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1
Vance, Carol Grace T. "Examination of parameters in transcutaneous electrical nerve stimulation effectiveness." Diss., University of Iowa, 2013. https://ir.uiowa.edu/etd/4779.
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Pain is the oldest medical condition and has been referenced through the ages. TENS is a non-invasive treatment for pain. Despite conflicting reports of treatment outcomes, TENS has enjoyed widespread clinical utilization. Seminal work by Sluka and colleagues reported low frequency TENS produces anti-hyperalgesia through µ-opioid receptors and high frequency TENS produces anti-hyperalgesia through ä-opioid receptors in an animal model of inflammation. The experimental results suggested that pain can be reduced by both high and low frequency TENS but by differing opioid receptors. These important findings require translational experiments to be conducted in humans.
Providing an adequate placebo for experimental investigation of any physical intervention presents as a challenge. An improvement in the placebo intervention is critical to ascertain the true effects of TENS on painful conditions. Clinical TENS experiments often only examine a single outcome - resting pain. Recent work suggests TENS is less effective on resting pain as compared to movement pain. Investigation to determine which outcome measures (pain at rest, movement pain, pain sensitivity, and function) are most likely to be affected by TENS in human subjects with pain are critical to inform the design of future studies.
The least investigated parameter for application of TENS electrode site determination. One method of selection employs a technique of finding points on the skin with suspected lower impedance. To date, no literature exists to determine the effectiveness of this clinical practice and speculation has existed for decades regarding the existence of distinct electrical properties associated with specific points on the body.
This series of experiments accomplishes the goals of improving the TENS placebo, testing established parameters from basic science experiments in a patient population, testing multiple outcome measures to direct future investigation; and examined the effect of electrode site selection in TENS analgesia. These experiments were the first to establish a placebo that can 100% blind the TENS examiner, to test this placebo in a patient population, and to show that although there are differences in impedance between optimal and sham sites, that this difference had no effect in the amount of analgesia produced by TENS.
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Chin, Steven R. (Steven Richard). "Transcutaneous electrical nerve stimulation (TENS) : effects of duration of stimulation on antinociception in man." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68165.
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Transcutaneous electrical nerve stimulation (TENS) has been employed for over 2 decades in pain management, however, definitive analgesic parameters have yet to be determined. The objective of this study was to determine the influence of 10, 30 and 60 min of TENS on the time course and magnitude of modulation on flexion reflex (FR) and on subjective pain estimates (visual analogue scale, VAS), as well as determining the relationship between FR responses and VAS scores following TENS of different durations.Ten (10) normal subjects received electrical stimuli of maximal tolerable intensity to the sole of their foot. Our results indicated that TENS could suppress the FR in 50% to 70% of subjects. However, longer durations (30 and 60 min) of TENS have a small, but discernible difference in the number of subjects that show inhibition of FR area and significant maximal FR suppression when compared to 10 min of TENS. Moreover, the 60 min of TENS generated significant depression of VAS scores in more subjects than 10 and 30 min of TENS and ensured that any increase in pain perception would not reach significance when compared to the shorter (10 and 30 min) durations of TENS.
Our results suggested that longer durations of TENS could be applied to produce antinociceptive and analgesic effects. (Abstract shortened by UMI.)
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Green, Seth A. "Experimental pain in hypnosis research ischemic vs transcutaneous electrical nerve stimulation (tens) /." Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Dissertations/Fall2009/S_Green_101509.pdf.
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Francis, Richard Paul. "The Hypoalgesic Effects of Acupuncture-Like Transcutaneous Electrical Nerve stimulation (AL-TENS) Compared to Conventional TENS." Thesis, Leeds Beckett University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.491234.
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Introduction: Transcutaneous electrical nerve stimulation (TENS) is used to reduce pain. TENS is applied as conventional TENS (50-100 Hz, causing paraesthesia) or acupuncture-like TENS (AL-TENS). AL-TENS is inconsistently characterised and research comparing its hypoalgesic effects to conventional TENS is lacking. Aim: To compare the hypoalgesic effects of acupuncture-like transcutaneous electrical nerve stimulation (AL-TENS) and conventional TENS.
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Tsang, Henry Hing-Yuen. "Diffuse inhibition of flexion reflex by transcutaneous electrical nerve stimulation (Tens) in man." Thesis, McGill University, 1986. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=65443.
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Shawley, Lucinda. "Women's experiences of Transcutaneous Electrical Nerve Stimulation (TENS) for pain control in labour." Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/210925/.
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The vision for maternity services focuses on women-centred care with choice, control and promoting normality at its centre, thus emphasising the need to empower women to make choices and decisions regarding their care in labour and birth. Some women will choose the medical model of care, however others prefer to be in control and choose to use non-pharmacological alternatives for pain control in labour such as Transcutaneous Electrical Nerve Stimulation (TENS). TENS has enabled the provision of non-invasive, mobile, self-controlled pain relief for women in labour and is used extensively by women in the UK who, when asked, assess it favourably and say they would use it again. Currently the available literature on TENS fails to consider individual women’s experiences of using TENS for labour and birth, this study therefore seeks to redress this balance. Set in the south of England, the study uses Interpretative Phenomenological Analysis (IPA) in order to explore the experiences of twenty purposively selected women, who were interviewed to expose their in-depth experiences of using TENS for pain control in labour and birth. The analysis of the verbatim transcripts revealed comprehensive findings ensuring an idiographic focus along with making claims for the larger group of women. In this study women used TENS as part of a combination of more natural pain control or as a ‘sole’ form of pain control for labour and birth. TENS was recognised as being part of a wider strategy for the maintenance of control in labour and normal birth for women. A super-ordinate theme of ‘control’ emerged from the data particularly relating to ‘internal control of self’, ‘external control of others’ and ‘control of the TENS machine’. Women’s positive experiences were enhanced by remaining mobile, using drug free pain control, being knowledgeable, having partners’ and midwives’ support, being distracted from their pain and trusting in TENS. By uncovering a group of women’s in-depth experiences of using TENS for pain control in labour and birth this study has filled a “gap” in the knowledge base. In addition, the findings suggest that TENS was identified as an ‘enabling mechanism’ for the women in order to be in control of a normalised birth. Women were able to maintain their independence, make decisions and actively take part in their pain control using TENS.
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Dailey, Dana Leigh. "Pain, fatigue, function and transcutaneous electrical nerve stimulation in individuals with fibromyalgia." Diss., University of Iowa, 2013. https://ir.uiowa.edu/etd/1579.
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The American College of Rheumatology (ACR) 1990 criterion classifies fibromyalgia as a clinical syndrome characterized by chronic widespread muscular pain and tenderness with hyperalgesia to pressure over 11/18 tender points of at least 3 months duration. Fibromyalgia is characterized by chronic widespread musculoskeletal pain and is associated with fatigue and cognitive dysfunction. The cause of fibromyalgia is unknown, but it has been shown to demonstrate sensitization of the central nervous system pain pathways by demonstrating lower pain pressure thresholds and reduced conditioned pain modulation (CPM).
Pain and fatigue associated with fibromyalgia can interfere with daily function, work, and social activities. Without greater understanding of the interaction of pain, fatigue and function, we are limited in our ability to improve these symptoms for individuals with fibromyalgia. We designed three experiments to examine the relationship of pain, fatigue and function in individuals with fibromyalgia.
Regression analyses demonstrated significant models that included pain, fatigue and fear of movement for prediction of function and quality of life in individuals with fibromyalgia and healthy controls. The fatigue study (cognitive fatigue, physical fatigue and dual fatigue task) demonstrated that people with fibromyalgia show enhanced pain and fatigue to both cognitive and physical fatigue tasks and reduced function in the physical fatigue task in comparison to healthy controls. Our final study showed active TENS restores CPM, decreases deep tissue pressure pain, decreases pain and fatigue during movement for individuals with fibromyalgia.
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Johnson, Mark Ian. "Factors influencing the analgesic effects and clinical efficacy of transcutaneous electrical nerve stimulation (TENS)." Thesis, University of Newcastle Upon Tyne, 1991. http://hdl.handle.net/10443/539.
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Transcutaneous electrical nerve stimulation (TENS) is a simple, non-invasive technique used in the control of chronic pain. Despite the success of TENS and its continued use for over twenty years, some patients either fail to respond or show only a partial response. Furthermore some patients respond initially to TENS but then become tolerant to its analgesic effects. The reasons for poor response to TENS are unknown; different clinics report widely differing success rates, and information on long-term efficacy is sparse. Furthermore, TENS is still administered on an empirical basis in which the patient determines by trial and error the most appropriate stimulator settings (i. e. electrical characteristics of TENS) to treat his or her particular pain. It is impossible to predict whether an individual patient will respond to TENS or which stimulator settings will be optimal. In an attempt to elucidate these problems, the clinical, electrophysiological, neuropharmacological, psychological and sociological factors that influence the analgesic effects and clinical efficacy of TENS have been examined in this thesis. Three clinical studies were performed. The first (Study 2.1) reviewed the use of TENS since its introduction to Newcastle Pain Relief Clinic in 1979. It was found that 1582 patients have been given a trial of TENS of which 927 (58.6%) continue to use a stimulator on a long-term basis (Study 2.1). The clinical use of TENS by 179 of these patients was examined in-depth (Study 2.2). Although previous literature suggests that TENS is most efficacious for pains of neurogenic (neuropathic) origin, it was found that any type of pain may respond. No relationships were found to exist between the electrical characteristics of TENS (i. e. stimulator settings) used by patients during TENS treatment and the cause and site of pain. However, patients utilised specific pulse frequencies and patterns and consistently used these settings on subsequent treatment sessions (Study 2.3). These clinical studies showed that in this population, 41.4% of patients failed to respond to TENS and half using TENS on a long-term basis achieved less than 50% relief of pain. Thus, a systematic investigation to determine optimal electrical characteristics of TENS was performed. Three experiments were undertaken to examine separately the analgesic effects of different electrical characteristics of TENS (pulse frequency, pulse pattern and stimulation mode) on cold-pressor pain in healthy subjects. The effects of a range of Long Abstract pulse frequencies (10Hz to 160Hz) applied to produce a 'strong but comfortable' electrical paraesthesia within the painful site were measured (Exp. 3.1). It was found that frequencies between 20-80Hz were most effective. However, no differential effects were observed between a range of pulse patterns (continuous, burst, modulation, random; Exp. 3.2). When TENS was applied in burst mode at an intensity sufficient to produce phasic muscle twitches at a site distant yet myotomally related to the site of pain (acupuncture-like TENS) a powerful analgesic effect was observed during and post-stimulation (Exp. 3.3). It is suggested that continuous mode stimulation at 80Hz, producing a 'strong but comfortable' electrical paraesthesia within the painful site, should be the primary TENS treatment choice in the clinic but that in selected cases AL-TENS may be more effective. A number of improvements in stimulator design are suggested. Further experiments were aimed at elucidating the mechanism of TENS effects by investigating the influence of TENS on electrophysiological and neuropharmacological variables. It was found that TENS reduced peak-to-peak amplitudes of the late waveform components (N1P2) of somatosensory evoked potentials (Exp. 4.1) and increased alpha, beta and theta activity of spontaneous EEG in healthy subjects (Exp. 4.2) and/or pain patients (Exp. 4.3). As TENS produced changes in SEPs elicited from non-painful stimuli, and also changes in spontaneous EEG in pain-free subjects, it is suggested that the effects of TENS may be due in part to changes in sensory processing at several levels in the nervous system which may not specific for the perception of pain. The surprising finding that TENS increased peripheral circulating met-enkephalin in chronic pain patients was attributed to a stress-like release although this observation remains to be confirmed using a larger population sample (Exp. 5.1). The results of these experiments suggest that baseline electrophysiological and neuropharmacological variables may be important determinants of individual response to TENS. Thus, a prospective investigation was undertaken on 29 patients who were undergoing a trial of TENS to control chronic pain, in an attempt to identify predictors of patient response. Patient response to TENS was related to baseline SEP amplitudes and spontaneous EEG but was not related to biochemical, psycho-social, personality or pain related factors (Exp. 6.1). Thus, patients with small peak-to-peak amplitudes of the SEP, and low power spectrum of spontaneous EEG showed poor response to TENS (Exp. 6.1). It is suggested that an individual's intrinsic central response pattern to external stimuli may influence response to TENS.
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Chesterton, Linda Shirley. "The relevance of transcutaneous electrical nerve stimulation (TENS) parameter manipulation to observed hypoalgesic effects." Thesis, Keele University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.411882.
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Levin, Mindy F. "The influence of transcutaneous electrical nerve stimulation (tens) on hemiplegic spasticity and voluntary muscle power /." Thesis, McGill University, 1990. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=74642.
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These studies investigated possible relief of spasticity in hemiparetic subjects by transcutaneous electrical nerve stimulation (TENS) and its underlying mechanisms. The first two studies quantified the disorders in reflex and voluntary motor functions and addressed the reproducibility of their measurement and their correlation with spasticity scores. Soleus stretch reflexes were enhanced and isometric voluntary contraction force was decreased linearly with increasing spasticity. The last two studies addressed the effects of single and repetitive TENS stimulation on spasticity, reflex and isometric voluntary contractions. Compared to placebo stimulation, single 45 min sessions of TENS prolonged H and stretch reflex latencies for up to 60 min following stimulation. Repetitive (15 daily, 60 min) applications significantly decreased spasticity scores, Hvib/Hctl ratios, stretch reflexes and co-contraction while improving dorsiflexion force. The improvement in spasticity and voluntary motor control may partly have been mediated by presynaptic inhibition and reduced hyperactive stretch reflexes thereby 'unmasking' descending control.
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Liu, Jiaqiang. "Do the effects of repetitive transcutaneous electrical nerve stimulation (TENS) on experimental pain cumulate over time?" Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68203.
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This study investigated the immediate and possible cumulative effects respectively of a single 60 min of TENS and of 10 repeated daily applications on subjective pain sensation and flexion reflex. Twenty young healthy subjects were randomly assigned to a TENS or a placebo group, with 10 in each. TENS or placebo stimulation was applied to the lumbro-sacral region for 60 minutes on 10 treatment days over a two-week period. Before, during and after TENS and placebo stimulation on Day$ sb1$, Day$ sb5$ and Day$ sb{10}$, the FR was elicited by electrically stimulating the sole of subject's right foot and recorded electromyographically from biceps femoris (BF) and tibialis anterior (TA) muscles. Subjective pain sensation was measured using the visual analog scale (VAS). Compared to placebo stimulation, a single session of 60 min TENS significantly decreased the VAS scores (p $<$ 0.05) and TA FR areas (p $<$ 0.05) obtained during the 60 min post-stimulation period. However, the between-group difference in the decrease of the BF FR area did not reach statistical significance. After 10 repeated daily applications of TENS, the pre-stimulation VAS scores and FR areas of both muscles were significantly more inhibited (p $<$ 0.01) than placebo stimulation. Furthermore, the suppression of VAS scores during and after TENS was linearly correlated with that of FR areas of both muscles in each of the 3 testing days. These findings indicated that repeated daily TENS applications produced cumulative inhibitory influence on both subjective pain sensation and FR over a two-week period. Such a gradual development probably implicated that plastic changes could have been induced in the neural pathway. The similar time course of the inhibitory effects of TENS on the two pain indices, which could cumulate over time, suggest possible similar processing at both cortical (subjective pain) and spinal (FR) levels.
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Hasan, Tahseen. "Transcutaneous electrical nerve stimulation (TENS) and temporary S3 nerve root stimulation in idiopathic detrusor instability and characterization of the human detrusor smooth muscle contraction." Thesis, University of Newcastle Upon Tyne, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310132.
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Kirk, Kerry Alicia. "The influence of stimulus control on the effects of transcutaneous electrical nerve stimulation (TENS) on experimental ischaemic pain." Thesis, Open University, 1997. http://oro.open.ac.uk/57699/.
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A review of the relevant literature suggested a number of unresolved issues in the most efficacious use of TENS for pain-relief including the degree of control and the frequency of TENS. The study investigated the influence of giving subjects control of the TENS stimulus on reported pain intensity and unpleasantness during experimental ischaemic pain induction of the arm. The pain induction and assessment procedures were established during an initial series of three experiments. Subjects in these and the subsequent experiments were healthy female student volunteers from Queen Margaret College. A further series of experiments investigated the influence of control of the TENS intensity on VAS scores of pain intensity and unpleasantness. When used, TENS (symmetrical biphasic current; pulse duration 200ýts; intensity 'just perceptible') was applied for the 15 minutes prior to cuff inflation and during the 15 minutes of pain induction (electrodes placed over Erb's point and lateral to C6/7). The first TENS experiment investigated the. influence of three different conditions (experimenter controlling TENS intensity; subject controlling TENS intensity; no TENS) using high frequency (100Hz) TENS. All subjects (n=12) were randomly exposed to the three testing conditions using a repeated measures design. A 2-way ANOVA with repeated measures on both factors showed no statistically significant effects (p≥0.05) on either VAS pain intensity or unpleasantness scores. The procedure was repeated with different subjects (n=12) using low frequency (5Hz) TENS. The results showed that mean pain scores were statistically significantly lower (p≤0.05) in the subject control condition than in the other two conditions (experimenter control and no TENS). A final experiment (n=12) compared VAS pain intensity and unpleasantness scores between the three conditions of, subject controlling 100Hz TENS, subject controlling 5Hz TENS and no TENS. The results demonstrated a trend for the 5Hz TENS condition to give lower mean pain scores than the other two conditions with both intensity (p=0.239) and unpleasantness scores (p=0.110). From the results and discussion it was suggested that the pain-relieving benefit of TENS was enhanced when the subjects were given control of the current intensity, especially when using low frequency TENS. The clinical implications of the results are discussed.
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Kim, Yu Kyung. "Segmental and heterosegmental effects of repeated transcutaneous electrical nerve stimulation (TENS) on voluntary motor functions in spastic hemiparetic subjects." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22749.
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We conducted two studies to examine the changes in voluntary motor functions in spastic hemiparetic muscles, their relationship to clinical spasticity and the reliability of these measures, as well as to investigate the effects of transcutaneous electrical nerve stimulation (TENS) on spasticity and voluntary motor functions in hemiparetic subjects. In our first study, the alterations in voluntary motor functions in the upper and lower limb muscles of spastic subjects were delineated through a comparative study with age-matched controls. Moreover, the test-retest reliability was evaluated for each measure. We noted a marked reduction in peak isometric torques, associated with a tendency towards an increase in antagonist co-contraction ratios for all the muscles tested in these spastic subjects. Of interest is that the elbow flexion torque was inversely related to the clinical severity of spasticity--especially that of its upper extremity score. Furthermore, the peak torque was the most reproducible measure. In our second study, the effects of 20 sessions of TENS applied to the radial nerve for 60 min every weekday over 4 weeks was investigated. In contrast to placebo stimulation, TENS produced a significant reduction in upper extremity spasticity after 4 weeks and a significant decrease in the tibialis anterior co-contraction ratio after 2 weeks of stimulation. Furthermore, 4 weeks of TENS, but not placebo stimulation, led to a significant improvement in elbow extension torque as compared with the control values in the majority (67%) of hemiparetic subjects. Such a reduction in spasticity and improvement in voluntary motor functions could have involved segmental reciprocal inhibitory mechanisms as well as non-segmental mechanisms via descending pathways.
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Gladwell, Peter William. "Focusing outcome measurement for Transcutaneous Electrical Nerve Stimulation evaluation: incorporating the experiences of TENS users with chronic musculoskeletal pain." Thesis, University of the West of England, Bristol, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.601206.
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This thesis has used qualitative interviews to generate knowledge about the use of Transcutaneous Electrical Nerve Stimulation (TENS) by patients with chronic musculoskeletal pain. This knowledge can inform the selection of appropriate outcome measures which are relevant to the patients' use of TENS, and can be used to focus the design of future TENS evaluations. Methods Semi-structured interviews were used to explore the perceived benefits of TENS reported by secondary ca re pain clinic patients with chronic musculoskeletal pain. The data were analysed using an ind uctive thematic analysis and a parallel, theo retical thematic analysis was undertaken to faci litate linking against other datasets and outcome measures. Two other forms of data generation were used to ens ure that a comprehensive understanding of the perceived benefits of TENS was developed. The analysis was compared with outcome measures used previously for TENS evaluations in chronic pain and chronic low back pain findings & impli ca tions The analysis indicated that TENS should be considered as a complex intervention, with benefits which extend beyond pain relief, including a red uction in muscle sensations (such as tension and spasm), and di straction from pain as separate benefits. Patients reported using TENS in a strategic manner, for example in order to manage pain fl are-ups, ach ieve functiona l goals, enhance rest periods and reduce medication. This indicates that outcomes need to be contextualised to the specific strategy of use. The benefits re ported by TENS users had a low degree of match against previously used outcome measures. This indicates that these previously used outcome measures have limi ted ca pacity to capture patient-reported benefits. An alte rna tive a pproach to outcome measurement is developed, which has the potential to test elements of the analysis developed in t hi s thesis, as well as enhancing the sensitivity of future TENS evaluations.
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Alves-Guerreiro, JoseÌ. "An investigationof the hypoalgesic, neurophysiological and anti-emetic effects of transcutaneous electrical nerve stimulation (TENS) and interferential therapy (IFT)." Thesis, University of Ulster, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.400592.
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Chubaci, Eliana Fazuoli. "Eficácia da utilização simultânea de aparelhos de estimulação elétrica nervosa transcutânea (TENS) em pacientes portadores de Fibromialgia." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/17/17142/tde-27092012-143551/.
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INTRODUÇÂO: Fibromialgia é caracterizada como síndrome, a qual inclui dor muscular, fadiga e distúrbio do sono. Ansiedade e depressão estão freqüentemente associados, porém a causa é desconhecida. A intensidade da dor piora ao se deitar, durante a noite e no despertar. Normalmente a dor se difunde na região lombar e cervical. A TENS é um método não medicamentoso, estabelecido para controle da dor, o qual minimiza o consumo de analgésicos. OBJETIVOS: Este estudo visou avaliar a utilização de dispositivos de TENS simultâneos em pacientes portadores de Fibromialgia. MÉTODOS: Após aprovação do Comitê de Ètica em Pesquisa e consentimento, 39 pacientes portadores de Fibromialgia foram avaliados de forma prospectiva, aleatória e duplamente-encoberta. Avaliou-se a utilidade clínica de um novo, muito pequeno e leve dispositivo de a TENS (TANYX). Dois dispositivos de TENS, foram aplicados de forma simultânea em cada paciente: 1) na região lombar (perpendicular à coluna sobre L5), e 2) na região cervical (perpendicular à coluna, entre C7 e T1), durante 20-min, a cada 12 horas, durante 7 dias consecutivos (antes de se deitar, à noite, e antes de se levantar, pela manhã). Os pacientes foram divididos em 3 grupos (n=13). O grupo placebo (GP) utilizou adesivos que não transmitiam estímulo elétrico, semelhantes aos originais. O grupo de únicoTENS (TENS-1) (n=13), utilizou um adesivo de TENS ativo na área mais dolorida (cervical ou lombar) e placebo na área menos doloroa. O terceiro grupo (TENS-2) utilizou dois adesivos ativos de TENS nas áreas cervical e lombar, simultaneamente. Para controlar a dor, diclofenaco (50mg) foi utilizado como analgésico de resgate, até três vezes ao dia. Foram avaliados a intensidade da dor através da escala numérica visual (ENV 0-10 cm), consumo de analgésicos de resgate, qualidade do sono e fadiga. RESULTADOS: Os pacientes foram demograficamente semelhantes. 36 pacientes completaram o estudo. Três pacientes do grupo placebo desistiram no 4o dia de ausência de alívio da dor. A avaliação entre cada grupo antes e após o tratamento revelou que pacientes do grupo placebo não apresentaram alívio da dor (ENV 8 cm, p>0,05), da fatiga, ou melhora do padrão de sono, enquanto o grupo TENS-1 apresentou diminuição de 2,5 cm na ENV para dor (ENV anterior 8,5 cm e após 6 cm) (p<0,05). Finalmente, o grupo TENS-2 referiu redução de 4 cm na intensidade da dor (ENV anterior ao tratamento 8,5 cm e 4,3 cm após tratamento) (p<0,02). O consumo de analgésicos diários foi menor para TENS-1 (p<0,05) e TENS-2 (p<0,02). A comparação entre os 3 grupos revelou que a analgesia, qualidade de sono e melhora da fadiga foi: grupo TENS-2 > TENS-1 > GP (p<0,05). Os participantes consideraram os aparelhos ativos úteis. Não foram observados efeitos adversos. CONCLUSÕES: enquanto a aplicação de um dispositivo de TENS na área dolorida, lombar ou cervical, amenizou a dor em pacientes portadores de fibromialgia, a fadiga e a qualidade do sono foram minimizadas apenas quando dois dispositivos foram utilizados, demonstrando que este novo dispositivo pode ser adjuvante para dor da fibromialgia.BACKGROUND: Fibromyalgia is characterized by a range of symptoms that include muscle pain, fatigue and sleep disorders. Anxiety and depression are often also present, and the cause is unknown. Worst pain is normally felt during bedtime, at night and before waking up in the morning, and pain is normally widespread at the low back and cervical area. Transcutaneous electrical nerve stimulation (TENS) is an established method for pain relief, which does not involve the use of medication and can be advantageous, as adjuvant, for pain control. OBJECTIVES: The purpose of the study was to evaluate the effectiveness and safety of the use of two simultaneously new TENS devices for Fibromyalgia pain. METHODS: The local Ethics Committee approved the study, and informed consent was obtained. This prospective, double-blind randomized study evaluated the clinical utility of a new, very small and light, high frequency TENS device (TANYX) in 39 patients suffering from Fibromyalgia. Two TENS device were applied simultaneously in each patient: 1) at the lower back (perpendicular to the vertebrae canal, at the level of the 5th lumbar vertebrae), and 2) centrally above and below the space between the C7 and T1 spinous processes, perpendicular to the spine. The two devices were applied during 20-min at 12-hour interval during 7 consecutive days (Before bed-time and just after waking up in the morning). Patients were randomly divided into three groups (n=13): For the placebo group (PG), the two devices did not transmitted electrical stimulus, although they were externally similar to the active ones. The single-TENS group (STG) had applied one active TENS device at the worst area of pain (low back or cervical), and the placebo device at the less painful area. The third group double-TENS group (DTG) applied both active TENS devices at the low back and cervical areas. Diclofenac (50 mg) up to three times daily was used as rescue analgesic if necessary for pain control. The efficacy measures were pain relief evaluated on a visual analogue scale (VAS 0-10 cm),, reduction in use of daily analgesic tablets, quality of sleep, and fatigue. MAIN RESULTS: Patients were demographically similar. 36 patients completed the study. Three patients from the PG give up the study on the fourth day for absence of any pain relief. The evaluation within groups revealed that patients from DPG refereed no pain relief when compared to their previous VAS pain score (8-cm, p>0.05), while patients from the STG refereed improvement of 2.5 cm in the pain VAS (previous 8.5 cm compared to 6-cm after treatment) (p<0.05); and the DPG refereed daily maintained reduction of 4 cm in the VAS-pain (previous 8.5-cm to 4.3-cm) (p<0.02). Concurrent daily consumption of analgesic tablets was reduced in both STG (p<0.05) and DTG (p<0.02). Comparison among groups revealed that analgesia, as well as quality of sleep and disposition was: DTG > STG > PG (p<0.05). Participants subjectively found the active device useful. No adverse effects were observed. CONCLUSIONS: while the application of one active TENS device at either the lower back or cervical area improved pain relief in patients suffering from Fibromyalgia pain, the pain and fatigue were further improved when two actives devices were simultaneously applied, reflecting this new device an useful adjuvant for Fibromyalgia pain.
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Cappeli, Angela Juliana. "Estudo randomizado do uso da estimulação elétrica nervosa transcutânea (TENS) no alívio da dor no trabalho de parto." Universidade Estadual Paulista (UNESP), 2018. http://hdl.handle.net/11449/153472.
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Objetivo: Avaliar a eficácia da aplicação da estimulação elétrica nervosa transcutânea (TENS) no controle da dor durante o período da dilatação do trabalho de parto. Método: Foi realizado um ensaio clínico, paralelo e randomizado. Sessenta e oito parturientes com gestação única, de baixo risco, no termo, com dilatação cervical ≥ 4 cm e ≤ 7 cm e sem uso de medicação analgésica prévia. Foram randomizadas em dois grupos: TENS (n=34) e placebo (n=34) e avaliados os desfechos primários (intensidade da dor após a intervenção, grau de desconforto e grau de satisfação materna) e secundários (uso de outros métodos não farmacológicos para alívio da dor, fármacos no parto vaginal, taxa de cesárea e duração do trabalho de parto). A TENS foi aplicada por 30 minutos, entre T10 – L1 e S2 – S4. A intensidade da dor e o grau de desconforto foram avaliados por meio da escala visual analógica (EVA) e o grau de satisfação materna por nota de 0 a 10. Considerando a diferença de 34% entre os grupos para detectar efetividade do tratamento e assumindo a margem de erro de 10% e confiabilidade de 95%, o tamanho amostral calculado foi de 34 parturientes por grupo. Os resultados foram analisados estatisticamente para comparação entre os grupos estudados, adotando-se o limite mínimo de significância de 95% (p<0,05) Resultados: No grupo TENS houve maior número de parturientes classificando a dor como leve/moderada (RR= 2,4; IC95%: 1,6-3,7), melhora do grau de desconforto (RR= 4,1; IC95%: 2,1-8,1), maior número de mulheres referindo plena satisfação (RR= 2,8; IC95%: 1,5-5,0) e menor taxa de cesárea (RR= 0,3; IC95%: 0,1-0,8), quando comparadas ao grupo placebo. Não houve diferença estatística entre os grupos em relação ao uso de métodos não farmacológicos, farmacológicos e na duração do trabalho de parto. Conclusões: a TENS é um método eficaz na melhora da dor e com alto grau de satisfação materna, quando aplicado em parturientes de baixo risco, durante o período da dilatação, podendo ser utilizado como método não farmacológico de alivio da dor. Registro de ensaio clínico: RBR-2ZGDGJ.
Objective: To evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) in the control of pain during the period of labor. Method: A clinical, parallel and randomized trial was performed. Sixty-eight parturients with single, low-risk pregnancies at term, with cervical dilatation ≥ 4 cm and ≤ 7 cm and without previous analgesic medication. They were randomized into two groups: TENS (n = 34) and placebo (n = 34) and primary outcomes (pain intensity after intervention, degree of discomfort and degree of maternal satisfaction) and secondary outcomes (use of other non-pharmacological methods for pain relief, vaginal delivery drugs, cesarean section rate and duration of labor). The TENS was applied for 30 minutes between T10 - L1 and S2 - S4. The intensity of the pain and the degree of discomfort were evaluated through the visual analogue scale (VAS) and the degree of maternal satisfaction by grade from 0 to 10. Considering the difference of 34% between the groups to detect treatment effectiveness and assuming the margin of error of 10% and reliability of 95%, the sample size calculated was 34 parturients per group. The results were statistically analyzed for comparison between the groups studied, adopting the minimum significance level of 95% (p <0.05). Results: In the TENS group, there was a higher number of parturients classifying pain as mild / moderate (RR = 2.4, 95% CI: 1.6-3.7), improvement in the degree of discomfort (RR = 4.1, 95% CI, (RR = 2.8, 95% CI: 1.5-5.0) and lower rate of cesarean section (RR = 0.3, 95% CI: 0.1-0.8) when compared to the placebo group. There was no statistical difference between the groups regarding the use of non-pharmacological, pharmacological and duration of labor methods. Conclusions: TENS is an effective method to improve pain and with a high degree of maternal satisfaction when applied to low-risk parturients during the period of dilation and can be used as a non-pharmacological method of pain relief. Trial registration: RBR-2ZGDGJ.
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Darwish, Mohamed Eslam [Verfasser], Sebastian [Gutachter] Jander, and Martina [Gutachter] Krüger. "High-tone external muscle stimulation (HTEMS) for radicular leg pain compared to transcutaneous electrical nerve stimulation (TENS) / Eslam Darwish Mohamed ; Gutachter: Sebastian Jander, Martina Krüger." Düsseldorf : Universitäts- und Landesbibliothek der Heinrich-Heine-Universität Düsseldorf, 2017. http://d-nb.info/1126641588/34.
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Poderoso, Neto Maurício Lima. "A colocação dos eletrodos interfere na antihiperalgesia promovida pela tens?" Universidade Federal de Sergipe, 2012. https://ri.ufs.br/handle/riufs/3917.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorAmong the non-pharmacologic therapy resources for inflammatory pain treatment, transcutaneous electric nerve stimulation (TENS) has been gaining attention in the literature. However, the clinical literature on TENS is sometimes difficult to be interpreted due to limitations in clinical trials and little methodological rigor. Another controversial issue is the lack of standardization in the parameters of the current as well as the ways of application of the electrodes, both needing to be better elucidated. Methods: Carrageenan and kaolin were used to (3%) to mimetize knee ostheoarthritis in rats. Twenty-five male Wistar rats were divided according to electrodes location in 5 groups (n=5, in each group): ipsilateral dermatome, contralateral dermatome, paravertebral, acupoints (Bp6 and E36) and control group. The frequency and the duration of the application were the same in all groups. In all groups, thermal and secondary mechanical hyperalgesia, as well as motor performance and joint edema were measured before and after TENS was applied by stimulating rats with 4 Hz,100 μs of pulse duration, at a sensory intensity during 20 minutes. Mechanical withdrawal threshold was tested for the differences between the treatment groups by using Kruskal Wallis followed by Tukey test, Wilcoxon Matched Pairs test for differences into the group and Friedman followed by Turkey test for repeated measures. P values less than 0.05 were considered significant. Results: Following TENS application with electrodes placed on ipsilateral or contralateral dermatome, paraspinal muscles or acupoints, there was a significant reduction in both mechanical and thermal hyperalgesia. Moreover, an increase in time for performing rota rod test when compared to control group and prior TENS was observed in all groups treated with active TENS. However, there was no difference for the edema between groups. The intensity was significantly lower in the contralateral dermatome in comparison to other electrode placements. Results for paw withdrawal latency and threshold and intensity suggest there is a tendency for developing tolerance to TENS after the fifth day of stimulation. Conclusion: It seems that TENS-induced antihyperalgesia does not depend on the electrode placement, indicating TENS acts through the central nervous system.
Dentre as terapêuticas não-farmacológicas para o tratamento da dor inflamatória, vem ganhando destaque na literatura a neuroestimulação elétrica transcutânea (TENS). Entretanto, a literatura clínica sobre TENS é, às vezes, difícil de ser interpretada devido a limitações nos ensaios clínicos e pouco rigor metodológico. Outro fator controverso é a falta de padronização nos parâmetros da corrente assim como nas formas de aplicação dos eletrodos, ambos necessitando ser melhor elucidados. Objetivos: a presente pesquisa teve como objetivo analisar se as diferentes localizações de eletrodos interfeririam na anti-hiperalgesia promovida pela TENS de baixa freqüência em um modelo de dor inflamatória. Métodos: Utilizando-se caolina e carragenina (3%), induziu-se a osteoartrite, modelo de dor inflamatória, em joelhos de ratos. Foram utilizados 25 ratos machos da linhagem Wistar, divididos de acordo com a localização dos eletrodos em 5 grupos (n=5, em cada grupo), sendo eles: dermátomo ipsilateral, dermátomo contralateral, região paravertebral, pontos de acupuntura (Bp6 e E36) e controle. Em todos os grupos, foram mensurados antes e pós a aplicação da corrente a hiperalgesia térmica, a hiperalgesia mecânica secundária e o edema da articulação do joelho. A TENS foi aplicada com a frequência de estimulação de 4 Hz, duração de pulso (100 μs), intensidade sensorial por 20 minutos durante 5 dias consecutivos. Para medidas entre grupos foram utilizados o teste de Kruskal-wallis e ANOVA seguido pelo post hoc teste de Tukey. Para medidas intra grupos foram utilizados os testes de Wilcoxon Matched Pairs e teste t. Os valores de p < 0,05 foram considerados significativos. Resultados: Após a aplicação da TENS com os eletrodos posicionados no dermátomo ipsilateral, dermátomo contralateral, na paravertebral e em pontos de acupuntura, observou-se uma redução significativa na hiperalgesia térmica e na hiperalgesia mecânica quando comparado ao grupo controle e ao pré-tratamento em cada grupo. Entretanto, não houve diferença significativa para a medida do edema articular. A intensidade de estimulação foi significativamente inferior no dermátomo contralateral em comparação aos demais locais de aplicação dos eletrodos. Os dados de latência, limiar mecânico e de intensidade mostram uma tendência a tolerância aos efeitos da TENS a partir do quinto de sua aplicação. Conclusão: Os achados sugerem que o efeito analgésico promovido pela TENS não depende do local de aplicação dos eletrodos, sugerindo ação da TENS no sistema nervoso central.
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Tribioli, Ricardo Alexandre. "Análise crítica atual sobre a TENS envolvendo parâmetros de estimulação para o controle da dor." Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/82/82131/tde-10092003-094654/.
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A estimulação elétrica nervosa transcutânea ou TENS (como é conhecida pela abreviação do inglês: Transcutaneous Electrical Nerve Stimulation), é uma valiosa técnica clínica não invasiva, onde estímulos elétricos são aplicados na superfície da pele, para promover o alívio sintomático da dor de diversas origens. Os mecanismos de ação e os parâmetros utilizados com essa técnica vem sendo pesquisados na tentativa de se obter os melhores resultados possíveis. A polêmica sobre o assunto atingiu proporções dignas de uma revisão sistemática, com abordagem das teorias envolvidas na modulação da dor pela TENS, evidências clínicas e fisiológicas mais discutidas. As pesquisas atuais sugerem que a TENS pode produzir analgesia por diferentes mecanismos, sendo que as evidências revelam a preferência de parâmetros preferenciais individuais como determinante para o sucesso no tratamento da dor.Transcutaneous electrical nerve stimulation or TENS is a valuable clinical technique no invasive, where electrical stimulus are applied on the skin surface to foment the symptomatic relief of pain from several origins. The action mechanisms and the parameters used with this technique are being researched on attempt to obtain the best results as possible. The polemics about the subject reached proportions deserved for a systematical review, with approaches of theories involved on pain modulation by TENS, clinical evidences and physiological more discussed the current surveys suggest that TENS may produce analgesia for different mechanisms, being that evidences reveal the preference of individual parameters as determinant for success on treatment of pain.
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Pereira, Thaís Alves Barreto. "Efeito preventivo da estimulação elétrica nervosa transcutânea (TENS) na dor muscular tardia em indivíduos destreinados." Pós-Graduação em Ciências da Saúde, 2018. http://ri.ufs.br/jspui/handle/riufs/7648.
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Fundação de Apoio a Pesquisa e à Inovação Tecnológica do Estado de Sergipe - FAPITEC/SEIntroduction: Delayed onset muscle soreness (DOMS) induced is characterized by muscle soreness, pain to movement and reduction of functionality. TENS has been shown to be effective in reducing pain severity associated with improved function, such as reduced fatigue and increased exercise tolerance. However, no study evaluated the ability of TENS, when applied prior to the painful process, to prevent DOMS and improve performance. Aims: evaluated the immediated effects of preventive TENS on pain and performance in DOMS of untrained individuals. Methods: Untrained individuals were included to perform DOMS protocol with functional push and pull movements. Volunteers were proportionally divided into: active TENS performed before DOMS protocol and placebo TENS. Volunteers were evaluated before exercise, reassessed immediately after and 24h after the intensity of pain, muscle fatigue, pressure pain threshold (PPT), muscle power, physical tolerance, temporal summation (TS), conditioned pain modulation (CPM) and body temperature. A reassessment of all variables measured after 24 hours of DOMS. For statistical analysis, the paired and independent T tests, Mann-Whitney, Wilcoxon and one-way ANOVA were used. Results: 44 volunteers were included in the project. It was found that the physical tolerance to rowing exercise in the immediate re-evaluation of the active TENS group (18.27 ± 5.27, 95% CI: 16.21 to 24) was significantly higher in comparison to the placebo TENS group (15.51 ± 6.21, p = 0.03, 95% CI: 13.32 to 18.93). The number of repetitions decreased in each series performed in both groups (p <0.05), but was significantly higher in the 5th series of the row exercise in the active TENS group (2.86 ± 1.24, 95% CI: 2, 34 to 3.38) compared to the placebo TENS group (1.81 ± 0.79, p = 0.001, 95% CI: 1.55 to 2.27). In both groups, there was an increase in the pain intensity at rest in the immediate re-evaluation (active TENS: p = 0.001, 95% CI 1.55 to 3.87, placebo TENS: p = 0.001, 95% CI: 1.18 to 3,24) and of movement in each exercise series (p <0.05), but without differences between groups. The same occurred for fatigue at rest (active TENS: p = 0.002, 95% CI: 4.61 to 4.91, TENS placebo: p = 0.001, 95% CI: 3.05 to 5.46), and on the move (p <0.05). In the MCD and ST variables, we observed the phenomenon of pain inhibition and pain summation (p <0.05), respectively, but there was no difference between the groups. Muscle power was lower in immediate reassessment in both groups at immediate reassessment (active TENS: p = 0.01, 95% CI: 207.01 to 287.11, TENS placebo: p = 0.001, 95% CI: 198.41 to 282.85), without recovery in the 24-h reevaluation and without significant difference between the groups. In the thermography, a statistically significant difference was found in the pectoralis major temperature between the groups (p = 0.04), and in the active TENS group there was no change in the temperature between the moments of evaluation and in the TENS placebo group there was a decrease in the reassessment immediate (p = 0.01, 32.36 to 33.70). Conclusion: Our results suggest the use of TENS in a preventive way to improve physical performance in the presence of DMT, without the increase of pain and fatigue beyond that expected.
Introdução: A dor muscular tardia (DMT) é caracterizada por hipersensibilidade, dor à movimentação e redução da funcionalidade local. A TENS tem se mostrado eficaz na redução da severidade da dor associada a melhora de funcionalidade, como redução de fadiga e maior tolerância ao exercício. Porém, nenhum estudo avaliou a capacidade da TENS para prevenir a DMT quando aplicada antes do processo doloroso e, dessa forma, melhorar o desempenho físico ao exercício. Objetivos: Avaliar os efeitos imediatos e após 24h da TENS preventiva na dor e no desempenho físico na DMT de indivíduos destreinados. Métodos: Foram incluídos indivíduos destreinados para realizar o protocolo de DMT através de exercícios fatigantes de puxar e empurrar. Os voluntários foram divididos em: TENS ativa realizada antes do protocolo de DMT e TENS placebo. Os voluntários foram avaliados antes dos exercícios, reavaliados imediatamente depois e 24h após quanto a intensidade de dor, fadiga muscular, limiar de dor por pressão (LDP), potência muscular, tolerância física, somação temporal (ST), modulação condicionada da dor (MCD) e temperatura corporal. Para análise estatística, foram utilizados os testes T pareado e independente, Mann-Whitney, Wilcoxon e ANOVA de um fator. Resultados: Foram incluídos no projeto 44 voluntários. Verificou-se que a tolerância física ao exercício de remada na reavaliação imediata do grupo TENS ativa (18,27±5,27; IC 95%: 16,21 a 24) foi significativamente maior em comparação ao grupo TENS placebo (15,51 ± 6,21; p=0,03; ; IC 95%: 13,32 a 18,93). O número de repetições diminuiu a cada série realizada nos dois grupos (p<0,05), mas foi significativamente maior na 5ª série do exercício de remada no grupo TENS ativa (2,86 ± 1,24; IC 95%: 2,34 a 3,38) em comparação ao grupo TENS placebo (1,81±0,79; p=0,001; IC 95%: 1,55 a 2,27). Em ambos os grupos, houve aumento da intensidade de dor em repouso na reavaliação imediata (TENS ativa: p=0,001; IC 95%: 1,55 a 3,87; TENS placebo: p=0,001; IC 95%: 1,18 a 3,24)) e de movimento a cada série do exercício (p<0,05), porém, sem diferença entre os grupos. O mesmo ocorreu para a fadiga em repouso (TENS ativa: p=0,002; IC 95%: 4,61 a 4,91; TENS placebo: p=0,001; IC 95%: 3,05 a 5,46) e em movimento (p<0,05). Nas variáveis de MCD e de ST, observou-se o fenômeno de inibição de dor e de somação de dor (p<0,05), respectivamente, mas não houve diferença entre os grupos. A potência muscular foi menor na reavaliação imediata nos dois grupos na reavaliação imediata (TENS ativa: p=0,01; IC 95%: 207,01 a 287,11; TENS placebo: p=0,001 ; IC 95%: 198,41 a 282,85), sem a recuperação na reavaliação de 24h e sem diferença significante entre os grupos. Na termografia, detectou-se diferença estatisticamente significante na temperatura do peitoral maior entre os grupos (p=0,04), sendo que no grupo TENS ativa não houve alteração da temperatura entre os momentos de avaliação e no grupo TENS placebo houve diminuição na reavaliação imediata (p=0,01; 32,36 a 33,70). Conclusão: Nossos resultados sugerem a utilização da TENS de forma preventiva para melhorar o desempenho físico na presença de DMT, sem o aumento de dor e de fadiga além do esperado.
Aracaju, SE
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Silva, Eveline Faria. "Utilização da eletroestimulação transcutânea do nervo durante o trabalho de parto: uma revisão sistemática voltada a bioética e biossegurança." Universidade Federal de Juiz de Fora (UFJF), 2008. https://repositorio.ufjf.br/jspui/handle/ufjf/2850.
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A utilização da estimulação elétrica transcutânea do Nervo (TENS) utilizada para a indução de analgesia durante as fases do parto tem sido empregada por diversos centros de obstetrícia, com o objetivo de redução e/ou interrupção do uso de drogas, a fim de evitar efeitos colaterais materno-fetais. Ao realizarmos o presente trabalho, encontramos estudos realizados de forma descritivos e explicativos, mostrando á eficácia da corrente,e excluindo relatos dos efeitos colaterais no pós- natal imediato e tardio, incidindo sobre o recém-nascido, não têm sido relatados. Recentemente, com a modernização de técnicas de avaliação de genoma e proteoma, inúmeros trabalhos têm sido realizados evidenciando alterações fenotípicas tardias. Relatamos, neste trabalho, algumas das possíveis conseqüências longitudinais de tal procedimento, relacionados à Bio-eletrogênese.(Science,2004) Na realização deste estudo escolhemos o método: revisão sistemática que é um recurso importante da prática baseada em evidências, que consiste em uma forma de síntese dos resultados de pesquisas relacionados com um problema específico. O estudo tem como objetivo oferecer subsídios que proporcionem reflexões para a construção e/ou aplicação de revisões sistemáticas no cenário da atuação da fisioterapia na obstetrícia.. Para isto várias etapas foram cumpridas para avaliação quanto ao seu uso potencial em seres humanos. A etapa 1 refere-se a uma caracterização do problema, identificando a necessidade desta revisão, passando para uma proposta e desenvolvimento do projeto. A etapa 2 refere-se à utilização de bases de dados para averiguação de estudos pertinentes à extração dos dados relevantes, perfazendo um total de 25 artigos. Na etapa 3, para nossa surpresa, não identificamos parâmetros que pudessem ser utilizados para comparação e avaliação por testes estatísticos. A etapa 4 sintetiza o trabalho, por meio desta Dissertação ,que envolveu a aplicação de estratégias científicas, com a finalidade de limitar vieses, congrega, avalia criticamente e sintetiza todos os estudos relevantes que respondem a uma pergunta clínica específica; além disso, promove a atualização dos profissionais de saúde, uma vez que sintetiza amplo corpo de conhecimento e ajuda a explicar as diferenças entre estudos com a mesma questão clínica.
Many Obstetrical Centers have been using T.E.N.S. (Transcutaneous Electrical Nerve Stimulation) trying the reduction, or even the interruption of drugs on pain relief during labour. As we observe, only cross section studies were performed. No late effects were described. Recently, modern techniques have been used to evaluate the genomics and proteomics, and have also been able to detect gene mutations where proteomics change only later on cell’s life. Relate, in this work, some of the possible consequences of such a procedure longitudinal, related to the Bioeletrogenesis(Science,2004). In this study chose the method: systematic review that is a major feature of the practice based on evidence, which consists of a summary of the results of research related to a specific problem. The study is intended to provide subsidies that provide reflections for the construction and / or application of systematic reviews of the stage performance of physiotherapy in obstetrics. For that several steps have been completed for evaluation as to its potential use in humans. The stage one refers to a characterization of the problem, identifying the need for this review, to a proposal and development of the project. Stage two refers to the use of databases for investigation of studies relevant to the extraction of relevant data, a total of twenty-five articles. In stage three, don’t was identification parameters that could be used for comparison and evaluation by statistical tests. The stage four summarizes the work through this dissertation, which involved the application of scientific strategies with the aim of limiting biases, gathers, evaluates critically and synthesizes all the relevant studies that respond to a specific clinical question. Moreover, it promotes the upgrade of health professionals, since it synthesizes large body of knowledge and helps explain the differences between studies with the same question clinic.
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Domingues, Flávia Seullner. "O efeito da eletroestimulação nervosa transcutânea (TENS) convencional portátil no tratamento durante as crises de migrânea ensaio clínico randomizado /." Botucatu, 2019. http://hdl.handle.net/11449/181148.
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Orientador: Guilherme Antonio Moreira de BarrosResumo: Introdução: A migrânea é uma doença prevalente, multifatorial e hereditária cujo diagnóstico é clinico. Uma opção de tratamento não farmacológico que tem despertado interesse entre os estudiosos é a estimulação elétrica nervosa transcutânea convencional (TENS). Considerada uma forma não invasiva e segura de tratamento da dor que consiste na aplicação de ondas elétricas transcutâneas através de eletrodos aplicados à pele. Objetivo: Avaliar a eficácia analgésica de um dispositivo portátil, descartável e autoaplicável de TENS aplicado de forma domiciliar nos momentos das crises de migrânea, assim como o seu perfil de segurança e tolerabilidade. Método: Ensaio clínico randomizado controlado, duplo cego, com uso de placebo ativo, com alocação 1:1 e tipo de erro I = 0,05 e tipo de erro II = 0,20. A amostra foi composta por adultos com diagnóstico de migrânea em acompanhamento em ambulatório especializado e em uso de doses estáveis de medicamentos profiláticos, ou na ausência do emprego de qualquer terapia medicamentosa. A intensidade da dor foi mensurada pela escala visual analógica autoaplicada antes e após a intervenção. O tempo de seguimento da intervenção foi de quatro meses, com acompanhamentos mensais. Foi considerado estatisticamente significativo valores de p < 0,05. Resultados: Foram incluídos 74 participantes, alocados aleatoriamente em dois grupos com características homogêneas. O grupo intervenção apresentou diferença estatística de redução de três pontos do escore de d... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Introduction: Migraine is a prevalent, multifactorial, hereditary disease whose diagnosis is clinical. Among the non-pharmacological treatment options that have attracted interest among scholars is conventional transcutaneous electrical nerve stimulation (TENS). It consists of a non-invasive and safe form of pain treatment based on the application of transcutaneous electrical waves through electrodes applied to the skin. Objective: To evaluate the analgesic efficacy of a portable, disposable and self-applied TENS device applied at home at times of migraine attacks, as well as its safety and tolerability profiles. Method: Randomized controlled clinical trial, double blind, with active placebo, with 1: 1 allocation and error type I = 0.05. The sample consisted of adults diagnosed with migraine in a specialized outpatient clinic and in the use of stable doses of prophylactic drugs or in the absence of any drug therapy. The pain intensity was measured by the self-applied analogue visual scale before and after the intervention. The follow-up time of the intervention was four months, with monthly follow-up. Values of p <0.05 were considered statistically significant. Results: A total of 74 participants were randomly assigned to two groups with homogeneous baseline characteristics. The intervention group had a statistical difference between three points of the pain score in the first month of the intervention and two points in the second month in relation to the placebo group. No pa... (Complete abstract click electronic access below)
Mestre
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Seenan, Christopher. "Laboratory and clinical investigation into lower limb ischaemic pain, and the effect of transcutaneous electrical nerve stimulation (Tens) on measures of pain and walking performance." Thesis, Queen Margaret University, 2013. https://eresearch.qmu.ac.uk/handle/20.500.12289/7417.
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Aims: The aims of this programme of research are to investigate the subjective description of ischaemic pain and to investigate the effects of TENS on lower limb ischaemic pain and walking performance in patients with Intermittent Claudication (IC). Methods: Four studies were conducted: two in the laboratory and two clinical trials. Laboratory- The first study investigated the reliability of a method of inducing lower limb ischaemic pain in healthy volunteers, the modified Submaximal Effort Tourniquet Test (mSETT). The second investigated the effects of High Frequency TENS (HF-TENS) and Placebo TENS (P-TENS) on lower limb ischaemic pain induced using the mSETT in healthy volunteers. Clinical- The first clinical study investigated the effects of HF-TENS and Low Frequency TENS (LF-TENS) on measures of pain and treadmill walking performance in patients with Peripheral Arterial Disease (PAD) and IC. The second examined patients’ experiences of using TENS at home for PAD and IC. Results: The mSETT was found to have good test-retest reliability and induce pain similar in quality to that experienced by patients with IC. The pain experience induced with the mSETT was reduced by both HF- and P-TENS compared to baseline. HF-TENS however was more effective compared to P-TENS in this regard, prolonging time to pain threshold and tolerance whilst reducing the levels of pain reported throughout. In patients with PAD and IC, HF and LF-TENS interventions were found to increase maximum walking distance on a treadmill compared to P-TENS. HF-TENS was also found to increase pain-free walking distance. The experience of using TENS in daily life was characterised by feelings of both benefit and disappointment. This was interpreted through the following themes: (i) ‘masking, but not taking the pain away’ and (ii) ‘walking further, but not far enough’. Conclusions: The mSETT is a reliable method of inducing lower limb, ischaemic pain in healthy volunteers and could be useful for the purposes of pre-clinical analgesic trials and investigation of the ischaemic pain experience. HF-TENS was found to reduce mSETT pain indicating hypoalgesic effects of TENS in experimentally induced, lower limb ischaemic pain. HF and LF-TENS have potential as interventions that increase walking performance for patients with IC. If using TENS at home for IC, expectations of treatment effect need to be managed to avoid disappointment and feelings of frustration.
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Michlitsch, Kenneth Jerome Francis 1976. "The design process applied to the development of orthopedic transcutaneous electrical nerve stimulations (TENS) devices for the treatement of acute pain." Thesis, Massachusetts Institute of Technology, 1999. http://hdl.handle.net/1721.1/80020.
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Dybeck, Axel, and Julia Persson. "Användning av transkutan elektrisk nervstimulering i smärtstillande syfte vid muskuloskeletala tillstånd : En litteraturstudie." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-43782.
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Bakgrund: Vid smärtsamma muskuloskeletalatillstånd är patienten beroende av sjuksköterskans omvårdnadsåtgärder och stöd till smärtlindring. Transkutan elektrisk nervstimulering (TENS) är en icke farmakologisk smärtlindringsmetod som med fördel kan kombineras med analgetiska läkemedel vid både akuta och långvariga smärttillstånd. För att optimera smärtlindringen i vardagen vid långvarig smärta kan patienten utbildas i att använda TENS i sin egenvård. Syfte: Syftet var att beskriva effekten av transkutan elektrisk nervstimulering som en del av smärtbehandlingen för personer med muskuloskeletala smärttillstånd. Metod: Allmän litteraturstudie med induktiv ansats där två kvalitativa artiklar samt sju kvantitativa artiklar granskats. Resultat: I resultatet framkom två teman: TENS effekt vid akut smärtaoch TENS effekt vid långvarig smärta. Resultatet visade att behandling med TENS kunde ge adekvat smärtlindring och var en säker metod med få negativa konsekvenser för patienten. Det framkom även att behandlingen medförde en reducering av intag av analgetiska preparat för patienterna. Patienter som behandlades med TENS visade även på en högre grad av fysisk funktion och psykiskt välbefinnande. Konklusion: För sjuksköterskans omvårdnad av patienter med muskuloskeletala tillstånd ter sig TENS vara en effektiv och säker omvårdnadsåtgärd med fler fördelar än enbart smärtlindrande effekt. Kunskap och utbildning för sjuksköterskan av denna behandlingsmetod kan ge sjuksköterskan ytterligare verktyg för multimodal omvårdnad av både akut och långvarig smärta. Sjuksköterskans kunskap om TENS ger även möjlighet till patientutbildning och kan stärka patientgruppens möjlighet till egenvård vid smärta.Background: In painful musculoskeletal conditions, the patient is dependent on the nurse's nursing measures and support for pain relief. Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological pain relief method that can be advantageously combined with analgesic drugs for both acute and long-term pain conditions. To optimize the pain relief in everyday life in the event of long-term pain, the patient can be trained in using TENS in their self-care. Aim: The aim was to describe the effect of transcutaneous electrical nerve stimulation as part of the pain treatment for people with musculoskeletal pain conditions. Method: A General literature study with inductive approach, where two qualitative articles and seven quantitative articles were examined. Results: The results revealed two themes: TENS effect in acute pain and TENS effect in long lasting pain. The results showed that treatment with TENS could provide adequate pain relief and was a safe method with few negative consequences for the patient. Itwas also found that the treatment resulted in a reduction in the intake of analgesic pharmaceuticals for the patients. Patients treated with TENS also showed a higher degree of physical function and mental well-being. Conclusion: For the nurse's nursing of patients with musculoskeletal conditions, TENS appears to be an effective and safe nursing measure with more benefits than just a pain-relieving effect. Knowledge and training for the nurse of this treatment method can provide the nurse with additional tools for multimodal care of both acute and long lasting pain. The nurse's knowledge of TENS also provides opportunities for patient education and can strengthen the patient group's opportunities for self-care in case of pain.
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Mira, Ticiana Aparecida Alves de 1986. "Estimulação elétrica nervosa transcutânea (TENS) no tratamento complementar da dor em mulheres com endometriose profunda = Transcutaneous electrical nerve stimulation (TENS) applied to complementary treatment of the pain in women with deep endometriosis." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312559.
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Orientadores: Cristina Laguna Benetti Pinto, Paulo César GiraldoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: Apesar dos tratamentos cirúrgico e medicamentoso utilizados para endometriose, muitas mulheres mantêm os sintomas álgicos. A literatura é escassa quanto a tratamentos complementares para dor. Objetivos: Avaliar a efetividade da TENS no tratamento complementar da dor pélvica crônica e dispareunia de profundidade em mulheres com endometriose profunda. Sujeitos e métodos: Ensaio controlado aleatorizado realizado no Departamento de Tocoginecologia da Universidade Estadual de Campinas. Foram incluídas 22 mulheres com endometriose profunda em uso de tratamento hormonal (progestagênios ou contraceptivo oral combinado), com persistência da queixa de dor pélvica crônica e/ou dispareunia de profundidade. Realizou-se aplicação da TENS por 8 semanas, com aleatorização das participantes em dois grupos: Grupo 1 - TENS modo acupuntura (Frequência: 8Hz, duração do pulso: 250µs e variação em intensidade e frequência (VIF) em 1ms) (n=11) e Grupo 2 - TENS autoaplicável (Frequência: 85Hz, duração do pulso: 75µs) (n=11); intensidade: ajustável "forte, mas confortável". Foram realizadas avaliações pré e pós-tratamento através da Escala Visual Analógica, Escala de Dispareunia de Profundidade, Questionário de Qualidade de Vida em Endometriose (EHP-30). Comparação pré e pós-tratamento através de teste de Wilcoxon e teste de Mann-Whitney. Resultado: As 22 mulheres com endometriose profunda utilizavam tratamento hormonal há 1,65±2,08 anos e mantinham queixa de dor pélvica e/ou dispareunia de profundidade. Os dois tipos de TENS, modo acupuntura e autoaplicável, promoveram melhora da dor pélvica crônica (p<.0001), dispareunia de profundidade (p=.0010) e qualidade de vida (p<.0001). Conclusões: Ambos os recursos (TENS modo acupuntura e TENS autoaplicável) demonstraram efetividade no tratamento complementar da dor pélvica crônica e dispareunia de profundidade e melhora da qualidade de vida de mulheres com endometriose profunda, independente do dispositivo utilizado para tratamento
Abstract: Introduction: Despite all the surgical and medical treatments for endometriosis many women have symptoms of pain. Nevertheless, the literature is scarce on additional treatments for pain. Objective: Evaluate the effectiveness of TENS applied as a complementary treatment of chronic pelvic pain and deep dyspareunia in women with deep endometriosis. Subjects and Methods: Randomized controlled trial conducted at the Department of Obstetrics and Gynecology of the University of Campinas. Twenty-two women were included and they presented deep endometriosis and made use of hormonal treatment (progestin or combined oral contraceptive) with persistent complaints of chronic pelvic pain and/or deep dyspareunia. TENS application for 8 weeks was applied with randomization of participants into two groups: Group 1 - TENS like acupuncture (frequency: 8 Hz, pulse duration: 250?s and variation in intensity and frequency (VIF) of 1 ms) (n = 11) and Group 2 - TENS self-applied (frequency: 85Hz, pulse duration: 75?s) (n = 11); intensity: Adjustable "strong but comfortable". Measurements by Visual Analogue Scale, Dyspareunia Depth Scale and Endometriosis Health Profile - Questionnaire (EHP-30) were performed pre and post treatment. To compare pre and post-treatment the Wilcoxon test and Mann-Whitney test were used. Results: The twenty-two women with deep endometriosis used hormonal treatment for 1.65±2.08 years and kept complaining about pelvic and / or deep dyspareunia pain. The two types of TENS (acupuncture and self-applied) promoted improvement in chronic pelvic pain (p <.0001), deep dyspareunia (p = .0010) and quality of life (p <.0001). Conclusion: Both features (TENS like acupuncture and TENS self-applied) demonstrated effectiveness as complementary treatment of chronic pelvic pain and deep dyspareunia and improved the quality of life of women with deep endometriosis regardless which one of the devices were used for treatment
Mestrado
Fisiopatologia Ginecológica
Mestra em Ciências da Saúde
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Guimarães, Elisama de Campos. "Ativação de neurônios encefálicos pela estimulação elétrica nervosa transcutânea (TENS) em ratos." Pós-Graduação em Ciências Fisiológicas, 2013. https://ri.ufs.br/handle/riufs/3973.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorTranscutaneous Electrical Nerve Stimulation (TENS) has been widely used by physical therapists for pain management, though other non-analgesic properties have been cited. A series of studies have shown that TENS acts through both central and peripheral mechanisms. However, little is known about the mechanisms of action of TENS. So, in order to improve the research on such mechanisms, this work aimed to identify brain areas activated by different protocols of TENS stimulation in non-hyperalgesic rats. Fos protein expression in neurons has been used as a marker of neural activity. A total of 15 male Wistar rats weighing between 250 to 350 g received a single administration of TENS with low (4 Hz) or high (100 Hz) frequency and sensory (absence of muscle contraction) or motor (muscle contraction) intensity of stimulation. Ninety minutes after stimulation, the animals were euthanized under general anesthesia and their encephalons were perfused and sectioned to perform the immunofluorescence for Fos technique. Then images were captured and analyzed. The animals were split into five groups (n=3, per group): control, whose animals did not received electrical stimulation, low frequency TENS at sensory level, low-frequency TENS at motor level, high frequency TENS at sensory level and high frequency TENS at motor level. After analyzing the images, a significant higher c-Fos expression was found in the electrically stimulated animals when compared to the control group at the following brain areas: preoptic area (p=0.003), insular cortex (p=0.01), motor cortex (p=0.009), prefrontal cortex (p=0.003), thalamic paraventricular nucleus (p=0.003), endopiriform cortex (p=0.01), inferior colliculus (p<0.005), entorhinal cortex (p.0.0003), secondary somatosensory cortex (p.0.0003) and olfactory tract (p.0.0003) in a manner dependent from both frequency of stimulation and intensity of current. Thus, one suggest that TENS activated several important encephalon regions, which are involved in neural function such as cognition, memory, cardiovascular regulation and motor control; however, we cannot restrict these areas as the only ones that are influenced by TENS stimulation. These results are of great relevance, because it open perspectives on new and different neurobiological actions of TENS and its possible clinical applicability and therapeutic efficacy for addressing clinical situations unrelated to analgesia, allowing wider direction for further studies.
A estimulacao eletrica nervosa transcutanea (TENS) e bastante utilizada para o controle da dor; no entanto, outras propriedades nao analgesicas tem sido citadas. Uma serie de estudos tem demonstrado que a TENS atua atraves de mecanismos perifericos e centrais. A fim de aprimorar as pesquisas sobre esses mecanismos, esse trabalho teve o objetivo de verificar as areas encefalicas ativadas pelo uso de diferentes protocolos de eletroestimulacao com TENS em ratos nao-hiperalgesicos. A imunodeteccao da proteina Fos em neuronios tem sido utilizada como marcador de atividade neural. Logo, um total de 15 ratos Wistar, pesando entre 250 a 350 g, receberam uma unica aplicacao de TENS, sendo utilizada com baixa (4 Hz) ou alta (100 Hz) frequencia de estimulacao e com intensidade em nivel sensorial (ausencia de contracao muscular) e motor (presenca de contracao muscular). Noventa minutos apos a eletroestimulacao, os animais foram eutanasiados sob anestesia e seus encefalos foram perfundidos e seccionados para realizacao de imunofluorescencia para proteina Fos. Posteriormente, imagens foram capturadas e analisadas. Os animais foram divididos em cinco grupos (n=3, por grupo): controle, cujos animais nao receberam nenhuma estimulacao eletrica; TENS de baixa frequencia em nivel sensorial, TENS de baixa frequencia em nivel motor, TENS de alta frequencia em nivel sensorial e TENS de alta frequencia em nivel motor. Apos analise das imagens, verificou-se um numero de celulas Fos positivas significativamente maior nos grupos eletroestimulados em comparacao ao grupo controle nas seguintes areas encefalicas: area preoptica (p=0,003), cortex insular (p=0,01), cortex motor (p=0,009), cortex pre frontal (p=0,003), nucleo paraventricular talamico (p=0,003), nucleo endopiriforme (p=0,01), coliculo inferior (p<0,005), cortex entorrinal (p.0,0003), cortex somatossensorial 2 (p.0,0003), nucleo supraoptico (p.0,0003) e trato olfatorio (p.0,0003). Entretanto, esta ativacao neuronal ocorreu de forma dependente da frequencia de estimulacao e da intensidade da corrente nas diferentes regioes encefalicas. Assim, conclui-se que a TENS ativou diversas regioes encefalicas importantes, associadas a funcao de cognicao, memoria, regulacao cardiovascular e controle motor; no entanto, nao se pode restringir essas areas como as unicas cujos neuronios sao ativados pela TENS. Esses resultados sao relevantes uma vez que disparam perspectivas quanto a novas e diferentes acoes neurobiologicas da TENS e sua possivel aplicabilidade e eficacia terapeutica para a abordagem de situacoes clinicas que nao relacionadas a analgesia, possibilitando a ampliacao do direcionamento para a realizacao de novos estudos.
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Guerra, Danilo Ribeiro. "Influência do momento de aplicação da estimulação elétrica nervosa transcutânea (TENS) como recurso analgésico em herniorrafias inguinais." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/17/17142/tde-23102008-172937/.
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Introdução. O uso da Estimulação Elétrica Nervosa Transcutânea (TENS) para o tratamento da dor pós-operatória tem sido objeto de estudo há alguns anos. Todavia, em quase a totalidade dos trabalhos, a TENS foi aplicada somente após os procedimentos cirúrgicos, à exceção de uma única pesquisa em que foi empregada no período pré-operatório. Em ambas as situações, esse recurso foi eficiente para o tratamento da dor, seja por meio da redução da sua intensidade ou do consumo de analgésicos. Porém, ainda hoje, não se sabe qual o papel que o seu momento de aplicação (somente antes da cirurgia; apenas após a operação; ou antes e após) pode vir a exercer no grau de analgesia obtido. Objetivo. Analisar a influência do momento de aplicação da TENS, na modalidade de alta freqüência, como recurso analgésico em pacientes do sexo masculino submetidos a herniorrafias inguinais pela técnica de Bassini. Casuística e método. A pesquisa clínica, controlada, aleatória e duplamente encoberta foi realizada no Hospital São José, entre abril de 2007 e junho de 2008, com amostra de 125 pacientes, distribuídos em 5 grupos: TENS depois (n = 25), TENS antes (n = 25), TENS antes e depois (n = 25), Placebo (n = 25) e Controle (n = 25). Todas as anestesias foram realizadas via raquidiana, com cloridrato de bupivacaína (0,5%); e a medicação analgésica utilizada no pós-operatório foi: dipirona, como medicação de resgate; e cetoprofeno, em horário programado. A mensuração da dor foi feita com a escala numérica (0-10 cm) e com a versão brasileira do Questionário de Dor McGill (Br-MPQ). Foram considerados estatisticamente significantes os valores de p 0,05. Resultados. Os grupos que foram tratados com a TENS apresentaram redução significante da dor, sendo os resultados mais expressivos naqueles pacientes em que a TENS foi aplicada tanto no período pré, quanto pós-operatório (TENS antes e depois). Houve também redução significante da administração de dipirona no período pós-operatório. Conclusão. O uso pré e pós-operatório da modalidade de alta freqüência da TENS, em pacientes submetidos a herniorrafias inguinais com técnica de Bassini, proporcionou analgesia mais satisfatória do que aquela obtida somente com a aplicação em um desses momentos.Introduction. The use of Transcutaneous Electrical Nerve Stimulation (TENS) to treat postoperative pain has been searched lately. However, in the most of studies, TENS has been applied only after surgeries, excepting one where TENS was utilized before. In the two situations, this resource has presented good benefits for pain treatment, observed not only by a reduction in its intensity but also in consumption of analgesics. Nevertheless, there is a doubt about the role that TENS applications moment can exert in analgesias level obtained in the postoperative period. Objective. To analyze the influence of applications moment of high frequency TENS as an analgesic resource in male patients submitted to inguinal herniorraphy (Bassini technique). Cases and method. It was a placebo-controlled, randomized and double-blinded trial, carried out at the Hospital São José (Aracaju, SE, Brazil), between April 2007 and June 2008, and had a sample of 125 patients, distributed in 5 groups: pre TENS (n = 25), post TENS (n = 25), pre- and post TENS (n = 25), Sham (n = 25) and Control (n = 25). There was the standardization of the bupivacaine (0,5 %) as an anesthetic drug, as well as postoperative analgesic prescription: dipyrone, only if the patient complained about pain; and ketoprofen, prescribed for every 8 h. Pain intensity was measured by the Numerical Rating Scale (NRS), in 8 moments (2½, 3, 3½, 4, 5, 6 and 7 h after inducing the anesthesia besides one last verification at the hospital discharge). Brazilian version of the McGill Pain Questionnaire (Br-MPQ) was used 4 h following the inducing of the anesthesia. P values .05 were considered significant. Results. Patients treated with TENS showed less pain intensity, and the most expressive results occurred in pre- and post TENS, moreover there was also significant reduction in dipyrone consumption. Conclusion. The pre- and postoperative use of high frequency TENS in inguinal herniorraphy provided major analgesia than the one obtained by TENS application only in the pre- or postoperative period.
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Pitangui, Ana Carolina Rodarti. "Avaliação do efeito da estimulação elétrica nervosa transcutânea (TENS) no alívio da dor pós-episiotomia em primíparas submetidas ao parto normal." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-07012008-115139/.
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O trauma perineal em mulheres submetidas ao parto normal, seja espontâneo ou cirúrgico, pode causar considerável desconforto à mulher no período pós-parto. A dor perineal no puerpério tem sido reportada como sendo uma das causas mais comuns de morbidade materna. Investigar medidas não farmacológicas capazes de amenizar a dor perineal é um assunto ainda abordado na literatura de modo escasso. A TENS é um recurso fisioterapêutico que tem como principal finalidade o alívio da dor. O objetivo deste estudo foi avaliar a eficácia da TENS como recurso de alívio de dor aplicada as puérperas que apresentem episiotomia e caracterizar a queixa dolorosa. Realizou-se um ensaio clínico, randomizado e controlado. Participaram voluntariamente do estudo 40 puérperas primíparas que foram submetidas ao parto normal com episiotomia. Todas preenchiam aos critérios de inclusão e receberam assistência em uma maternidade conveniada ao Sistema Único de Saúde na cidade de Ribeirão Preto - SP. Os grupos foram formados pelo método de blocos, onde 20 puérperas fizeram parte do grupo experimental que receberam a TENS no pós-parto e os procedimentos de rotina da maternidade e 20 do grupo controle que foram submetidas somente aos procedimentos de rotina da instituição. A pesquisa foi realizada em três etapas. Na primeira, para ambos os grupos, foi aplicado o formulário de dados sobre o perfil sócio demográfico e obstétrico das puérperas e sobre o neonato, questões a respeito da dor na episiotomia e escala de categoria numérica (NRS), para o repouso, e para as atividades; os descritores de dor e o item PPI (Present pain intensity) da versão brasileira do questionário McGill (Br-MPQ). Finalizando esta etapa, foi aplicada no grupo experimental durante 60 minutos a TENS fixada no modo convencional, com freqüência de 100Hz e duração de pulso 75µs. Quatro eletrodos de silicone-carbono foram posicionados próximos a episiotomia, na região da coxa e glúteo da puérpera. A segunda etapa foi iniciada após se passarem 60 minutos da primeira etapa e utilizaramse os mesmos instrumentos de avaliação da fase anterior. No grupo experimental aplicou-se o instrumento de verificação da opinião da puérpera em relação ao uso da TENS. A terceira etapa ocorreu após se passarem 60 minutos da segunda etapa. Nesta, foram utilizados como instrumentos em ambos os grupos a NRS e o item PPI do Br-MPQ. Verificou-se pelo teste de Mann-Witney que houve alívio de dor nas puérperas do grupo experimental quando comparadas com o grupo controle, havendo uma diferença estatística significativa (p<0,001) que persistiu durante todo o período do estudo. Em relação à caracterização da dor, ao comparar-se a primeira e a segunda avaliação, identificou-se que no grupo experimental houve em todas as categorias, variação no percentual de descritores, porém, não foi verificado este padrão para o grupo controle, onde se percebeu pequenas alterações na freqüência de alguns descritores sem, contudo mudar o perfil dos descritores selecionados a cada uma das avaliações. Pode-se afirmar com este estudo, que a TENS foi eficaz no alívio da dor das puérperas submetidas à episiotomia, e que foram encontradas diferenças na caracterização da queixa dolorosa.The perineal trauma in women submitted to a natural delivery, either spontaneous or surgical, can cause considerable discomfort to woman on the postpartum period. Perineal pain in the puerperium has been reported as being one of the most common causes of maternal morbidity. Investigate non-pharmacological measures capable to brighten up perineal pain still is a boarded subject in the literature in scarce way. The TENS it is a physical therapy resource that has as main purpose the pain relief. The objective of this study was to evaluate the effectiveness of TENS as a pain relief resource applied in puerperal women that present episiotomy, and to characterize the painful complaint. It was conducted a randomized controlled trial where it was included 40 primiparous volunteered women that had been submitted to a spontaneous vaginal delivery with episiotomy. All of them fullfilled the inclusion criteria and received assistance in a maternity conver by Unified National Health System in the city of Ribeirão Preto - SP/ Brazil. The groups had been formed by the method of blocks, where 20 puerperal women had been part of the experimental group that they had received TENS in the postpartum and the routine procedures of maternity and 20 of the control group that had been submitted only to the routine procedures of the institution. The research was made in three stages. In the first one, for both groups, were applied the data form\'s about the puerperal women\'s sociodemographic and obstetric profile and about neonate, questions regarding pain in the episiotomy and numeric rating scale (NRS), for the rest, and the activities; the describers of pain and the PPI (Present pain intensity) item of the Brazilian version of the McGill pain questionnaire (Br-MPQ). Finishing this stage, it was applied in the experimental group during 60 minutes the TENS fixed it in the conventional way, with frequency of 100Hz and duration of pulse 75µs. Four silica-carbon electrodes had been located next to the episiotomy, in the thigh and gluteus region of puerperal women. The second stage was initiated after to pass 60 minutes of the first stage and had used the same instruments of evaluation of the previous phases. In the experimental group it was applied the instrument of verification of the opinion of puerperal women in relation of the use of TENS. The third stage occurred after to pass 60 minutes of the second stage. In this, both groups had been used the instruments NRS and PPI item of the Br-MPQ. It was verified for the Mann- Witney test that women of the experimental group had relief of pain when compared with the controlled group, having a significant statistics difference (p<0,001) that persisted during all the study period. In relation to the characterization of pain, when comparing the first and the second evaluation, it was identified that the experimental group had variation in the percentage of the words of all the categories, however, it was not verified this standard for the controlled group, where it was perceived small alterations in the frequency of some words without, however to change the profile of the selected describers to each one of the evaluations. It can be affirmed with this study, that TENS was efficient in the relief of the pain of puerperal women submitted to episiotomy, and that differences in the characterization of the painful complaint had been found.
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Bergeron-Vézina, Kayla. "Efficacité analgésique de la neurostimulation périphérique (TENS) chez les aînés." Mémoire, Université de Sherbrooke, 2015. http://hdl.handle.net/11143/6067.
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La neurostimulation périphérique (en anglais transcutaneous electrical nerve stimulation ou TENS) est une modalité thérapeutique fréquemment utilisée en réadaptation pour diminuer la douleur. À ce jour, cependant, l’efficacité analgésique du TENS chez les aînés demeure peu documentée. La majorité des études effectuées jusqu’à présent ont été réalisées chez les jeunes adultes ou chez des populations d’âge hétérogènes. La présente étude, un essai croisé randomisé à double insu, avait pour objectif de documenter l’efficacité analgésique du TENS conventionnel et du TENS acupuncture chez les aînés et d’observer si la réponse analgésique de ces deux modalités de TENS entre les aînés et les jeunes adultes est différente. Quinze aînés et quinze jeunes adultes ont participé à l’étude. Les participants étaient évalués à trois occasions distinctes pour recevoir en alternance un TENS conventionnel, un TENS acupuncture et un TENS placebo. Une douleur expérimentale était créée à l’aide d’une thermode de type Peltier, appliquée au niveau de la colonne lombaire pendant deux minutes, période durant laquelle les participants devaient évaluer l’intensité de leur douleur avec une échelle visuelle analogue reliée à un ordinateur (CoVAS). Les mesures de douleur ont été prises avant, pendant et après l’application de chaque type de TENS. Chez les jeunes adultes, lorsque comparée au niveau de douleur initiale, une diminution significative de la douleur a été observée pendant et après l’application du TENS conventionnel et acupuncture. Le TENS conventionnel et acupuncture étaient supérieurs au traitement placebo (toutes les valeurs de p < 0,05). Cependant, chez les aînés, le TENS conventionnel et acupuncture n’ont pas permis de diminuer significativement la douleur. De plus, aucune modalité TENS ne se démarquait du traitement placebo (toutes les valeurs de p > 0,05). Bien que le TENS conventionnel et le TENS acupuncture soient efficaces chez les jeunes adultes, les présents résultats suggèrent que le TENS n’est pas la meilleure option de traitement pour diminuer la douleur chez les aînés, du moins lorsqu’il est utilisé seul (monothérapie). Des études futures, visant à déterminer des façons de bonifier l’effet du TENS chez les aînés, sont nécessaires.
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Morgan, Charles Ricardo. "Estudo da estimulação elétrica nervosa transcutânea (TENS) nível sensório para efeito de analgesia em pacientes com osteoartrose de joelho." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5167/tde-01022011-173211/.
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INTRODUÇÃO: A osteoartrose de joelho (OAJ) é uma das patologias que mais afetam o aparelho locomotor e interferem de forma considerável nas atividades da vida diária, acometendo os indivíduos em faixa etária variável e em diversos graus e níveis de dor articular. As propostas terapêuticas são bastante diversificadas para a osteoartrose (OA), a terapia física, a TENS está para colaborar no tratamento dos pacientes com osteoartrose de joelho. OBJETIVOS: Devido à importância da articulação do joelho nas atividades locomotoras e sua relação com as atividades da vida diária. Os pacientes com osteoartrose de joelho sofrem não somente pelo problema localizado, existe uma alteração funcional global que pode levar a processos dolorosos em outras articulações. Para uma eficaz orientação e avaliação do paciente primeiro é necessário que este faça a descrição clara de sua dor para que o profissional perceba como que esse estímulo doloroso prejudica sua vida. O objetivo do presente estudo foi avaliar o efeito da estimulação elétrica nervosa transcutânea (sigla em inglês TENS) nível sensório para tratamento de dor em pacientes com diagnóstico de osteoartrose de joelho, utilizando escalas de avaliação de dor, escala de avaliação funcional. MÉTODOS: Foram estudados 10 pacientes com diagnóstico de osteoartrose de joelho, utilizando uma modalidade fisioterapêutica, a eletroterapia, especificamente a (TENS), com parâmetros de 80 Hz e 140s, com um total de 10 sessões, 30 minutos para cada sessão, o período total de tratamento compreendeu 4 semanas, nesse total de 10 sessões, cada paciente foi entrevistado com um questionário na 1ª sessão, na 5ª e na 10ª sessão. Os formulários utilizados foram Questionário da Dor McGill Melzack, escala Analógica visual da dor, escala numérica com expressão facial de sofrimento, escala de atividades da vida diária da knee Outcome Survey - RESULTADOS: O resultado com a TENS nível sensório para efeito de analgesia mostra que as diferenças foram estatisticamente significativas (p<0,05) para escala Analógica visual da dor e o Questionário da Dor McGill, em alguns itens da escala de atividades da vida diária da knee Outcome Survey houve significância estatística. CONCLUSÃO: Nossos resultados sugerem que a TENS nível sensório reduz a dor e melhora a funcionalidade do joelho em alguns pontos da escala de atividades da vida diária em pacientes com OAJINTRODUCTION: Knee osteoarthritis (KOA) is one of the diseases that most affect the locomotor system and interfere significantly in activities of daily life, affecting individuals at varying ages and in different degrees and levels of joint pain. The proposals are quite diverse therapies for osteoarthritis (OA), physical therapy, TENS is to collaborate in the treatment of patients with osteoarthritis of the knee. OBJECTIVES: Because of the importance of the knee joint in locomotor activity and its relation to the activities of daily living. Patients with osteoarthritis of the knee not only suffer the problem located, there is a change in overall functional processes that can lead to pain in other joints. To provide efficient guidance and evaluation of the patient first must make this clear description of their pain for the professional to realize how painful stimulus that affect their lives. The aim of this study was to evaluate the effect of transcutaneous electrical nerve stimulation (TENS acronym in English) to the sensory processing of pain in patients with osteoarthritis of the knee, using rating scales of pain, functional scale. METHODS: We studied 10 patients with osteoarthritis of the knee, using a modality physiotherapy, electrotherapy, specifically (TENS), with parameters of 80 Hz and 140s, with a total of 10 sessions, 30 minutes for each session, the period Total treatment included 4 weeks in total of 10 sessions, each patient was interviewed with a questionnaire in the first session, on the 5th and 10th session. The forms used were the McGill Pain Questionnaire - Melzack, visual analogue pain scale, numerical scale with facial expression of pain, range of activities of daily living of the Knee Outcome Survey - RESULTS: The result with TENS for the effect of sensory analgesia shows that the differences were statistically significant (p <0.05) for visual analogue pain scale and McGill Pain Questionnaire, in some items of the scale of activities of daily living knee Outcome Survey of statistical significance. CONCLUSION: Our results suggest that sensory TENS reduces pain and improves knee function in some points of the scale of activities of daily living in patients with KOA
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Tonezzer, Tania. "Uso da Estimulação Elétrica Nervosa Transcutânea (TENS) na redução dos sintomas de neuropatia periférica induzida por quimioterapia anti-neoplásica." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5170/tde-08032017-163417/.
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INTRODUÇÃO: A neuropatia periférica induzida por quimioterapia (NPIQ) está entre os efeitos colaterais mais comuns decorrentes da quimioterapia antineoplásica e uma das principais causas da redução da dose ou interrupção do tratamento. Os sintomas mais prevalentes são a dor e a parestesia, acarretando desconfortos crônicos e perda de habilidades funcionais, interferindo negativamente na qualidade de vida dos pacientes. Estudos recentes têm avaliado o uso da Estimulação Elétrica Nervosa Transcutânea (TENS) nesta patologia, apresentando evidências positivas na redução da dor, porém seu efeito nos sintomas de parestesia e nas atividades de vida diária destes pacientes ainda não foram avaliados. OBJETIVO: Investigar os efeitos da Estimulação Elétrica Nervosa Transcutânea (TENS) nos sintomas de dor, parestesia e nas atividades de vida diária da NPIQ em indivíduos com diagnóstico de câncer de mama e colorretal, submetidos ao tratamento de quimioterapia. MÉTODOS: Trata-se de um ensaio clínico duplo-cego, controlado, randomizado e multicêntrico, com abordagem quantitativa, em pacientes submetidos ao tratamento de quimioterapia, contendo em seu protocolo os seguintes quimioterápicos: paclitaxel e oxaliplatina. Os sujeitos da pesquisa utilizaram o dispositivo terapêutico TENS com modulação de frequência entre 7 e 75 Hz na região distal dos membros, no local de maior desconforto, com intervenções diárias de 60 minutos, durante três ciclos de quimioterapia (45 dias). Os participantes foram divididos em dois grupos: grupo TENS ativa (GTA) e grupo TENS placebo (GTP). A avaliação dos efeitos da TENS foi medida através dos seguintes instrumentos: a Escala Visual Analógica (EVA) para avaliar os sintomas de dor e parestesia e Questionário de Neurotoxicidade Induzida por Anti-neoplásicos (QNIA) para avaliação dos sintomas da NPIQ. RESULTADOS: Finalizaram a pesquisa 24 pacientes. Não se observou uma diferença significativa entre os 2 grupos no que se refere ao desfecho primário de redução dos sintomas de dor (p = 0.666), parestesia (p = 0,673) e impacto da TENS na frequência dos sintomas (p = 0,5906) e atividades de vida diária (p = 0,8565). CONCLUSÃO: Estes resultados sugerem que a TENS aplicada no modo de modulação de frequência não foi eficaz para melhorar os sintomas de neuropatia periférica induzida por quimioterapia, durante os ciclos de quimioterapia. Não houve, porém, agravamento dos sintomas em ciclos subsequentes ao início dos sintomas da doençaBACKGROUND: Peripheral neuropathy induced by chemotherapy (PNIC) is amongst the most common side effects derived from antineoplastic chemotherapy and one of the principal causes of dose reduction or treatment interruption. The most prevalent symptoms are pain and numbness, resulting from chronic discomfort to loss of functional abilities, negatively affecting quality of life and autonomy of patients. Recent studies have evaluated the use of Transcutaneous Electrical Nerve Stimulation (TENS) in this disease, pointing to evidence of pain reduction, but its effect on symptoms of paresthesia and in daily life activities have not yet been evaluated. OBJECTIVE: To investigate the effects of Transcutaneous Electrical Nerve Stimulation (TENS) for reducing the symptoms of pain, paresthesia and the daily activities of PNIC in patients diagnosed with breast cancer and colorectal cancer undergoing chemotherapy treatment. METHODS: It is a double-blind, controlled, randomized, multicenter clinical trial with a quantitative approach in a sample of 24 patients undergoing chemotherapy treatment, containing in its protocol the following chemotherapeutic agents: paclitaxel and oxaliplatin. The research subjects used the TENS therapeutic device with frequency modulation between 7 and 75 Hz in the distal limb, on the location of greatest discomfort with daily interventions lasting 60 minutes for three chemotherapy cycles (45 days). Participants were divided into two groups: active TENS group (ATG) and placebo TENS group (PTG). The assessment of the effects of TENS was measured by the following instruments: The Visual Analogue Scale (VAS) to assess the symptoms of pain and numbness and Questionnaire for Neurotoxicity Induced by Anti-neoplastic (QNIA) to assess the symptoms of PNIC. RESULTS: A 24-patient study was completed. There was no significant difference between the two groups regarding the primary endpoint of reduced pain symptoms (p = 0.666) and paresthesia (p = 0.673), neither any measurable impact of TENS in the frequency of symptoms (p = 0.5906) or activities of daily living (p = 0.8565). CONCLUSION: These results suggest that TENS applied in frequency modulation mode is not effective for ameliorating the symptoms of peripheral neuropathy induced by chemotherapy during chemotherapy cycles. There was, however, no worsening of symptoms in subsequent cycles after the onset of symptoms
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Bragança, Rafaella Mariana Fontes de. "Estudo da repetibilidade de manobras para o registro da relação cêntrica após a aplicação da ULF-TENS, por meio da Análise Eletrônica de Posição (EPA)." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/58/58133/tde-16032016-141938/.
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A relação cêntrica (RC) é uma posição de grande importância no diagnóstico e tratamento em diversas áreas odontológicas. Durante a manipulação em RC, é importante impedir que a memória neuromuscular conduza a um registro incorreto. A neuroestimulação elétrica transcutânea de ultra baixa frequência (ULF-TENS) reduz a atividade eletromiográfica de músculos da mastigação. Desta forma, o presente estudo avaliou a influência da ULF-TENS no deslocamento da cabeça da mandíbula e na repetibilidade das técnicas de manipulação em RC (Bimanual de Dawson, tiras de Long e sistema R.O.C.A), além de verificar qual destas técnicas apresenta maior variabilidade. Para isso, 25 participantes sem Disfunção Temporomandibular (DTM) foram submetidos à duas etapas do estudo realizadas por meio da análise eletrônica de posição (EPA), que permite a avaliação da posição condilar em três eixos (X, Y e Z). Na primeira (ST), foram feitas três sequências com três registros de RC cada, um por técnica de manipulação. Na segunda (CT), foi aplicada a ULF-TENS por 30 minutos antes das sequências de registros, também realizada por três vezes. Utilizou-se o Mann-Whitney (p ≤ 0,05) para verificar a influência da ULF-TENS no deslocamento total para as técnicas Bimanual de Dawson, tiras de Long e sistema R.O.C.A e o ICC e 1-tailed F test a fim de avaliar a repetibilidade e a variância, respectivamente, dessas técnicas. A utilização da ULF-TENS não influenciou no deslocamento total da cabeça da mandíbula, independentemente da técnica de registro de RC utilizada (p>0,05). Apenas a técnica Bimanual apresentou uma melhora na repetibilidade com o uso da ULF-TENS, que foi restrita aos eixos X e Y direitos. Na comparação da variância entre as técnicas, a Bimanual demonstrou menor variação no eixo X, a de Long e R.O.C.A variaram menos no eixo Y e a de Long novamente teve menor variação no eixo Z. Pode-se concluir que o uso da ULF-TENS não altera o posicionamento condilar e melhora, embora discretamente, a repetibilidade apenas da técnica Bimanual. No geral, a técnica de Long apresentou menor variabilidade entre os participantes.Centric relation (CR) is a position of great importance in diagnosis and treatment for several dental specialties. When guiding the jaw to CR, it is important to prevent the neuromuscular memory to mislead the record. Ultra low frequency-transcutaneous electrical nerve stimulation (ULF-TENS) reduces the electromyographic activity of masticatory muscles. Thus, the current study evaluated the influence of ULF-TENS in the displacement of the mandibular condyle and in the repeatability of centric relation registration techniques (Bimanual manipulation, Long technique, R.O.C.A. wires). In addition it was verified which of these techniques presents greater variability. For this purpose, 25 participants without Temporomandibular disorder (TMD) underwent two study stages conducted via electronic position analysis (EPA), which allows the evaluation of condylar position in three axes (X, Y e Z). In the first stage (NT), three sequences were made with three CR records each, one for manipulation technique. In the second stage (WT), the ULF-TENS was applied for 30 minutes before the record sequences, also performed for three times. Mann-Whitney test (p ≤ 0.05) was used to check the ULF-TENS influence on total displacement for Bimanual manipulation, Long technique and R.O.C.A. wires. ICC and 1-tailed F test were applied to assess the repeatability and variance, respectively, of these same techniques. Application of ULF-TENS did not influence the condyle total displacement, regardless of RC recording technique used (p> 0.05). Only Bimanual technique showed an improvement in repeatability with the use of ULF-TENS, which was restricted to the X and Y right axes. Concerning the variance comparison between the techniques, Bimanual manipulation showed less variation in the X axis, Long technique and R.O.C.A. wires varied less in the Y axis and Long technique was again less variable in the Z axis. It could be concluded that the use of ULF-TENS does not affect the condylar positioning and improved, although slightly, only the repeatability of Bimanual manipulation. Overall, Long technique presented lower variability among participants.
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Garcez, Priscila de Araújo. "Efeito da TENS associada ao exercício na Doença de Parkinson : ensaio clínico randomizado." Universidade Federal de Sergipe, 2016. https://ri.ufs.br/handle/riufs/3782.
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Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqIntroduction: Parkinson’s disease (PD) is a chronic, degenerative and progressive disorder, responsible for developing disabling motor and non-motor symptoms. It occurs due to a loss of dopaminergic neurons in the substantia nigra, locus coeruleus and striatum and the presence of extranigrais dysfunction. Pain is one of the most frequent non-motor features. Transcutaneous Electrical Nerve Stimulation (TENS) as well as therapeutic exercise may help the treatment of PD as both of them activate central pathways that reduce pain by releasing opioids. Aims: To evaluate the effect of TENS associated with physical exercise in the intensity of pain, temporal summation, skin sensitivity, fatigue, gait speed, sitting and standing speed, dynamic balance and psycho-emotional factors. Method: This is a randomized, placebo-controlled, double-blind clinical trial, using a crossover design. PD patients were randomly distributed into to groups: Active TENS or Placebo TENS, both associated with 20 minutes of exercise, for TENS application in the lumbar and thoracic spine. Study groups went through the following procedures: evaluation (before and after each application session TENS; before the start and after completion of each group), physical therapy intervention of 20 sessions (with 10 sessions in each group). Instruments or procedures used in the assessment and reassessment were: numerical scale of 11 points (intensity of pain and fatigue), Test Timed Up and Go (functionality of legs in displacement), accelerometry (movement speed during the act of sitting and up), figure 8 test (dynamic balance), esthesiometer (skin sensitivity), pendulum fleximeter (range of motion), temporal summation (central sensitization), Pain Catastrophizing Scale (negative expectation regarding pain), Beck Depression Inventory (depression). Results: Comparing pre- and post-treatment, there was improvement in: pain intensity in the active group (p = 0.0068), running speed in the active group (p <0.0001) skin sensitivity on the right (p = 0.0022) and left (p = 0.0410) points on the chest of the active group, dynamic balance (p = 0.0085) in the active group, temporal summation (p = 0.0044) trunk muscle flexibility in flexion movements (p = 0.0103) extension (P = 0.0104) right (p = 0.0001) and left rotation (p = 0.0001) in the active group and flexion ( p = 0.0001) extension (P = 0.0349), right slope (p = 0.0042) and left rotation (p = 0.0001) in the placebo group. Conclusion: According to the results obtained in our study, the active TENS associated with physical exercises showed effectiveness in the treatment of pain, reduced temporal summation, skin sensitivity, fatigue, gait speed, muscle flexibility and dynamic balance of individuals with PD. There was no effect of analgesic tolerance in these individuals.
Introdução: A Doença de Parkinson (DP) é uma desordem crônica e degenerativa, de caráter progressivo, responsável pelo desenvolvimento de sintomas incapacitantes motores e não motores sendo a dor uma das características não motoras mais frequentes. A Estimulação Elétrica Nervosa Transcutânea (TENS), bem como exercícios terapêuticos, podem auxiliar no tratamento da DP, pois ativam vias centrais que reduzem a dor através da liberação de opióides. Objetivos: Avaliar o efeito da TENS associada ao exercício físico na intensidade de dor, somação temporal, sensibilidade cutânea, fadiga, velocidade de marcha, velocidade de movimento, equilíbrio dinâmico e fatores psicoemocionais. Método: Trata-se de um ensaio clínico com distribuição aleatória, controlado por placebo, duplamente encoberto, do tipo crossover. Vinte e seis pacientes com DP foram distribuídos, aleatoriamente, nos tratamentos com ordem TENS Ativa-Placebo ou TENS Placebo-Ativa, ambos associados a exercícios físicos de 20 minutos, para aplicação da TENS (frequência de 100 Hz, pulso de 100 μs, intensidade no limiar motor) nas regiões lombar e torácica paravertebrais. Os grupos de estudos passaram pelos seguintes procedimentos: avaliação (antes e após cada sessão de aplicação da TENS; antes do início e após finalização de cada grupo), intervenção fisioterapêutica de 20 sessões (sendo 10 sessões em cada grupo, com washout de sete dias). Os instrumentos ou procedimentos utilizados nos processos de avaliação e reavaliação foram: escala numérica de 11 pontos (intensidade de dor e fadiga), teste Timed Up and Go (tempo de deslocamento), acelerometria (velocidade de movimento durante o ato de sentar e levantar), teste da figura 8 (equilíbrio dinâmico), estesiometria (sensibilidade cutânea), fleximetria pendular (amplitude de movimento), somação temporal (sensibilização central), escala de catastrofização da dor (expectativa negativa em relação à dor), inventário de depressão de Beck (depressão). Resultados: Comparando o pré e pós-tratamento, foi observada melhora no (a): intensidade de dor do grupo ativo (p=0,0068), velocidade de marcha no grupo ativo (p<0,0001), sensibilidade cutânea nos pontos direito (p=0,0022) e esquerdo (p=0,0410) da região torácica do grupo ativo, equilíbrio dinâmico (p=0,0085) do grupo ativo, somação temporal (p=0,0044), flexibilidade muscular de tronco nos movimentos de flexão (p=0,0103), extensão (p=0,0104), rotação direita (p=0,0001) e esquerda (p=0,0001) no grupo ativo e flexão (p=0,0001), extensão (p=0,0349), inclinação direita (p=0,0042) e rotação esquerda (p=0,0001) no grupo placebo. Conclusão: TENS ativa associada a exercícios físicos se mostrou efetiva através da redução da intensidade de dor e da somação temporal, sensibilidade cutânea, fadiga, velocidade de marcha, flexibilidade muscular e equilíbrio dinâmico dos indivíduos com DP. Não foi observado efeito de tolerância analgésica nestes indivíduos.
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França, Fabio Jorge Renovato. "Estabilização segmentar lombar e TENS na hérnia discal lombar: um ensaio clínico randomizado." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-26052014-103540/.
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INTRODUÇÃO: A hérnia de disco lombar (HDL) acomete cerca de 5% dos pacientes com de dor lombar e o tratamento cirúrgico nestes casos é cada vez menos indicado, optando-se, na maior parte dos casos, pelo conservador. Embora o método estabilização lombar (EL) e a estimulação elétrica nervosa transcutânea (TENS) tenham mostrado bons resultados em indivíduos portadores de dor lombar inespecífica, há escassa literatura que tenha verificado a eficácia destes tratamentos isoladamente em sujeitos acometidos por hérnia de disco lombar. OBJETIVO: Comparar a eficácia dos exercícios de estabilização lombar e da TENS na dor, incapacidade funcional, e capacidade de ativação do músculo transverso do abdome (TrA) de indivíduos com hérnia de disco lombar. METODOLOGIA: Participaram da pesquisa 40 indivíduos com idade variando de 25 a 58 anos com dor lombar e hérnia de disco, e foram randomizados em dois grupos: Grupo estabilização lombar (EL) (exercícios específicos para os músculos TrA e multífido lombar(ML)) (n=20) e Grupo TENS (GT) (n=20) que receberam atendimento com corrente de estimulação elétrica nervosa transcutânea. Foram avaliados quanto à dor (Escala Visual Analógica e Questionário McGill de Dor), incapacidade funcional (Índice de Incapacidade de Oswestry), e capacidade de recrutamento do TrA (Unidade de Biofeedback Pressórico-UBP). Os grupos foram tratados em duas sessões semanais com duração de 60 minutos por oito semanas. Cada indivíduo foi avaliado antes e após o tratamento. O nível de significância estabelecido foi de alfa=0,05. RESULTADOS: Após oito semanas, o grupo estabilização lombar mostrou melhora significativa na dor (p < 0,001), incapacidade funcional (p < 0,001), e capacidade de ativação do TrA (p < 0,001). O grupo TENS apresentou diferença estatisticamente significante apenas na dor (p < 0,012). A estabilização foi superior à TENS na melhora na dor (p < 0,001), incapacidade funcional (p < 0,001), e capacidade de ativação do TrA (p < 0,001). CONCLUSÃO: Os resultados indicam que a estabilização é efetiva na melhora da dor, incapacidade funcional, e capacidade da ativação do TrA, e a TENS apenas na dor. A estabilização foi superior à TENS em todas as variáveisINTRODUCTION: Lumbar disc herniation (LDH) affects about 5% of low back pain (LBP) patients. Surgical treatment in these cases is increasingly less suitable, opting, in most cases, for the conservative. Although lumbar stabilization method and transcutaneous electric nerve stimulation (TENS) have shown good results in patients with nonspecific low back pain, there is scarce literature that has verified the effectiveness of these treatments alone in subjects suffering from lumbar disc herniation.OBJECTIVE: To compare the effectiveness of lumbar stabilization exercises and transcutaneous electrical nerve stimulation (TENS), on pain, functional disability and activation of the transversus abdominis muscle (TrA), in individuals with lumbar disc herniation (LDH). METHODS: This study involved 40 patients (age range 25-58 years) with lumbar disc herniation randomized into two groups: Stabilization group (SG: n=20); which received of stabilization exercises (transversus abdominis and lumbar multifidus muscles) and TENS group (TG: n=20), which received electrotherapy. The following instruments were used: visual analogue pain scale and McGill Pain Questionnaire for pain, Oswestry Disability Index for functional disability, and pressure biofeedback unit (PBU) for ability to contract the TrA. Analyses within and between groups were performed after treatment. Groups underwent 16 sessions, for 60 minutes, twice a week and they were evaluated before and after eight weeks. Significance level was set at alfa= 0.05. RESULTS: After eight weeks, lumbar stabilization group showed significant improvements in pain (p < 0.001), functional disability (p < 0.001), and the ability to contract the TrA (p < 0.001). There were no significant differences in TENS group in terms of disability (p < 0.264) or ability to contract the TrA muscle (p < 0.181), however, improvement in pain was demonstrated (p < 0.012). The stabilization was superior to TENS in terms of improvements in pain (p < 0.001), functional disability (p < 0.001), and ability to contract the TrA (p < 0.001). CONCLUSION: The results indicate that stabilization is effective in improving pain, functional disability, and the ability to contract the TrA in individuals with LDH. In the TENS group, the only improvement after treatment was in terms of pain. Stabilization was superior to TENS in all outcomes
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Bertoli, Patricia Ribeiro. "Efeito da estimulação elétrica nervosa transcutânea (TENS) no tratamento da dor e capacidade funcional do ombro de pacientes com doença renal crônica." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5163/tde-05032010-151851/.
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INTRODUÇÃO: A doença renal crônica (DRC) favorece o desenvolvimento de inúmeras complicações entre elas a amiloidose. Nos ombros os depósitos de amilóide desencadeiam reações inflamatórias e dor intensa o que compromete a qualidade de vida dos pacientes acometidos. As propostas terapêuticas para o tratamento dessa complicação são escassas. OBJETIVO: O objetivo do presente estudo foi avaliar o efeito da estimulação elétrica nervosa transcutânea (do inglês, TENS) no tratamento da dor e capacidade funcional do ombro e dos fatores relacionados à qualidade de vida em pacientes com DRC. MÉTODOS: Trinta pacientes foram avaliados 5 vezes num período de 6 semanas. Na 1ª semana, o aparelho foi programado para não transmitir a corrente elétrica (placebo) e nas 5 semanas subseqüentes, utilizamos corrente de baixa frequência (10Hz, 150 µs, 2xdia, 40 minutos). A dor (escala visual analógica), a funcionalidade do ombro (Escore de Constant e Escala da UCLA) e os fatores relacionados à qualidade de vida (SF-36) foram avaliados. RESULTADOS: Nossos resultados mostram que o tratamento com a TENS reduziu significativamente a dor (p<0,05), melhorou a funcionalidade do ombro (tanto pelo Escore de Constant quanto Escala da UCLA; p<0,05) já na primeira semana e estes benefícios permaneceram até o final do tratamento (5 semanas) quando comparado com o período placebo. Os domínios capacidade funcional, dor, vitalidade e aspectos sociais apresentam uma melhora após 5 semanas de tratamento quando comparado com o período placebo (p<0,05). Foi verificado ainda que este efeito foi observado mesmo com a redução da quantidade de medicação analgésica. CONCLUSÃO: Nossos resultados mostram que a TENS de baixa frequência reduz a dor e melhora a funcionalidade do ombro e os fatores relacionados à qualidade de vida de pacientes com DRC.INTRODUCTION: Chronic kidney disease (CKD) favors the development of numerous complications such as amyloidosis. In the shoulders, amyloid deposits promote inflammatory reactions and severe pain, which compromises the quality of life of patients with this disease. There are few therapeutic options for the treatment of this complication. OBJECTIVE: The objective of the present study was to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) in the treatment of pain and in shoulder functional capacity, as well as factors related to the quality of life in patients with CKD. METHODS: Thirty patients were evaluated 5 times over a period of 6 weeks. At week 1, the equipment was programmed to not transmit the electrical current (placebo) and in the 5 subsequent weeks we used low frequency current (10Hz, 150 µs, twice a day, 40 minutes). Pain (visual analog scale), shoulder functional capacity (Constant score and UCLA Shoulder Rating Scale) and factors related to the quality of life (SF-36) were evaluated. RESULTS: Our results show that the treatment with TENS significantly reduced pain (p<0.05), improved shoulder functional capacity (using both Constant score and UCLA Shoulder Rating Scale; p<0.05) at week 1 and these benefits remained until the end of the treatment (5 weeks) when compared with the placebo period. The domains of functional capacity, pain, vitality and social functioning present improvement after 5 weeks of treatment when compared with the placebo period (p<0.05). It was also found that this effect was observed even after the administration of analgesics was reduced. CONCLUSION: Our results show that low frequency TENS reduces pain and improves shoulder functional capacity and factors related to the quality of life of patients with CKD.
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Oliveira, Amanda Gabriela de. "Efeito imediato da estimulação elétrica nervosa transcutânea (TENS) associada à Lax Vox na voz, dor e atividade elétrica muscular de mulheres disfônicas: estudo clínico, randomizado e cego." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/25/25143/tde-22062017-210043/.
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Esse estudo investigou os efeitos imediatos da TENS, TENS placebo, TENS e Lax Vox e TENS placebo e Lax Vox nos sintomas vocais, laríngeos e de dor, bem como na qualidade vocal e na atividade muscular de mulheres disfônicas e comparou essas etapas de intervenção. Participaram 10 mulheres (18 a 45 anos), com disfonia comportamental. Todas realizaram quatro etapas de intervenção randomizadas: TENS (200 s, 10 Hz, limiar motor, 20 minutos, eletrodos bilaterais: região submandibular e trapézio-fibras descendentes); TENS placebo (mesmas condições que TENS; aparelho em mínima intensidade); TENS e Lax Vox (após TENS, dez minutos de sopro sonorizado com Lax Vox - pitch habitual e glissando ascendente) e TENS placebo e Lax Vox. Antes e após cada etapa foram realizadas avaliações: questionários sobre intensidade de sintomas vocais/laríngeos/dor, gravação vocal (/a/, contagem) e eletromiografia de superfície dos músculos trapézio-fibras descendentes (TFD), esternocleidomastóideos (ECM), infra-hióideos e supra-hióideos. Após a TENS houve diminuição da intensidade da maioria dos sintomas, tanto quanto após TENS e Lax Vox. Porém, somente após a TENS houve melhora da dor ao falar (p=0,027) e ao engolir (p=0,020). A TENS reduziu intensidade dos sintomas pigarro (p=0,050) e falhas na voz (p=0,020) assim como TENS e Lax Vox; também houve melhora de: pigarro (p=0,010) e falhas na voz (p=0,020). Após a TENS placebo e Lax Vox houve diminuição da intensidade de grande parte dos sintomas e de voz grossa (p=0,035) e tosse seca (p=0,012), esses últimos também após TENS e Lax Vox (p=0,036; p=0,018, respectivamente). A TENS diminuiu a intensidade de dor nos ombros (p=0,041), parte superior das costas (p=0,032) e temporal (p=0,035), como as demais etapas. A TENS placebo reduziu a intensidade de dor de muitas regiões corporais. Após TENS placebo e Lax Vox houve diminuição da intensidade de dor da maior parte das regiões corporais, inclusive laringe (p=0,028). Após TENS placebo e Lax Vox, houve melhora de 40% do grau geral da qualidade vocal (/a/), após TENS e Lax Vox, de 50% (contagem). A análise acústica revelou aumento do jitter (p=0,009) e variação da frequência fundamental (p=0,012) após TENS placebo. A eletromiografia revelou aumento da atividade elétrica após TENS no ECM direito no repouso (p=0,036); aumento da atividade no TFD esquerdo na contagem (p=0,046) após TENS placebo e Lax Vox. Na comparação entre etapas, a TENS associada à Lax Vox diminuiu a atividade elétrica no TFD esquerdo, enquanto TENS placebo e Lax Vox, aumentou (p=0,045) na contagem; na vogal /a/ a TENS placebo associada à Lax Vox diminuiu a atividade elétrica para TFD esquerdo, enquanto que a TENS aumentou (p=0,040); a TENS placebo foi a etapa que mais diminuiu a atividade elétrica no repouso, em comparação com: TENS e Lax Vox e TENS (p=0,015). Como conclusão, a TENS e Lax Vox e a TENS placebo e Lax Vox trouxeram mais benefícios. Apenas uma aplicação das etapas de intervenção fonoaudiológica não atuou de forma homogênea sobre as características da atividade elétrica dos músculos avaliados.This study investigated the immediate effects of TENS, placebo TENS, TENS and Lax Vox and placebo and Lax Vox TENS on vocal, laryngeal and pain symptoms, as well as vocal quality and muscle activity of dysphonic women and compared these intervention steps. Participated 10 women (from 18 to 45 years old), with behavioral dysphonia. All performed four randomized intervention steps: TENS (200 s, 10 Hz, motor threshold, 20 minutes, bilateral electrodes: submandibular region and trapezoid-downward fibers); TENS placebo (same conditions as TENS; apparatus in minimal intensity); TENS and Lax Vox (after TENS, ten minutes of blowing sound with Lax Vox - usual pitch and upward bass to treble variation) and TENS placebo and Lax Vox. Before and after each stage, evaluations were performed: questionnaires on intensity of vocal/laryngeal symptoms/pain, vocal recording (/a/, counting) and surface electromyography of the trapezius-descending fibers (PDT), sternocleidomastoid (ECM) Hyoids and supra-hyoids. After TENS there was a decrease in the intensity of most symptoms as much as after TENS and Lax Vox. However, only after the TENS there was an reduction in pain when speaking (p=0.027) and swallowing (p=0.020). The TENS reduced the intensity of the choking symptoms (p=0.050) and speech failures (p=0.020) as well as TENS and Lax Vox; there was also reduction of: clearing (p=0.010) and voice failures (p=0.020). After TENS, placebo and Lax Vox, there was a decrease in the intensity of a large number of symptoms, including low voice (p=0.035) and dry cough (p=0.012), also these last ones after TENS and Lax Vox (p=0.036; p = 0.018, respectively). The TENS decreased the intensity of pain in the shoulders (p=0.041), upper back (p=0.032) and temporal (p=0.035), as the other stages. TENS placebo reduced the pain intensity of many body parts. After TENS, placebo and Lax Vox, there was a decrease in pain intensity of the most body parts, including larynx (p = 0.028). After placebo TENS and Lax Vox, there was improvement of 40% of the general degree of vocal quality (/a/), after TENS and Lax Vox, of 50% (counting). The acoustic analysis revealed increased of the jitter (p=0.009) and the fundamental frequency variation (p=0.012) after placebo TENS. Electromyography revealed electrical activity increasing after TENS in the right ECM at rest (p=0.036); Increased activity in the left PDT at the count (p=0.046) after placebo TENS and Lax Vox. In the comparison between steps, TENS associated to Lax Vox the electrical activity, reduced the left PDT, while TENS placebo and Lax Vox increased (p=0.045) in the counting; in the /a/ vowel the placebo TENS associated to Lax Vox reduced the electrical activity for left PDT, whereas the TENS increased (p=0.040). The TENS placebo was the stage that had the biggest electrical activity decreasing at rest, compared with: TENS and Lax Vox and TENS (p=0.015). As a conclusion, both associations, TENS combined whit Lax Vox and TENS placebo combined with Lax Vox brought more benefits than the other methods tested (isolated TENS and placebo TENS). Only one application of the phonoaudiological intervention steps did not act homogeneously on the characteristics of the electrical activity of the evaluated muscles.
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Skeil, Debbie. "Transcutaneous nerve stimulation (TENS) in the treatment of neuropathic urinary symptoms." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325174.
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Hale, Janet L. "Transcutaneous electrical nerve stimulation in the management of spasticity." Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=63995.
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Cramp, Alice Fiona Louise. "The physiological and hypoalgesic effects of transcutaneous electrical nerve stimulation." Thesis, University of Ulster, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.314031.
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Chen, Chih Chung. "The hypoalgesic effects of different pulse frequencies of transcutaneous electrical nerve stimulation (T.E.N.S.)." Thesis, Leeds Beckett University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.445605.
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Mulvey, Matthew R. "The Use of Transcutaneous Electrical Nerve Stimulation for Phantom Pain,Stump Pain and Prosthesis Embodiment." Thesis, Leeds Beckett University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529461.
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Foster, Nadine Elizabeth L. "Current clinical management of low back pain and hypoalgesic effects of transcutaneous electrical nerve stimulation." Thesis, University of Ulster, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243735.
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Logan, Michael P. (Michael Paul). "The Effect of Transcranial Stimulation on the Mechanical Efficiency of Persons with Cerebral Palsy." Thesis, North Texas State University, 1987. https://digital.library.unt.edu/ark:/67531/metadc330982/.
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The problem of this study concerns the reduction of spasticity in physically handicapped persons with CP. The hypotheses tested were: that there would be no significant difference between the mechanical efficiency (ME) of persons with spastic CP following application of the TENS Unit and following application of the placebo unit; that there would be no significant difference between the ME of males with spastic CP, following application of the TENS Unit or the placebo unit, and the ME of females with spastic CP, following application of the TENS Unit or the placebo unit; and that there would be no significant interaction between the treatment factor and the gender category.
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Slovak, Martin. "Investigation of transcutaneous electrical nerve stimulation with a specific focus on the treatment of overactive bladder." Thesis, University of Sheffield, 2015. http://etheses.whiterose.ac.uk/12301/.
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This thesis investigates transcutaneous electrical nerve stimulation (TENS), and in particular its role in the treatment of overactive bladder (OAB), which has been of interest for several decades. A standardization and an evaluation of various TENS parameters of stimuli would be beneficial to optimize the techniques used and to achieve the maximal effectiveness. Previously, Hoffman reflex (H reflex) inhibition was interpreted as a surrogate measure of bladder afferent nerve activity, and thus showed a potential to be useful for such evaluations. However, an influence of other factors, such as pelvic floor muscle contraction on this H reflex inhibition makes this surrogate measure unsuitable. In general TENS techniques are usually implemented in the patient’s treatment pathway as secondary treatment options. This is presumably due to a lack of effectiveness. Therefore a thought was given to enhance the effectiveness of the stimuli by producing a larger sensory input with a spatial temporal pattern. This lead to a development of a novel ‘Sensory Barrage Stimulation’, as introduced in this thesis. The technique showed promising effectiveness in comparison to a conventional type of TENS in the patients with elbow spasticity. Other researcher groups have tried to enhance the effectiveness by stimulating deep nerve structures (usually only targetable by implanted devices) using non/invasive transcutaneous stimulation and a specific waveform. However the “Transdermal Amplitude Modulated Signal” waveform introduced for the treatment of OAB symptoms, which claimed to pass through the skin more easily did not appear to be any different to a conventional stimuli and thus it is not of benefit for the routine clinical practice. Specifically, on the treatment for OAB syndrome symptoms, the most promising seems to be the Posterior Tibial Nerve Stimulation (PTNS) applied near the ankle. A well-established form of PTNS, which uses a needle to stimulate the nerve have disadvantages of being invasive and expensive due to the patient’s clinical sessions. The transcutaneous form of PTNS was investigated here in a home based randomized pilot trial of idiopathic overactive bladder patients. A promising effect indicates that there might be patients who can benefit from this type of non-invasive and low cost approach of PTNS. Additionally a numerical modelling of both types of PTNS showed that both techniques achieve a stimulation comparable in a way of physiological effects. Thus suggesting the evidence of percutaneous form of PTNS is plausible to be present in the transcutaneous form.
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Walsh, Deirdre Mary. "Investigations of the neurophysiological and hypoalgesic effects of low intensity laser therapy and transcutaneous electrical nerve stimulation." Thesis, University of Ulster, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.385777.
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Fiala, Catherine Anne. "Adherence to treatment: development and testing of the Fiala treatment adherence model with transcutaneous electrical nerve stimulation for acute postoperative pain after total knee replacement as an exemplar." Diss., University of Iowa, 2018. https://ir.uiowa.edu/etd/6571.
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Adherence is a complex concept, with multiple definitions, over 200 possible predictors, and inconsistent measurement. This has had a detrimental impact on producing interventions to promote treatment adherence. Promoting and maintaining treatment adherence can decrease the likelihood of poor health outcomes and decrease healthcare costs for patients. This study created a conceptual model that was utilized in a secondary analysis to determine if patient factors (Income, Depression, Perceived Threat of Illness Severity, Social Support, and Treatment Beliefs) in the model predict adherence to Transcutaneous Electrical Nerve Stimulation (TENS) when used for pain control post-Total Knee Replacement (TKR). The sample included 97 patients who were randomized to TENS treatment. A higher level of Perceived Threat of Illness Severity, measured with the Pain Catastrophizing Scale, was significantly related to a Moderate level of Adherence (60-79%) versus Non-Adherence (0-59%) (OR= .260, 95% CI= .073-.992, p= .037). The other patient factors of income, depression, social support and treatment beliefs did not significantly predict adherence. This finding is clinically important, as clinicians can assess how patients are interpreting or perceiving actual (or potential) threats of illness severity, then provide education and support to help patients adhere to treatment. The effect of Daily Pain [measured with an 11-point Numeric Rating Scale (0-10)] on Daily Adherence was also investigated in this study. Daily Pain and Daily Adherence did not show a significant association in this sample. This could be attributed to the fact that Daily Adherence was maintained consistently around 70% throughout the 2-week period.
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Ting, Sharlene L. H. "Optimal parameters of electroacupuncture and transcutaneous electrical nerve stimulation for analgesia : an investigation using systematic reviews and randomised controlled trials." Thesis, Keele University, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.545758.
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