Differences in Waveform Characteristics Have No Effect on the Anti-Hyperalgesia Produced by Transcutaneous Electrical Nerve Stimulation (TENS) in Rats With Joint Inflammation

Hingne, Priyanka M.; Sluka, Kathleen A.

doi:10.1016/j.jpain.2006.08.008

Cited by 29 publications

(20 citation statements)

References 28 publications

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“…50) These perceived discomfort with the asymmetric waveform could be attributed to the accumulation of ions under the electrodes. 51) However, other study reported that the differences in waveform characteristics had a negligible effect on analgesic efficacy produced by TENS when compared between symmetrical and asymmetrical biphasic waveform. 51) In addition, there was no significant difference in pain threshold and tolerance between monophasic and asymmetric biphasic waveform.…”

Section: Waveformmentioning

confidence: 96%

“…51) However, other study reported that the differences in waveform characteristics had a negligible effect on analgesic efficacy produced by TENS when compared between symmetrical and asymmetrical biphasic waveform. 51) In addition, there was no significant difference in pain threshold and tolerance between monophasic and asymmetric biphasic waveform. 52) Regarding the shape of current waveform, there are various shapes of waveforms determined by manufacturers, including square, rectangular, sine wave or triangular/spiked waveform.…”

Section: Waveformmentioning

confidence: 96%

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Basic Understanding of Transcutaneous Electrical Nerve Stimulation

Jung¹,

Byun²,

Choi³

2016

Journal of Oral Medicine and Pain

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Transcutaneous electrical nerve stimulation (TENS) is one of the representative physiotherapical modalities used for the treatment of various musculoskeletal disorders by the application of electrical stimuli. In dental practice, it has long been used in the treatment of acute and chronic orofacial pain conditions including temporomandibular disorders. TENS is the delivery of therapeutic electrical stimuli with a variety of electrical intensity, frequency and duration to stimulate peripheral nerve through surface electrodes with various form and placement. While controversy still remains over the clinical effectiveness and application of TENS, basic understanding of its electrical properties and the expected biological reactions is important to increase the therapeutic effect and decrease the risk of possible side effects. This review, therefore, focuses on basic understanding of TENS including its underlying mechanisms and stimulation parameters.

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Section: Waveformmentioning

confidence: 96%

Section: Waveformmentioning

confidence: 96%

Basic Understanding of Transcutaneous Electrical Nerve Stimulation

Jung¹,

Byun²,

Choi³

2016

Journal of Oral Medicine and Pain

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“…High-frequency, but not low-frequency, TENS applied to the inflamed knee joint increases extracellular GABA concentrations in the spinal cord dorsal horn in animals with and without joint inflammation. Interestingly, blockade of GABA A receptors with bicuculline prevented the reduction in hyperalgesia produced by both high- and low-frequency TENS [13,14•]. In another study, spinal serotonin concentrations were increased during and immediately after treatment with low-frequency, but not high-frequency, TENS.…”

Section: Basic Science Mechanismsmentioning

confidence: 99%

Effectiveness of transcutaneous electrical nerve stimulation for treatment of hyperalgesia and pain

DeSantana

Walsh²,

Vance³

et al. 2008

Curr Rheumatol Rep

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369

215

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Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacologic treatment for pain relief. TENS has been used to treat a variety of painful conditions. This review updates the basic and clinical science regarding the use of TENS that has been published in the past 3 years (ie, 2005−2008). Basic science studies using animal models of inflammation show changes in the peripheral nervous system, as well as in the spinal cord and descending inhibitory pathways, in response to TENS. Translational studies show mechanisms to prevent analgesic tolerance to repeated application of TENS. This review also highlights data from recent randomized, placebo-controlled trials and current systematic reviews. Clinical trials suggest that adequate dosing, particularly intensity, is critical to obtaining pain relief with TENS. Thus, evidence continues to emerge from both basic science and clinical trials supporting the use of TENS for the treatment of a variety of painful conditions while identifying strategies to increase TENS effectiveness.

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“…Several meta-analyses and Cochrane systematic reviews have highlighted the range of TENS treatment regimes used, including various electrode shapes and sizes 3–5,18,20. Although a number of animal and human studies have examined the effects of different current parameters, including frequency, pulse amplitude, pulse duration, and waveform,1,13,14,21,32 few studies have investigated the effects of different types of electrodes and their placement 15,16,30. Manufacturers currently offer a variety of electrode shapes for applications to different body regions, including a novel glove electrode design that is marketed for use in conditions that affect the hand, including arthritis and Reynaud’s syndrome.…”

mentioning

confidence: 99%

An Investigation of the Hypoalgesic Effects of TENS Delivered by a Glove Electrode

Cowan

McKenna

McCrum-Gardner

et al. 2009

The Journal of Pain

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This randomized, placebo-controlled, blinded study investigated the hypoalgesic effects of highfrequency transcutaneous electrical nerve stimulation (TENS) delivered via a glove electrode compared with standard self-adhesive electrodes. Fifty-six TENS-naïve, healthy individuals (18 to 50 years old; 28 men, 28 women) were randomly allocated to 1 of 4 groups (n = 14 per group): glove electrode; placebo TENS using a glove electrode; standard electrode; and no treatment control. Active TENS (continuous stimulus, 100 Hz, strong but comfortable intensity) was applied to the dominant forearm/hand for 30 minutes. Placebo TENS was applied using a burst stimulus, 100-Hz frequency, 5-second cycle time for 42 seconds, after which the current amplitude was automatically reset to 0 mA. Pressure pain thresholds (PPTs) were recorded from 3 points on the dominant and nondominant upper limbs before and after TENS. Statistical analyses of dominant PPT data using between-within groups ANOVA showed significant differences between groups at all 3 recording points (P = .01). Post hoc Scheffe tests indicated no significant difference between the standard electrode and glove electrode groups. There was a significant hypoalgesic effect in the standard electrode group compared with the control group and between the glove electrode group and both the control and placebo TENS groups. There was no significant interactive effect between time and group at any of the recording points (P > .05).Perspective-This study presents a comparison of the hypoalgesic effects of 2 different types of TENS electrode, a novel glove electrode and standard self-adhesive rectangular electrodes. The glove electrode provides a larger contact area with the skin, thereby stimulating a greater number of nerve fibers. The results show that both electrodes have similar hypoalgesic effects and therefore give the clinician another choice in electrode. Transcutaneous electrical nerve stimulation (TENS) is a noninvasive modality commonly used for both acute and chronic pain conditions. 29 The successful application of TENS involves a period of trial and error in the selection of a number of stimulation parameters, for example, frequency and amplitude of the current and the type and size and location of the electrodes used to deliver the current. 19 Several meta-analyses and Cochrane systematic reviews have highlighted the range of TENS treatment regimes used, including various electrode shapes and sizes. [3][4][5]18,20 Although a number of animal and human studies have examined the effects of different current parameters, including frequency, pulse amplitude, pulse duration, and waveform, 1,13,14,21,32 few studies have investigated the effects of different types of electrodes and their placement. 15,16,30 Manufacturers currently offer a variety of electrode shapes for applications to different body regions, including a novel glove electrode design that is marketed for use in conditions that affect the hand, including arthritis and Reynaud's syndrome. Only 1 study h...

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Differences in Waveform Characteristics Have No Effect on the Anti-Hyperalgesia Produced by Transcutaneous Electrical Nerve Stimulation (TENS) in Rats With Joint Inflammation

Cited by 29 publications

References 28 publications

Basic Understanding of Transcutaneous Electrical Nerve Stimulation

Basic Understanding of Transcutaneous Electrical Nerve Stimulation

Effectiveness of transcutaneous electrical nerve stimulation for treatment of hyperalgesia and pain

An Investigation of the Hypoalgesic Effects of TENS Delivered by a Glove Electrode

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