Chronic Pain Clinical Trial
Official title:
Using Transcutaneous Electrical Nerve Stimulation (TENS) to Relieve Pain and Potentiate the Rehabilitation of Pain Patients: a Double Blind, Randomized Study Among Patients at the CSSS-IUGS Day Hospital
Introduction: Chronic pain affects more than half of elderly individuals. Past studies have
shown that pain can interfere with motor learning and rehabilitation. It was suggested that
relieving pain before physical therapy sessions might be an interesting strategy to
potentiate the rehabilitation of older patients suffering from pain.
Objective: This study aims to determine if the analgesic effect induced by TENS can be used
to maximize the rehabilitation of elderly patients suffering from chronic pain. More
specifically, the objectives are to: 1) compare functional outcomes of patients from the Day
Hospital receiving rehabilitation with either active TENS treatments or simulated TENS
treatments, and 2) determine if there is an association between the analgesic effect of TENS
and the clinical evolution of patients following their rehabilitation.
Methods: In this RCT, patients will be assigned randomly to either the: 1) experimental
group receiving active TENS treatments or 2) the control group receiving simulated TENS
treatments. Thirty-six patients will be recruited according to the following criteria: 1)
will receive physiotherapy rehabilitation at the Day Hospital of the CSSS-IUGS, 2) be at
least 65 years of age, 3) suffering from chronic pain (pain lasting for more than 6 months),
4) presenting pain during the rehabilitation at the Day hospital. For security reasons,
patients with a cardiac simulator will be excluded from the present study (TENS
contraindications). Patients with cognitive alterations (score of < 24/30 at the Folstein
test) will also be excluded. Sociodemographic information will be retrieved from medical
records by the research assistant at baseline (T1). Moreover, various questionnaires will be
administered at T1, after half of the rehabilitation period (i.e. 4 to 6 weeks) (T2), and
after the 8- to 12- week rehabilitation period (T3) to measure the qualitative aspects of
pain, mood, and physical function. Functional outcomes will as well be collected directly
from the medical record at each assessment times (T1, T2 and T3).The measures include
exercise tolerance, balance, mobility and balance, and functional ability.
Anticipated results: We believe that: 1) use of active TENS during the rehabilitation
sessions will potentiate rehabilitation of patients suffering from chronic pain at the
CSSS-IUGS Day Hospital, and 2) there is a relationship between the analgesic effect induced
by TENS and the clinical evolution of patients.
Introduction Chronic pain affects more than half of elderly individuals. Past studies have
shown that pain can interfere with motor learning and rehabilitation. This phenomenon,
potentially attributable to the deleterious effect that nociceptive inputs have on the motor
system, suggests that relieving pain before physical therapy sessions might be an
interesting strategy to potentiate the rehabilitation of older patients suffering from pain.
Objective The objective of this study is to determine if the analgesic effect induced by
transcutaneous electrical nerve stimulation (TENS) can be used to maximize the
rehabilitation of elderly patients suffering from chronic pain. More specifically, this
study aims to: 1) compare functional outcomes of patients from the Day Hospital receiving
rehabilitation with active TENS treatments with patients receiving rehabilitation with
simulated TENS treatments, and 2) determine if there is an association between the analgesic
effect of TENS and the clinical evolution of patients following their rehabilitation.
Methods This study is a randomized clinical trial with two parallel arms. Patients will be
assigned randomly to either the: 1) experimental group receiving active TENS treatments or
2) the control group receiving simulated TENS treatments (double blind study). Thirty-six
patients will be recruited according to the following criteria: 1) will receive
physiotherapy rehabilitation at the Day Hospital of the Pavillon d'Youville of the
CSSS-IUGS, 2) be at least 65 years of age, 3) suffering from chronic pain (pain lasting for
more than 6 months), 4) presenting pain during the rehabilitation at the Day hospital. For
security reasons, patients with a cardiac simulator will be excluded from the present study
(TENS contraindications). Patients with cognitive alterations (score of < 24/30 at the
Folstein test) will also be excluded. In order to have a better characterisation of the
sample, information will be retrieved from medical records by the research assistant,
including: 1) age, gender, pain localisation, medical diagnosis and medication. Moreover,
various questionnaires will be administered at baseline (T1), after half of the
rehabilitation period (i.e. 4 to 6 weeks) (T2), and after the 8- to 12- week rehabilitation
period (T3) to measure: 1) the qualitative aspects of pain (McGill-Melzack pain
questionnaire), 2) mood (Beck Depression Inventory), and 3) physical function (Brief Pain
Inventory). Functional outcomes will also be collected directly from the medical record at
baseline at each assessment times (T1, T2, T3). The measures include: 1) exercise tolerance
(6-minute walk test [6MWT]), 2) balance (Berg Balance Scale [BBS]), 3) mobility and balance
(Time up and go [TUG]), and 4) functional ability (Functional autonomy measurement system
[SMAF]).
Anticipated results We believe that: 1) use of active TENS during rehabilitation sessions
will potentiate rehabilitation of patients suffering from chronic pain at the CSSS-IUGS Day
Hospital, and 2) there is a relationship between the analgesic effect induced by TENS and
the clinical evolution of patients.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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