The effectiveness of transcutaneous electrical nerve stimulation on neuropathic pain

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The effectiveness of transcutaneous electrical nerve stimulation on neuropathic pain

 

Author: Luk, Lai-mei May
Title: The effectiveness of transcutaneous electrical nerve stimulation on neuropathic pain
Degree: M.Sc.
Year: 2002
Subject: Hong Kong Polytechnic University -- Dissertations
Transcutaneous electrical nerve stimulation
Pain -- Treatment
Nervous system -- Diseases -- Diagnosis
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: vii, 68 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1637829
URI: http://theses.lib.polyu.edu.hk/handle/200/380
Abstract: Hypersensitivity is a condition of extreme discomfort in response to normally non-noxious tactile stimulation, which may caused by peripheral nerve injuries. Patients with hypersensitive hands usually avoid using the irritable hands, resulting in a reduction in grip strength, loss of joint range of motion and thus affecting their work activities. Transcutaneous electrical nerve stimulation (TENS) has proven to be effective in managing varies pain conditions. Recent studies also showed that high frequency TENS produced analgesic effect on reducing the experimentally induced hypersensitivity in animals. Although TENS is a common treatment modality in clinical setting for relieving hypersensitivity in hand rehabilitation, there is a lack of research evidence to support the application of TENS for this condition. The objective of the study was to examine the effectiveness of high frequency TENS in decreasing the hypersensitivity in hand after peripheral nerve injury. A single-blinded randomized controlled study design was used. Nineteen patients with a mean age of 42.5 years suffered from hand hypersensitivity participated in this study. They were randomly assigned into two groups received either TENS or sham TENS treatment. The TENS treatment was delivered at a frequency of 100Hz and pulse width of 200us for 20minutes, and the intensity was at a maximum tolerable intensity. The placebo group received a sham TENS for 20 minutes. Treatment was given 5 days a week for 2 weeks. The outcome measures were assessed on Day 1, Day 4, Day 7 and Day 11 before applying the stimulation. Visual analogue scale (VAS) and the ten dowel textures of Downey Hand Center Hand Sensitivity Test (DHCHST) were used to measure the tactile tolerance in hand. The grip strength was also assessed by grip dynanometer of Eval Sono System. After repeated stimulations of TENS for two weeks, the average pre-stimulation VAS score was significantly reduced by 70% (100% on Day 1 to 29.6% on Day 11, p=0.000). The average pre-stimulation VAS score in the placebo group was reduced by 30% (100% on Day 1 to 69.4% on Day 11, p=0.000 Significant between-group difference in the VAS scores was reached by Day 7 (p=0.003), and Day 11 (p=0.002). in which TENS group showed lower VAS scores on both days. Similar findings were shown on the improvement in the ranking of ten dowel textures of the DHCHST. The ranking of ten dowel textures after TENS was significantly increased by 6.1 hierarchy level as compared to the pre-stimulation value (p=0.000), whereas the placebo TENS demonstrated only an increase by 2 hierarchy level (p=0.000). The significant between-group differences were reached by Day 7 (p=0.005), and Day 11 (p=0.006). By Day 11, there was a significant increase in grip strength in both the TENS group (by 40.2%, p=0.000), and the placebo group (by 32.3%, p=0.000) respectively. However, the between-group difference was insignificant. In conclusion, our findings suggest that high frequency TENS is effective in reducing hand hypersensitivity. Ten sessions of TENS for 20 minutes each can significantly improved the tactile tolerance of hand as measured by VAS score, and the ten dowel textures in DHCHST, but not the grip strength.

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