Transcutaneous Electrical Nerve Stimulation Clinical Trial
Official title:
The Effect of Frequency Modulation in Transcutaneous Electrical Nerve Stimulation (TENS) on Habituation and Pain Threshold: a Randomized, Double Blind, Controlled Cross-over
Purpose
The purpose of this study is to determine whether application of Transcutaneous Electrical
Nerve Stimulation (TENS) is effective on habituation to electrical current whether delivered
at a fixed frequency of 100 Hz or at patterned frequency. The secondary purposes are to
determine the effectiveness on mechanical pressure pain and the subjective perception of the
subjects regarding habituation and comfort of the different stimulations.
Low frequency and low intensity TENS showed strong evidence of inefficiency while
conventional high frequency TENS (around 100Hz) applied at "strong but comfortable" intensity
proved strong evidence of efficacy on pressure pain. In addition, some studies have shown the
importance of current intensity in the effect of TENS.
Either in clinical practice and in research, TENS intensity is usually adjusted according to
the sensation of the subjects "strong but comfortable" "strong just below the motor
threshold", ...). Usually throughout the TENS applications there is a phenomenon called
"habituation" that involve a wide decrease of the sensation of the current applied, even
though the perception the output-parameters are maintained.
In this sense, It has been seem that adjusting the intensity throughout the TENS intervention
produced a greater hypoalgesic effect than when the intensity remained fixed.
On the other hand, most TENS devices offer the possibility of modulating current with the aim
of preventing habituation phenomenon. The modulation of the electric current consists of
changing the characteristics of the current (pulse width, pulse frequency, ...) every few
seconds during the intervention. Nevertheless, the most common pattern used is the frequency
modulation. However, there is a lack of evidence regarding what it is the better methods to
avoid habituation during a TENS application.
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