Pain Clinical Trial
Official title:
Acute Effects of Transcutaneous Electric Nerve Stimulation in Patients Rehabilitation After Total Knee Arthroplasty.
Total knee arthroplasty (TKA) consists of a surgical replacement of this joint by a prosthesis, and it is mainly carried out in cases of knee osteoarthrosis. In the postoperative period of TKA, the pain is intense and limits the mobility of patients, so the analgesia is one of the goals of the physical therapy. One of the alternatives available for pain management is the transcutaneous electrical nerve stimulation (TENS), characterized by the application of an electric pulsed current through electrodes positioned on the skin. Therefore, the present study aims to evaluate the acute effects of TENS associated with conventional physical therapy compared with conventional physical therapy on the pain level, knee range of motion and administration of morphine in the rehabilitation of patients after TKA.
The study included patients who underwent TKA surgery in the Hospital de Clínicas de Porto
Alegre (HCPA) and met the study eligibility criteria. The sample was randomly divided into
experimental group, which received conventional physical therapy associated with the
application of TENS, and control group, which held only conventional physical therapy, both
on the first day after the surgery. The pain level, the range of motion of the operated knee
and the Administration of morphine.
The experimental group received TENS application held by two self-adhesive electrodes size
5x9cm positioned parallel to the lumbar spine, on the nerve roots L3, L4 and L5. TENS was
applied in conventional mode, emitting a pulsed biphasic, symmetrical rectangular wave with
frequency of 100 Hz and pulse duration of 100 µs, for 30 minutes. The intensity was set
according to the tolerance of the patient and was gradually increased during the application.
The device used was the Neurodyn II model, by Ibramed.
Subsequently, the conventional physical therapy was performed, with the use of the CPM device
and performing exercises. The CPM device was used for 30 minutes, and realized continuous
passive flexion and extension of the operated knee. The amplitudes of these movements were
gradually increased in accordance with the tolerance of the patient. The device used was
Spectra model, by Kinetec.
Then, the patients realized active exercises of plantar flexion and dorsal flexion of the
ankles and adduction and abduction of the hips, isometric exercises of flexion and extension
of the operated knee and active exercises of flexion and extension of the non-operated knee.
All exercises were performed in 10 repetitions, with the patient positioned in the supine
position in the bed.
The control group received only conventional therapy consisting of the use of the CPM device
in the operated leg and the exercises in both lower limbs, identical to those performed in
the experimental group.
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