Background & Aims
People with knee osteoarthritis (KOA) often have pain comorbidities at the lower back and lower extremities in addition to sympathetic knee. Transcutaneous electrical nerve stimulation (TENS) has demonstrated efficacy in alleviating movement-evoked pain (MEP) through frequency-specific mechanisms, inducing segmental analgesia. Applying TENS to the lower back (TENS-LB) theoretically stimulates an innervational area of bilateral knees and the lower back region, which potentially produces widespread analgesia against MEP. Although TENS-LB relieves low back pain, its effects on knee pain have not been well established. We evaluated the effects of TENS-LB on MEP at the symptomatic knee, with a focus on setting frequency to achieve higher analgesic effects.
Methods
We randomly allocated 57 people with KOA to three groups: high-frequency TENS (HF-TENS), modulated-frequency TENS (MF-TENS), placebo TENS (P-TENS). All TENS were administered to the lower back. MEP tests at land-based activities were conducted at baseline and during the TENS administrations. The MEP test encompassed a ground walking test, stair ascending descending test and 30-second chair stand test (CS-30). Pain intensity in each MEP test was measured using a Visual Analogue Scale (VAS) ranging from 0 to 100. The VAS scores for MEP tests were subjected to analysis, assessing differences among the TENS groups at each time point through the non-parametric Kruskal–Wallis test. Subsequently, post hoc testing between groups was performed using the non-parametric Mann–Whitney U-test with Bonferroni correction. The significance level was set at ? = 0.05.
Results
No significant differences were detected in each MEP test among all TENS groups test at baseline. During TENS administration, we observed a significant difference in all MEP test. At the Ground walking test, the VAS scores of the MF-TENS group were significantly lower than those of the P-TENS group (P =0.032). At the stair ascending descending test, VAS scores of the HF-TENS group were significantly lower than those of the P-TENS group (P =0.04). At the CS-30, the VAS scores of the HF-TENS group (P =0.031) and the MF-TENS group (P =0.02) were significantly lower than those of the P-TENS group.
Conclusions
TENS-LB administration either HF or MF attenuated MEP at symptomatic knee during land-based activities in people with KOA. TENS-LB may be beneficial for people with KOA who have pain at several sites. Future studies are needed to reveal that TENS-LB alleviates MEP several sites in people with KOA who has pain comorbidities.
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Presenting Author
Nobuhiro Takiguchi
Poster Authors
Topics
- Specific Pain Conditions/Pain in Specific Populations: Rheumatology, Arthritis, and Other