The effects of electro-acupuncture and transcutaneous electrical nerve stimulation (TENS) on patients with painful osteoarthritic knees (a pilot study)

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The effects of electro-acupuncture and transcutaneous electrical nerve stimulation (TENS) on patients with painful osteoarthritic knees (a pilot study)

 

Author: Ng, Ma-li Mary
Title: The effects of electro-acupuncture and transcutaneous electrical nerve stimulation (TENS) on patients with painful osteoarthritic knees (a pilot study)
Degree: M.Sc.
Year: 2001
Subject: Osteoarthritis -- Treatment
Knee -- Diseases -- Treatment
Acupuncture
Electrotherapeutics
Transcutaneous electrical nerve stimulation
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: xi, 96 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1569097
URI: http://theses.lib.polyu.edu.hk/handle/200/1491
Abstract: The prevalence of knee osteoarthritis (OA) increases with increasing age. Therefore, effective pain control in the elderly is of great importance in enhancing their functional status and improving their quality of life. Both electro-acupuncture (EA) and transcutaneous electrical nerve stimulation (TENS) are common and effective treatment of choice for the reduction of osteoarthritic knee pain. This pilot study (single blind, randomized controlled trial) intended to examine the relative effectiveness of EA and TENS in alleviating OA induced knee pain. Twenty-four subjects (23 women and 1 man), of mean age 85.08, were recruited from 8 subvented Care & Attention Homes for the elderly. They were randomly assigned into the EA, TENS and control groups. All subjects had received standard osteoarthritic knee care and education. Subjects in the EA group (N=8) received low-frequency EA (2Hz) on two acupuncture points (ST-35, Dubi and EX-LE-4, Neixiyan) of the painful knee for 20 minutes. Subjects in the TENS group (N=8) received low-frequency TENS of 2 Hz and pulse width of 200 us on the same acupuncture points for 20 minutes. Subjects in the control group (N=8) were just receiving osteoarthritic knee care and education. Electrical treatments were carried out on alternate days for a total of 8 sessions. All evaluations of subjects were performed by an assessor, who was blind to the group assignment of subjects. Subjects were tested before the first treatment, after the last treatment and at 2-week follow-up periods. The outcome measures included numerical rating scale (NRS) of pain, passive range of movement (ROM) of the knee and timed up-and-go test (TUGT). Repeated measures ANOVA was used to analyze the time effect as well as the group effect on each outcome measure. The results showed that there was significant interaction between the time and the group effects for the NRS and TUGT (p=0.001 and 0.031 respectively) but no significant interaction for the ROM. Further analysis of the time effect on each group, there was significant improvement of the NRS and TUGT in the EA group across sessions (p=0.000 and 0.024 respectively) and significant improvement of the NRS in the TENS group (P=0.006). For the between-group comparison, there were no significant differences among the three groups as NRS was concerned. For the TUGT measurement, there was significant between group differences at the post-treatment time (p=0.048). Post-hoc test showed that the TUGT score of the EA group was significant lower than the control group after treatment (p=0.043). To conclude, both EA and TENS treatments demonstrated significant pain reduction effect on patients with OA induced knee pain after 8 sessions of treatment. But at 2-week follow-up time, the EA group demonstrated a prolonged analgesic effect while the effect of TENS could not be maintained. Therefore, in order to have a carry over effect, or a prolonged effect, the use of EA may be more preferable.

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