The Effect of Transcutaneous Electrical Nerve Stimulation (TENS) Applied to the Foot and Ankle on Strength, Proprioception and Balance: A Preliminary Study

Sadeghi-Demneh, Ebrahim; Tyson, Sarah; Nester, Christopher; Cooper, Glen M.

doi:10.4172/2329-910x.1000170

Cited by 7 publications

(6 citation statements)

References 36 publications

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“…(39)(40)(41) Application of TENS causing stimulation of cutaneous sensory nerve endings in the foot showed no immediate effect on either ankle proprioception or leg-muscle strength. A recent study concluded that TENS has a distracting impact on balance, (38) which con icts with the results of the present study, which found a signi cant improvement in balance and proprioception in post-treatment and follow-up assessments among EG 1 subjects. It can be held that EG 1 showed a signi cant difference and improvement attributable to the autogenic inhibition re ex, which is the re ex produced when a Golgi organ registers an increase in muscle tension.…”

Section: Discussionsupporting

confidence: 78%

“…TENS not only improves strength, but also increases joint position sense and balance. (38) TENS causes elicited muscle contractions and also allows for activation of a greater proportion of type-II muscle bers compared to volitional exercise at comparable intensity. (39)(40)(41) Application of TENS causing stimulation of cutaneous sensory nerve endings in the foot showed no immediate effect on either ankle proprioception or leg-muscle strength.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post-Ankle-Sprain Balance and Proprioception in Adults- a Randomized controlled trial

Alahmari

Samuel

Ahmad

et al. 2020

Preprint

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BackgroundStretching is an important part of post-ankle-sprain rehabilitation, as well as an effective exercise for improving general ankle-joint performance. But the combination of stretching alongside muscle stimulation has not yet been extensively studied. Therefore the purpose of the present research is to compare the baseline, post- and follow-up effects of the proprioceptive neuromuscular facilitation (PNF) stretching technique combined with transcutaneous electrical nerve stimulation (TENS), as compared against the effects of the PNF stretching technique alone.MethodsSixty subjects with lateral ankle sprains were selected and randomly allocated to three groups: Experimental Group One (EG 1), Experimental Group Two (EG 2), and the Control Group (CG). Subjects in EG 1 received the PNF stretching technique combined with TENS. Subjects in EG2 received the PNF stretching technique alone. Both experimental groups received these treatments for 4 weeks (4 days/week); follow-up assessments were administered in the third and fifth weeks. CG received no treatment; outcome measures alone were assessed. Outcome measures comprised pain, flexibility, proprioception, range of motion, muscle strength, physical activity, and balance. A mixed-model ANOVA was used to analyze the effects of time factors and groups on these outcome measures.ResultsThere was significant interaction (time and group), and the time effect for all the outcome measures (p < 0.05). Physical activity, dorsiflexion, and balance in the medial, lateral, anterolateral, and anteromedial directions did not show a significant difference between the groups. EG 1 showed significant improvement for all the outcome variables between pre- and post-treatment and follow-up when compared to the other groups.ConclusionsThe present study showed that a 12-session treatment program of 3 weeks’ duration that combines PNF stretching with low-frequency TENS for post-ankle sprain subjects, compared against PNF stretching alone, produced significant improvements in balance, proprioception, strength, and range of motion. The study also showed that the treatment effect was sustained even after treatment was ceased after the follow-up assessment in the fifth week.Trial Registration:Human Research Ethics Committee approval for the trial (approval no.: (ECM#2019-26)Clinical trial was also registered in the Clinical Trials Registry – ISRCTN 18013941

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post-Ankle-Sprain Balance and Proprioception in Adults- a Randomized controlled trial

Alahmari

Samuel

Ahmad

et al. 2020

Preprint

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“…Limited mobility and increased risk of falls, which are associated with older adults and many neurological conditions, may be related to deficits of strength, joint position sense and balance control. Applying TENS at the foot and ankle has the potential to be a highly beneficial intervention in deficits in these abilities [23]. It is hypothesized that using TENS in the foot and ankle area would improve the balance and postural control [23].…”

Section: Discussionmentioning

confidence: 99%

“…Applying TENS at the foot and ankle has the potential to be a highly beneficial intervention in deficits in these abilities [23]. It is hypothesized that using TENS in the foot and ankle area would improve the balance and postural control [23]. As TENS improves strength, joint position sense and balance control, it is reasonable that it has effects on joint mobility.…”

Section: Discussionmentioning

confidence: 99%

The effect of adding TENS to stretch on improvement of ankle range of motion in inactive patients in intensive care units: a pilot trial

Shamsi

Vaisi-Raygani

Rostami

et al. 2019

BMC Sports Sci Med Rehabil

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Background Patients hospitalized in intensive care units (ICUs) are susceptible to joint contracture and diminished range of motion. This is due to immobility as well as other underlying factors such as brain damage. Joint contracture causes functional disorders thereby diminishing the quality of life of patients following the intensive care period. Recent studies have introduced transcutaneous electrical nerve stimulation (TENS) as a new method for preventing and treating joint contracture. This study was performed to determine the effect of adding TENS to stretch on the range of ankle motion in patients hospitalized in ICUs. Methods Thirty-six patients admitted to the ICU ward of the hospital who were not able to move their legs voluntarily were assigned randomly into experimental ( n = 18) and control ( n = 18) groups. The intervention group received TENS along with manual stretch in the ankle three times a week for 2 weeks. The control group only received stretch in the ankle for the same time. The extent of dorsiflexion and plantar flexion of the ankle was measured using a standard goniometer. Both groups were evaluated before and one and 2 weeks after the intervention. The obtained data were analyzed by SPSS 21 through analysis of covariance and repeated measures ANOVA tests. Results In both groups, the increase in the ankle range of motion parameters was significant over time (means ranged over 44–48 for plantar flexion and means ranged over 5–11 for dorsiflexion, P < 0.001 for all of time points). The increase in ankle plantar and dorsiflexion in experimental group was significantly more than control group (mean between-group differences ranged over 1.35–3.57 within 95% CI of 1.04 to 4.01, P < 0.001). Conclusion Adding TENS to stretch may provide more improvement in ankle dorsiflexion and plantar flexion. Trial registration Trial registration: This study was registered in the Iranian Clinical Trial Center with the code IRCT2017010814333N64 , registered 20 January 2017.

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“…Kang et al [ 53 ] suggested that TENS, when applied directly to the skin overlying the gastrocnemius (calf muscle), is effective in improving balance for healthy adults, which concurs with the results of the present study. TENS not only improves strength but also increases joint position sense and balance [ 54 ]. The present study used TENS in combination with PNF stretching and found significant improvement in strength, balance, and proprioception compared to PNF and CG.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post Ankle Sprain Balance and Proprioception in Adults: A Randomized Controlled Trial

Alahmari

Samuel

Ahmad

et al. 2020

BioMed Research International

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Stretching is an important part of post ankle sprain rehabilitation, as well as an effective exercise for improving general ankle-joint performance. But the combination of stretching alongside low-frequency stimulation has not yet been extensively studied. Therefore, the purpose of the present randomized controlled trial was to compare the combined effects of low-frequency transcutaneous electrical nerve stimulation (TENS) with proprioceptive neuromuscular facilitation (PNF) on strength, balance, and proprioception among individuals with post ankle sprain. Sixty male subjects with lateral ankle sprain were selected and randomly allocated to three groups: group 1, group 2, and the control group (CG). Subjects in group 1 received the PNF stretching technique combined with TENS. TENS stimulation was provided using two electrodes placed 5 cm apart directly on the triceps sural muscle of the affected leg and a biphasic current with a symmetrical waveform at 50 Hz for 15 seconds, tuned for a 3-second ramp up time and a 30-second rest time with a 250-microsecond pulse duration was given with PNF stretching. Subjects in group 2 received the PNF stretching technique alone. Both group 1 and group 2 received these treatments for 4 weeks (4 days/week); follow-up assessments were administered in the third and fifth weeks. CG received no treatment; outcome measures alone were assessed. Outcome measures comprised pain, balance, flexibility, proprioception, range of motion, muscle strength, and functional limitation. A mixed-model ANOVA showed significant interaction (time and group) and the time effect for all the outcome measures (p≤0.05). Group 1 (PNF-TENS) showed significant improvement for all the outcome variables compared to the other groups. The present study showed PNF stretching combined with TENS for the triceps sural muscle to trigger muscle contraction during the muscle contraction phase of the PNF stretch, compared against PNF stretching alone, produced significant improvements in ankle function for post ankle sprain subjects.

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The Effect of Transcutaneous Electrical Nerve Stimulation (TENS) Applied to the Foot and Ankle on Strength, Proprioception and Balance: A Preliminary Study

Cited by 7 publications

References 36 publications

Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post-Ankle-Sprain Balance and Proprioception in Adults- a Randomized controlled trial

Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post-Ankle-Sprain Balance and Proprioception in Adults- a Randomized controlled trial

The effect of adding TENS to stretch on improvement of ankle range of motion in inactive patients in intensive care units: a pilot trial

Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post Ankle Sprain Balance and Proprioception in Adults: A Randomized Controlled Trial

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