The influence of auricular transcutaneous electrical nerve stimulation (TENS) on autonomic function and pain threshold in healthy subjects

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The influence of auricular transcutaneous electrical nerve stimulation (TENS) on autonomic function and pain threshold in healthy subjects


Author: Lau, Wai-leung
Title: The influence of auricular transcutaneous electrical nerve stimulation (TENS) on autonomic function and pain threshold in healthy subjects
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Transcutaneous electrical nerve stimulation.
Pain -- Treatment.
Department: Dept. of Rehabilitation Sciences
Pages: xiii, 94 leaves : ill. (chiefly col.) ; 30 cm.
Language: English
InnoPac Record:
Abstract: Background Information: Acupuncture is one of the commonly used traditional Chinese therapeutic procedures. Auricular acupuncture is a form of acupuncture that has been used to manage pain or other conditions. Transcutaneous electrical nerve stimulation (TENS) is a commonly used pain relieving modality in physiotherapy, it has also been used in combined with the auricular acupuncture to modulate autonomic function for patients suffering from cardiovascular conditions such as hypertension and ischaemic heart disease. However, limited studies have investigated the effects of auricular stimulation on autonomic nervous system and pain threshold. An increase in the parasympathetic activities is supposed to be one of the underlying physiological mechanisms of using auricular acupuncture on the management of cardiovascular conditions, but it has not been demonstrated in previous studies. Therefore, the objective of our study was to determine the influence of auricular stimulation on the autonomic system and pain threshold in healthy subjects. Study Design: A single-blinded randomized controlled trial with a convenience sample. Methodology: A total of sixty healthy volunteers (30 men, 30 women, age ranged from 20 to 40 years old) were recruited and randomly allocated into three groups. Subjects received either auricular stimulation at appropriate ear acupuncture points (treatment group); or auricular stimulation at inappropriate ear acupuncture points (placebo group); or no stimulation (control group). Low frequency (2 Hz) electrical stimulation was given to both treatment and placebo groups for 30 minutes. Main Outcome Measures: Forehead temperature (Ftemp), ear temperature (Etemp), heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP), respiratory rate (RR) and mechanical pain threshold (MPT) were measured before stimulation; at the end of the stimulation (tl); and 30 minutes after stimulation (t2). Results: At the end of the stimulation, only the treatment group demonstrated a significant decrease in heart rate, systolic and diastolic blood pressure (p=0.001[HR], 0.001 [SBP], 0.005[DBP]). At the end of stimulation, the HR, and DBP of the treatment group were significant lower than did the control group (all p<0.05) However, the effects did not outlast at 30 minutes after stimulation and no significant between-group difference was found. Significant increase in mechanical pain threshold over time was found in both treatment group (p<0.001) and placebo group (p<0.001). The between-group comparisons revealed that the MPT of both treatment group and placebo groups were significant higher than the control group at the end of stimulation (all p<0.05). But greater carryover effect was found in the treatment group as compared to placebo group. No significant change was found within group and between-group in ear temperature, forehead temperature and respiratory rate in all recording periods. Conclusion: A single session of 30 minutes auricular TENS produced a significantly greater reduction in the heart rate, diastolic blood pressure and pain threshold at the end of the stimulation as compared to the placebo and control groups. Only the effect on pain threshold can last over 30 minutes. The treatment group did demonstrate a decrease in systolic blood pressure at the end of stimulation, but the between-group did not reach significance.

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