External Noninvasive Peripheral Nerve Stimulation Treatment of Neuropathic Pain: A Prospective Audit

Johnson, Selina; Ayling, Helen; Sharma, Manohar; Göebel, Andreas

doi:10.1111/ner.12244

Cited by 22 publications

(24 citation statements)

References 29 publications

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“…Within the previous study we observed a post-treatment NRS reduction of 6.4 to 3.6 (average difference 2.8) for the entire group ( n = 20), and 6.6 to 3.1 (average difference 3.5) within the peripheral neuropathic pain group ( n = 8) [19]. The mean observed effect for the treatment group would remain 3.5 only if the control group showed no change over time.…”

Section: Methodsmentioning

confidence: 64%

“…This method is in keeping with both the technique used in the previous study [19] and literature regarding implantable PNS [9, 29]. The independent physiotherapist will have no further direct patient contact during the trial.…”

Section: Methodsmentioning

confidence: 92%

“…Patients will be taught to use the EN-PENS machine to which they have been allocated over one to three training sessions within a 1-week timeframe [19]. …”

Section: Methodsmentioning

confidence: 99%

“…No treatment-related adverse events were reported. Significant improvements in QOL (measured using the EuroQol (EQ)-5D-5 L) and function (using the Brief Pain Inventory Interference Subscale and the task-specific scale) were also reported [19]. This study identified a trend toward patients with PPNI demonstrating greater reductions in pain for longer periods than patients with CRPS.…”

Section: Introductionmentioning

confidence: 93%

“…Previous study results do not allow for the exclusion of possible moderate long-lasting changes in the pain intensity after stopping EN-PENS treatment [19]; therefore, a crossover RCT design is not feasible.…”

Section: Introductionmentioning

confidence: 99%

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A randomised, patient-assessor blinded, sham-controlled trial of external non-invasive peripheral nerve stimulation for chronic neuropathic pain following peripheral nerve injury (EN-PENS trial): study protocol for a randomised controlled trial

Johnson

Göebel

Richey

et al. 2016

Trials

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BackgroundEight percent of people in the UK are estimated to have persistent (chronic) neuropathic pain, and for many there is no effective treatment. Medications are the most common first-line treatment but often have limited benefit or adverse events. Surgical treatments, such as spinal cord stimulation, are then often considered. External non-invasive peripheral nerve stimulation (EN-PENS) is a form of electrical stimulation that involves placing a pen-shaped electrode onto the skin, which can be easily self-administered by patients. Observational studies suggest that EN-PENS may relieve pain for people with localised neuropathic pain; however, there is currently no evidence from controlled trials to confirm the efficacy and confidently determine the effect size for patients with longstanding neuropathic pain.MethodsEN-PENS is a single-site, blinded, randomised controlled parallel-group superiority add-on trial with a 1:1 allocation ratio, designed to evaluate the efficacy of treatment versus control treatment in 76 patients with longstanding neuropathic pain following peripheral nerve injury. Patients with moderate to -severe neuropathic pain following peripheral nerve injury will be randomised to receive either the active or control treatment, followed by an optional treatment extension or treatment switch to the alternative treatment arm. The primary outcome is average 24-h pain intensity recorded on an 11-point (0–10) numerical rating scale, averaged over the last 7 days of treatment.DiscussionStudy results will be used to inform potential treatment efficacy and cost-effectiveness of EN-PENS for this population group.Trial registration ISRCTN53432663. Registered on 7 July 2016.

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Section: Methodsmentioning

confidence: 64%

Section: Methodsmentioning

confidence: 92%

“…Patients will be taught to use the EN-PENS machine to which they have been allocated over one to three training sessions within a 1-week timeframe [19]. …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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