The choice of electrode placement for transcutaneous electrical nerve stimulation (TENS)

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The choice of electrode placement for transcutaneous electrical nerve stimulation (TENS)

 

Author: Chan, Wing-yee
Title: The choice of electrode placement for transcutaneous electrical nerve stimulation (TENS)
Degree: M.Sc.
Year: 2004
Subject: Hong Kong Polytechnic University -- Dissertations
Transcutaneous electrical nerve stimulation
Department: Dept. of Rehabilitation Sciences
Pages: xi, 91 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1800277
URI: http://theses.lib.polyu.edu.hk/handle/200/4119
Abstract: Objectives: Transcutaneous electrical nerve stimulation (TENS) has been widely adopted by physiotherapists in the management of acute and chronic pain conditions. The stimulation parameters have to be well controlled so as to achieve the maximum hypoalgesic effect. However, there is little consensus regarding the optimal stimulation parameters in particular there is a lack of investigation on the most effective site for electrode placement. The aim of this study is to determine whether the selection of electrode placement of TENS on acupuncture point would produce greater hypoalgesia than non-acupuncture point by measuring the peripheral neurophysiological and sensory changes. Study Design: Forty-five healthy subjects (21 male, 24 female) were randomly assigned to one of the three groups: TENS group with electrode placement on acupuncture point LI 11 (Quchi) of right elbow (TENSA), TENS group with electrode placement on non-acupuncture point over the lateral border of right forearm (TENSNA) or control group. Subject of the two TENS groups both received electrical stimulation delivering at frequency of 4 Hz and pulse duration of 200 us for 30 minutes. Peripheral neurophysiological effect was measured in terms of negative peak latency (NPL) in the sensory nerve conduction study of the right superficial radial nerve (SRN). Sensory changes were measured in terms of mechanical pain threshold (MPT) and mechanical pain tolerance (MPTol) over the first dorsal web space of right hand. All of the outcome measures were recorded at 10 minutes and 0 minute before TENS stimulation as the baseline data, and then they were collected every 15 minutes during and after the stimulation up to 30 minutes of post-stimulation period. Results: The baseline data of NPL, MPT and MPTol were similar in all three groups (all p >0.05). Repeated measures analysis of variance (ANOVA) showed that there was no interaction between 'group' and 'time' in all outcome measures (all p>0.05). No significant difference in NPL, MPT and MPTo1 was observed between the three groups at any of the five times of measurement (all p >0.05). However, there was significant increase of NPL over time (p=0.015) with a maximally 4.1% change in the two TENS groups. There was an increase in MPT over time (p=0.002) as well, which amounted to 11.6% at most in the TENSNA group. No significant increase was found in MPTo1 over time (p=0.427). Conclusion: The present findings suggest that TENS application over acupuncture point was no more favourable than stimulation over non-acupuncture point along the peripheral nerve. The choice of placing electrodes over acupuncture points seems not able to enhance the hypoalgesic effect of TENS.

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