Pain Management Table 18 TENS in Post-SCI Pain

Author Year
Country
PEDro Score
Research Design
Total Sample Size

Methods

Outcome

Ozkul et al. 2015
Turkey
RCT Crossover
PEDro=5
N=24

Population: Mean age: 32.3 yr; Gender: males=18, females=6; Level of injury: paraplegia=6, quadriplegia=18; Level of severity: incomplete=7, complete=17; Mean time since injury: 12.5 mo; Type of pain: neuropathic.
Intervention:
Participants received transcutaneous electrical nerve stimulation (TENS) and visual illusion (VI) in a randomized sequence. Each treatment was delivered for 2 wk with a 1 wk washout period in between. Outcomes were assessed pre-and post each treatment period.
Outcome Measures:
Visual Analogue Scale – Pain Intensity (VAS-PI), Neuropathic Pain Scale (NPS), Brief Pain Inventory (BPI).
  1. There was a reduction in VAS-PI immediately after VI (p=0.07) and TENS (p=0.08), but there was no statistically significant group effect.
  2. There was a significant reduction in pain 2wk post TENS (p=0.04) but not 2 wk post VI (p>0.05).
  3. On NPS, VI significantly decreased the following pain types: hot (p=0.047), sharp (p=0.02), unpleasant (p=0.03), and deep (p=0.047); TENS did not show any significant effects.
  4. On BPI, VI significantly decreased the negative effect of pain on moving ability (p=0.04) and TENS significantly decreased the negative effect of pain on mood (p=0.03), relationships (p=0.04), and sleep (p=0.04).
Effect Sizes

Yeh et al. 2010
Taiwan
PEDro=6
RCT
N=99

Population: Mean age: 60.4 yr.
Treatment: Patients who previously underwent surgery for non-traumatic SCI were randomized to one of three groups: 1) true acupoint intervention through electrical stimulation; 2) sham acupoint; 3) no treatment.
Outcome Measures: VAS,BPI
  1. Significant difference was seen in pain intensity between the true acupoint group and sham group (p<0.03) and the true acupoint group and control group (p<0.02).
  2. A significant reduction was also seen in the impact of pain on sleep in the true acupoint group compared to the other two groups (p<0.05).

Norrbrink 2009
Sweden
Prospective Controlled Trial
N=24

Population: Age=47.2yr; Gender: males=20, females=4; Level of injury: C=13, T=8, L=3. Type of pain=Neuropathic and musculoskeletal
Intervention: Patients were provided with either low frequency (2Hz) or high frequency (80Hz) TENS stimulation for 30-40 min 3x/day for 2 wk followed by a 2 wk washout period and switched stimulation frequency.
Outcome Measures: NRS
  1. No significant difference was found between the two modes of stimulation.
  2. 21% reported reduction of greater than or equal to 2 units of general pain intensity (more than 1.8 considered significant clinical reduction), 29% in worst pain intensity and 33% in pain unpleasantness.
  3. 29% reported a favorable effect on the global pain relief scale from HF and 38% from LF stimulation.

Davis & Lentini 1975
USA
Case series
N=31

Population: Type of pain=neuropathic
Treatment: Patients were tested with transcutaneous nerve stimulation.
Outcome Measures: Subjective patient report.
  1. Those with a cervical injury (n=4) were not successfully treated with TENS. About 1/3 (n=11) felt that the treatment was a success, with those experiencing at-injury site pain most effectively treated.
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