Transcutaneous electrical nerve stimulation over acupoint for chronic obstructive pulmonary disease: A systematic review and meta-analysis

Abstract

BackgroundTranscutaneous electrical nerve stimulation over an acupoint (acu-TENS), a new technique applied in pulmonary rehabilitation programs, has been gradually used in the management of chronic obstructive pulmonary disease (COPD). However, the effects of acu-TENS have not been fully evaluated. Therefore, this review was conducted to assess the effects of acu-TENS on COPD.MethodsA total of seven electronic databases were searched from their inception to September 2021 for randomized controlled trials of acu-TENS for COPD. Two investigators independently performed data extraction and methodological quality assessment. Heterogeneity was examined by Cochrane χ2 and I2 tests. The source of heterogeneity was investigated by subgroup analysis or sensitivity analysis.ResultsIn our review, ten studies between 2008 and 2021 were included. The aggregated results indicated that acu-TENS showed positive effects in forced expiratory volume in 1 s (FEV1) [MD = 0.13 L, 95% CI (0.11–0.16), P < 0.00001], FEV1% predicted [MD = 5.92%, 95% CI (3.43–8.41), P < 0.00001], 6-min walk distance (6MWD) [MD = 14.68m, 95% CI (6.92–22.44), P = 0.0002], dyspnea visual analog scale (DVAS) [MD = −7.58, 95%CI (−14.33 to −0.84), P = 0.03], modified Borg scale (MBS) [MD = −0.46, 95% CI (−0.86 to −0.06), P = 0.03], and COPD assessment test (CAT) [MD = −4.25, 95% CI (−5.24 to −3.27), P < 0.00001]. Although six studies reported adverse effects, only one patient had shoulder pain after acu-TENS.ConclusionAcu-TENS seems to be effective in improving pulmonary function and health status in patients with COPD, with little effect on exercise capacity and dyspnea. However, this result should be interpreted with caution, and high-quality RCTs were needed for further verification.

Efficacy and Safety of Acupuncture in Managing COPD: An Overview of Systematic Reviews

“…CAT was observed in ten 38 , 40 , 44–46 , 49 , 51 , 54–56 SRs. Compared with conventional treatment, moxibustion [MD=−3.40, 95% (−5.82, −0.98), P =0.006], acupoint catgut embedding [MD=−2.39, 95% (−3.65, −1.13), P =0.0002], acupoint application [MD=−3.33, 95% (−3.87, −2.79), P <0.00001], acupoint autohemotherapy [SMD=3.22, 95% (2.72, 3.73), P <0.00001], warm needling [MD=−4.77, 95% (−6.53, −3.01), P <0.00001] and TENS [MD=−4.25, 95% (−5.24, −3.27), P <0.00001] all significantly reduced CAT.…”

“…Its effect is superior to that of basic treatment alone. Yu 2018 50 China 10 (992) Acupoint application + CT CT ①②④⑥⑧ Cochrane Unknown For patients with stable COPD, point application can effectively improve lung function, reduce the frequency of acute exacerbation, improve the quality of life Wei 2022 51 China 10 (472) TENS + CT CT ①②⑤⑨⑩⑭ Cochrane Yes TENS seems to be effective in improving pulmonary function and health status in patients with COPD, with little effect on exercise capacity and dyspnea. Pang 2020 52 China 28 (1615) Acupoint application + CT CT ①③④⑤⑥⑦⑯ Cochrane Yes Acupoint application with CT appears to be more effective than CT or CT plus placebo only on improving the quality of life, but the effect on lung function is not obvious.…”

“…Fifteen 22 , 36 , 37 , 39–46 , 51–54 SRs assessed exercise capacity, with all trials using the 6-minute walking distance (6MWD). Carles 43 found that electroacupuncture [MD=68.82, 95% (10.81, 126.83), P =0.02] was superior to warm needling [MD=51.44, 95% (14.00, 88.88), P =0.007], manual acupuncture + ear acupuncture [MD =5.40, 95% (2.55, 8.25), P <0.05].…”

“…Nine 36 , 38 , 40–43 , 45 , 51 , 52 SRs assessed Dyspnea. The modified Medical Research Council (mMRC) scale was used in eight 34, 36, 38–41, 43, 50 SRs.…”

Silver Spike Point Therapy in smoking cessation

“…TENS and similar techniques have been investigated in the treatment of various conditions, including acute and chronic pain in adults,cancer-related peripheral neuropathy, knee osteoarthritis, dry mouth following radiotherapy, lower urinary tract dysfunction in children, enuresis in children, chronic obstructive pulmonary disease,labor pain relief, and rehabilitation after stroke. [41][42][43][44][45][46][47][48][49] F. Acupuncture and related therapies in scientific research. Acupuncture therapy has been the focus of interest for several decades in a variety of diseases, especially diseases with no effective treatment in Western medicine.…”