What Makes Transcutaneous Electrical Nerve Stimulation Work? Making Sense of the Mixed Results in the Clinical Literature
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- Kathleen A. Sluka
- K.A. Sluka, PT, PhD, FAPTA, Department of Physical Therapy and Rehabilitation Science, College of Medicine, College of Nursing, Pain Research Program, University of Iowa, 100 Medical Education Bldg, #1-252, Iowa City, IA 52242 (USA).
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- Jan M. Bjordal
- J.M. Bjordal, PT, PhD, Physical Therapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; and Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway.
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- Serge Marchand
- S. Marchand, PhD, Département de Chirurgie, Centre de Recherche clinique Étienne-Le Bel du CHUS, Université de Sherbrooke, Québec, Canada.
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- Barbara A. Rakel
- B.A. Rakel, RN, PhD, Department of Physical Therapy and Rehabilitation Science, College of Medicine, College of Nursing, Pain Research Program, University of Iowa.
説明
<jats:p>Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological treatment for control of pain. It has come under much scrutiny lately with the Center for Medicare Services rendering a recent decision stating that “TENS is not reasonable and necessary for the treatment of CLBP [chronic low back pain].” When reading and analyzing the existing literature for which systematic reviews show that TENS is inconclusive or ineffective, it is clear that a number of variables related to TENS application have not been considered. Although many of the trials were designed with the highest of standards, recent evidence suggests that factors related to TENS application need to be considered in an assessment of efficacy. These factors include dosing of TENS, negative interactions with long-term opioid use, the population and outcome assessed, timing of outcome measurement, and comparison groups. The purpose of this perspective is to highlight and interpret recent evidence to help improve the design of clinical trials and the efficacy of TENS in the clinical setting.</jats:p>
収録刊行物
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- Physical Therapy
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Physical Therapy 93 (10), 1397-1402, 2013-10-01
Oxford University Press (OUP)