.