Physical therapy
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of transcutaneous electrical nerve stimulation characteristics on clinical pain.
We compared the effects of four treatment variables on the pain reduction produced by transcutaneous electrical nerve stimulation and attempted to establish indications for TENS based on patient history and pain evaluation items. Treatment variables were the therapist and the three TENS stimulus characteristics--pulse width, frequency, and amplitude. We randomly assigned 192 consecutive adult patients suffering from painful conditions to one of four physical therapists and one of 12 stimulus characteristic combinations. ⋯ The amplitude effect, however, was borderline (p = .056), and subthreshold stimulation proved more effective than stimulation to tolerance (p = .05). Extensive multiple linear regression analyses failed to provide indications for TENS based on patient information and pain evaluation items. Therefore, pain remains the only indication for TENS, and we recommend subthreshold rather than higher amplitude stimulation on the initial TENS trial.
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Comparative Study
Effect of different forms of transcutaneous electrical nerve stimulation on experimental pain.
The purpose of this study was to compare the effects of five different types of transcutaneous electrical nerve stimulation on experimentally induced pain threshold and tolerance in healthy subjects. Fourteen subjects received the following treatments on different days: low frequency TENS, burst frequency TENS, hyperstimulation TENS, high frequency TENS with a low voltage galvanic stimulator, and high frequency TENS with a high voltage galvanic stimulator to the left upper extremity. Pain threshold and tolerance were tested with electric current on a fingertip of the left upper extremity before each treatment, immediately after each treatment, and 20 minutes after the end of each treatment. ⋯ No significant effects of treatment or time for pain threshold or tolerance were found. A significant interaction between treatment and time for pain threshold was found. Further study is needed to compare the effects of these treatments in patients with clinical pain.