Author: Law, Pui-wah Pearl
Title: The optimal stimulation frequency of transcutaneous electrical nerve stimulation (TENS) on people with knee osteoarthritis
Degree: M.Sc.
Year: 2002
Subject: Hong Kong Polytechnic University -- Dissertations
Transcutaneous electrical nerve stimulation
Osteoarthritis -- Treatment
Knee -- Diseases -- Treatment
Department: Multi-disciplinary Studies
Department of Rehabilitation Sciences
Pages: ix, 98 leaves : ill. (some col.) ; 30 cm
Language: English
Abstract: TENS is an effective means of alleviating pain. In past decades it has been widely used by physiotherapists in managing various pain conditions, including osteoarthritic (OA) knee. Clinical studies have indicated that TENS of different frequencies may work through different endogenous opioid system for pain relief Low frequency (2-4 hertz) TENS triggers the release of enkephalin and |B-endorphin acting on the mu and delta receptors, whereas high frequency (100 Hz) TENS appears to involve mostly dynorphin and acts on the kappa opioid receptors. Studies in rats have suggested that the use of alternating low frequency TENS with high frequency would produce a more potent anti-nociceptive effect. The present study was designed to compare the analgesic effect of this alternating frequency mode of treatment to a fixed high or low frequency stimulation in the treatment of patients with OA knees. Patients suffering from forty-eight painful OA knees were randomly divided into four groups receiving TENS at pulse width of 200us to 600us for 40 minutes for either (I) 2 Hz., (II) 100Hz, (111) 2/100 Hz, or (IV) placebo TENS. Treatment was administered 5 days a week for 2 weeks. A follow-up session was conducted 2 weeks after the treatment period. Outcome measures (I) The visual analogue scale was used to measure the intensity of pain of the patients. (II) The "timed up-and-go" test was used to assess patient's functional mobility. (III) Range of knee motion including both pain limit range and maximum passive range was measured. Repeated measures ANOVA was used to compare the pre- and post-treatment data across sessions and between groups. Results: All of the 3 active TENS groups (2Hz, 100Hz, 2/100Hz) demonstrated a significant reduction in OA knee pain whereas the placebo group did not. In the first session, TENS at 100 Hz produced a significantly greater analgesic effect than TENS at 2Hz and placebo at 60 min after treatment (p=0.047, p=0.028 respectively). However, no significant between-group difference was noted among the TENS2/100 group and the other two active TENS groups in all treatment sessions. Conclusion: Our findings demonstrated that 2 weeks of repeated applications of TENS at 2 Hz, 100 Hz or 2/100 Hz significantly reduced OA knee pain, whereas the placebo group did not.
Rights: All rights reserved
Access: restricted access

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