Peripheral Neural Excitability: Implications for Transcutaneous Electrical Nerve Stimulation

Howson, David C.

doi:10.1093/ptj/58.12.1467

Cited by 43 publications

(22 citation statements)

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“…Non-invasive alternatives to needle acupuncture have been explored using transcutaneous nerve stimulators with selected treatment parameters, such as the acupuncture-like transcutaneous nerve stimulator (ALTENS). A-delta and C nerve fibres that are involved in needle acupuncture treatment with the typical ‘De qi’ response (experienced as a mild ache by the subject) can be activated by ALTENS using high intensity and low frequency stimulation 20, 21, 22 . The use of electrode pads that are 3 to 4 cm in size also make the precise localization of acupuncture points (usually 0.5 to 2 cm in size) less important.…”

Section: Discussionmentioning

confidence: 99%

Phase 2 results from Radiation Therapy Oncology Group Study 0537

Wong

James

Sagar

et al. 2012

Cancer

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Purpose This phase II component of a multi-institutional phase II/III randomized trial assessed the feasibility and preliminary efficacy of acupuncture-like transcutaneous electrical nerve stimulation (ALTENS) in reducing radiation-induced xerostomia. Methods Head and neck cancer patients who were 3–24 months from completing radiotherapy ± chemotherapy (RT±C) and experiencing xerostomia symptoms with basal whole saliva production ≥0.1 ml/min and without recurrence were eligible. Patients received twice weekly ALTENS sessions (24 over 12 weeks) using a Codetron™ unit. The primary objective assessed the feasibility of ALTENS treatment. A patient was considered compliant if 19/24 ALTENS were delivered, with a targeted 85% compliance rate. Secondary objectives measured treatment-related toxicities and ALTENS effect on overall radiation-induced xerostomia burden using the University of Michigan Xerostomia-Related Quality of Life Scale (XeQOLS). Results Of 48 accrued patients, 47 were evaluable. Median age was 60 years; 84% were male, 70% completed RT±C for > 12 months and 21% had received prior pilocarpine. All ALTENS sessions were completed in 34 patients, but 9 and 1 completed 20–23 and 19 sessions respectively, representing a 94% total compliance rate. 6-month XeQOLS scores were available for 35 patients; 30 (86%) achieved a positive treatment response with a mean reduction of 35.9% (SD 36.1). Five patients developed grade 1–2 gastrointestinal toxicity and one had grade 1 pain event. Conclusions ALTENS treatment for radiation-induced xerostomia can be uniformly delivered in a cooperative multicenter setting and has possible beneficial treatment response. Given these results, the phase III component of this study was initiated.

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Section: Discussionmentioning

confidence: 99%

Phase 2 results from Radiation Therapy Oncology Group Study 0537

Wong

James

Sagar

et al. 2012

Cancer

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“…26) In addition, it is known that the amplitude of electrical current necessary to excite nerve fiber tends to diminish as its pulse duration and frequency increase. Some findings from animal and human studies reported that conventional TENS produces segmental analgesia with a rapid onset and offset which was predominantly localized to the dermatome.…”

Section: Gate Control Theorymentioning

confidence: 99%

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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“…Strength-duration curves for sensory, motor, and pain tolerance thresholds converge at longer phase durations, i.e. there is less separation between pain and motor thresholds, so the increase in discomfort with phase duration is perhaps not unexpected [41][42][43] .…”

Section: Discomfort and Stimulus Phase Durationmentioning

confidence: 99%

The influence of stimulus phase duration on discomfort and electrically induced torque of quadriceps femoris

Liebano¹,

Rodrigues²,

Murazawa³

et al. 2013

Braz. J. Phys. Ther.

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| Background: Although a number of studies have compared the influence of different electrical pulse parameters on maximum electrically induced torque (MEIT) and discomfort, the role of phase duration has been poorly investigated. Objective: To examine the variation in muscle torque and discomfort produced when electrically stimulating quadriceps femoris using pulsed current with three different phase durations in order to establish whether there are any advantages or disadvantages in varying the phase duration over the range examined. Method: This is a two repeatedmeasures, within-subject study conducted in a research laboratory. The study was divided into 2 parts with 19 healthy young adults in each part.In part 1, MEIT was determined for each phase duration (400, 700, and 1000 µs), using a biphasic pulsed current at a frequency of 50 Hz. In part 2, stimulus amplitude was increased until the contractions reached 40% of maximum voluntary isometric contraction (MVIC) and the associated discomfort produced by each phase duration was measured. Results: In part 1 of the study, we found that the average MEITs generated with each phase duration (400, 700, and 1000 µs) were 55.0, 56.3, and 58.0% of MVIC respectively, but the differences were not statistically significant (p=.45). In part 2, we found a statistically significant increase in discomfort over the same range of phase durations. The results indicate that, for a given level of torque production, discomfort increases with increasing phase duration (p=.008). Conclusions: Greater muscle torque cannot be produced by increasing the stimulus phase duration over the range examined. Greater discomfort is produced by increasing the stimulus phase duration.Keywords: electric stimulation; torque; quadriceps muscle; physical therapy. Trial Registration: NCT01862393 (ClinicalTrials.org). HOW TO CITE THIS ARTICLELiebano RE, Rodrigues TA, Murazawa MT, Ward AR. The influence of stimulus phase duration on discomfort and electrically induced torque of quadriceps femoris. Braz J Phys Ther. 2013 Sept-Oct; 17(5):479-486. http://dx

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Peripheral Neural Excitability: Implications for Transcutaneous Electrical Nerve Stimulation

Cited by 43 publications

References 0 publications

Phase 2 results from Radiation Therapy Oncology Group Study 0537

Phase 2 results from Radiation Therapy Oncology Group Study 0537

Basic Understanding of Transcutaneous Electrical Nerve Stimulation

The influence of stimulus phase duration on discomfort and electrically induced torque of quadriceps femoris

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