H-Wave® Device Stimulation for Chronic Low Back Pain: A Patient-Reported  Outcome Measures (PROMs) Study

Norwood, Stephen M.; Han, David; Gupta, Ashim

doi:10.1007/s40122-023-00570-6

Cited by 6 publications

(21 citation statements)

References 18 publications

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“…Further clinical systematic review reported significant pain relief and improvement in overall function, along with reduction in pain medication usage post-treatment with HWDS ( 4 ). Norwood et al reported patient-recorded outcome measures (PROMs) for 2,711 non-specific chronic low back pain, sprain, strain HWDS patients, resulting in substantial pain improvement (3.12 on a 0–10 visual analogue scale), with profound positive effects on function and ADL, in addition to benefits like decreased medication use, better sleep, and improved work performance ( 14 ). Trinh et al in a large retrospective cohort study involving end-stage worker's compensation patients, reported no adverse effects associated with HWDS, with significant reduction in pain, opioids/polypharmacy use, and anxiety/depression, while improving overall QoL ( 2 ).…”

Section: Mechanism Of Action and Effectiveness On Pain And Functionmentioning

confidence: 99%

Transcutaneous electrical nerve stimulation vs. H-Wave® device stimulation—similar or different?

Gupta,

Norwood

2024

Front. Pain Res.

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Section: Mechanism Of Action and Effectiveness On Pain And Functionmentioning

confidence: 99%

Transcutaneous electrical nerve stimulation vs. H-Wave® device stimulation—similar or different?

Gupta,

Norwood

2024

Front. Pain Res.

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“…Even for other body areas, most TENS studies have been at best only low-quality evidence, demonstrating short-term marginal pain improvement, with no beneficial effects on patient psychological parameters, physical function, or overall quality of life (QoL) [4,6]. In contrast, recent studies utilizing H-Wave ® device stimulation (HWDS), generally considered as low-to moderate-quality evidence, have consistently demonstrated significant decreases in reported pain and medication usage, as well as improvements in physical function and overall QoL [4,[6][7][8][9][10]. To date, there have been no publications specifically evaluating the efficacy of HWDS for cNP patients.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…HWDS is a distinct form of transcutaneous ES, emitting a proprietary, biphasic exponentially decaying waveform [4,[6][7][8][9][10]. An H-Wave ® device distributes 0-35 mA current and 0-35 V voltage at ×1000 load with an ultra-long pulse duration of 5000 µs [4,[6][7][8][9][10]. HWDS consists of two treatment components: 2 Hz low-frequency and 60 Hz high-frequency, with two dual modes permitting output of either two high-or two low-or a combination of high-and low-frequency therapies [4,[6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…An H-Wave ® device distributes 0-35 mA current and 0-35 V voltage at ×1000 load with an ultra-long pulse duration of 5000 µs [4,[6][7][8][9][10]. HWDS consists of two treatment components: 2 Hz low-frequency and 60 Hz high-frequency, with two dual modes permitting output of either two high-or two low-or a combination of high-and low-frequency therapies [4,[6][7][8][9][10]. The low-frequency component causes multiple physiological effects including: (1) stimulation of voluntary contraction of small, slow-twitch skeletal red muscle fibers, resulting in (2) non-fatiguing, low-tension contractions; (3) improved blood flow via nitric oxide-mediated vasodilation; (4) angiogenesis; and (5) augmented rhythmic lymphatic vessels drainage, through (6) stimulation of voluntary contraction of smooth muscle fibers, resulting in (7) elimination of fluid waste and proteins from inflammatory sites, leading to (8) restoration of tissue homeostasis [6,7,10].…”

Section: Introductionmentioning

confidence: 99%

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H-Wave® Device Stimulation for Chronic Neck Pain: A Patient-Reported Outcome Measures (PROMs) Study

Gupta,

Han,

Norwood

2024

Pain Ther

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Introduction: Chronic neck pain (cNP) is one of the leading causes of disability worldwide, often being refractory to conventional forms of treatment. Various forms of electrical stimulation have been proposed to decrease pain and improve function. Patient-reported outcome measures (PROMs) for treatment of cNP have rarely been published. Methods: An independent retrospective statistical analysis of PROMs data for users of H-Wave ® device stimulation (HWDS), prospectively collected by the device manufacturer over a 4-year period, was conducted. Final surveys for 34,192 pain management patients were filtered for pain chronicity limited to 3-24 months and device use of 22-365 days, resulting in 11,503 patients with "all diagnoses"; this number was further reduced to 1482 patients with cNP, sprain, or strain. Results: Neck pain was reduced by 3.13 points (0-10 pain scale), with significant (≥ 20%) relief in 86.6%. Function/activities of daily living (ADL) improved in 96.19%, while improved work performance was reported in 84.76%. Medication use decreased or stopped in 65.42% and sleep improved in 60.39%. Over 95% reported having expectations met or exceeded, service satisfaction, and confidence in device use, while no adverse events were reported. Subgroup analyses found positive benefit associations with longer duration of device use. Conclusion: Near-equivalent outcomes were self-reported by cNP HWDS patients as for (previously published) chronic low back pain (cLBP) patients. HWDS provided effective and safe cNP relief, improvements in function and ADL, along with additional benefits including decreased medication use, better sleep, and improved work performance.

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The effect of EMS, IFC, and TENS on patient-reported outcome measures for chronic low back pain: a systematic review and meta-analysis

Wolfe,

Rosenstein,

Fortin

2024

Front. Pain Res.

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IntroductionChronic low back pain (CLBP) is the leading cause of years lived with disability worldwide. Transcutaneous electrotherapies have been widely used to treat CLBP but, with the partial exception of transcutaneous electrical nerve stimulation (TENS), their effect on pain, disability, quality-of-life, and psychosocial outcomes have not been systematically reviewed. The purpose of this systematic review and meta-analysis was to clarify the overall effect of transcutaneous electrotherapies on patient-reported outcome measures (PROMs) in CLBP patients.MethodsFour databases and two study registries were searched for studies that utilized transcutaneous electrotherapies as a primary intervention for CLBP, compared against active or passive controls. Two reviewers independently extracted study data and assessed risk of bias. Studies were grouped by intervention vs. comparison, and by time of follow-up. Meta-analyses were conducted where appropriate.ResultsA total of 89 full-text were assessed for eligibility; 14 studies were included, with 6 in the meta-analyses (all TENS or mixed TENS). Pain: meta-analyses revealed no significant difference for TENS vs. active control, TENS vs. passive control, or mixed TENS vs. active control at post-intervention, nor for mixed TENS vs. active control at 1-month post-intervention. Interferential current (IFC) was more effective than active control (2 studies), while electromyostimulation (EMS) was generally superior to passive, but not active, controls (6 studies).DisabilityMeta-analyses revealed no significant difference for TENS vs. active control at post-intervention, mixed TENS vs. active control at post-intervention, or mixed TENS vs. active control at 1-month post-intervention. IFC was more effective than active control (2 studies), while the EMS results were mixed (6 studies). We were unable to perform meta-analyses for quality-of-life or psychosocial outcomes.ConclusionThere is moderate evidence that TENS is similar to all controls for improving pain and disability. There is limited evidence that IFC is superior to active controls for improving pain and disability. There is limited evidence that EMS is superior to passive but not active controls for improving pain, and similar to all controls for improving disability.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=452851, Identifier (CRD42023452851).

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H-Wave® Device Stimulation for Chronic Low Back Pain: A Patient-Reported Outcome Measures (PROMs) Study

Cited by 6 publications

References 18 publications

Transcutaneous electrical nerve stimulation vs. H-Wave® device stimulation—similar or different?

Transcutaneous electrical nerve stimulation vs. H-Wave® device stimulation—similar or different?

H-Wave® Device Stimulation for Chronic Neck Pain: A Patient-Reported Outcome Measures (PROMs) Study

The effect of EMS, IFC, and TENS on patient-reported outcome measures for chronic low back pain: a systematic review and meta-analysis

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