Usefulness and Safety of a Wearable Transcutaneous Electrical Nerve Stimulation Device for Promoting Exercise Therapy in Patients With Chronic Knee Pain: A Randomized Controlled Trial

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2025-02-01 DOI:10.1016/j.apmr.2024.08.021

Keisuke Yamada MS , Hiroki Shimizu PT, MS , Naoki Doi PT, MS , Keiko Harada MS , Mami Ishizuka-Inoue PT, MS , Reika Yamashita PT, MS , Shozo Takamatsu MS , Saki Hayashi-Nishiyama MS , Yukihiro Okamoto MD , Tomoki Aoyama MD, PhD

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Abstract

Objective

To investigate the effect of transcutaneous electrical nerve stimulation (TENS) in reducing barriers to the implementation of exercise therapy and promoting exercise therapy, focusing on physical activity (PA).

Design

A single-center, participant-blinded, randomized controlled trial with a pre-post design.

Setting

Orthopedic clinic at a single institution,.

Participants

Participants (N=63, aged ≥50y) who had knee pain for ≥3 months were randomly assigned to the TENS (N=21), exercise (N=23), or combined (N=19) groups.

Interventions

Participants were provided with 4 weeks of intervention: the TENS group using a wearable TENS device, exercise group performing designated exercises, and combined group performing activities from the TENS and exercise groups.

Main Outcome Measures

The primary outcome measure was PA. The secondary outcome measures were 6-minute walk test (6MWT); timed Up and Go (TUG) test; stair climbing; knee pain using the visual analog scale at 6MWT, TUG test, and stair climbing; and patient-reported changes in knee pain over time.

Results

At pre- and postintervention, light-intensity PA time (minutes per day) in the TENS, exercise, and combined groups was 735.62±68.82 vs 714.21±73.06 (P=.061), 733.05±103.90 vs 700.31±90.33 (P=.057), and 710.09±62.98 vs 685.22±58.35 (P=.049), respectively, with a significant decrease in the combined group. Significant improvement in knee pain and stair climbing was observed in all groups pre- and postintervention.

Conclusions

The group using TENS showed improved effects of early reduction in knee pain and when combined with exercise therapy, a reduction in time spent in light-intensity activities such as sedentary behavior. Thus, the use of TENS in combination with conventional exercise therapy has the potential to reduce psychological barriers to the introduction of exercise therapy. It also promotes and ensures the safe implementation and continuation of exercise therapy.

查看原文本刊更多论文

可穿戴经皮神经电刺激装置在促进慢性膝关节疼痛患者运动疗法方面的实用性和安全性：随机对照试验

目的：研究经皮神经电刺激（TENS）在减少运动疗法实施障碍和促进运动疗法方面的效果：研究经皮神经电刺激（TENS）在减少运动疗法实施障碍和促进运动疗法方面的效果，重点关注体力活动：设计：单项参与者盲法随机对照试验（RCT），采用前后对照设计：参与者：膝关节疼痛至少 3 年的参与者：参与者膝关节疼痛至少3个月（63人，年龄≥50岁），随机分配到TENS组（21人）、运动组（23人）或联合组（19人）：参与者接受为期 4 周的干预：使用可穿戴 TENS 设备的 TENS 组、进行指定运动的运动组，以及进行 TENS 组和运动组活动的联合组：主要结果测量：主要结果测量为体力活动（PA）。次要结果指标包括：6 分钟步行测试（6MWT）；定时上下楼测试（TUG）；爬楼梯；6MWT、TUG 和爬楼梯时膝关节疼痛的视觉模拟量表；以及患者报告的膝关节疼痛随时间的变化：干预前后，TENS组、运动组和联合组的轻强度PA时间（LPA）分别为735.62±68.82 vs. 714.21±73.06（P=0.061）、733.05±103.90 vs. 700.31±90.33（P=0.057）和710.09±62.98 vs. 685.22±58.35（P=0.049），联合组的轻强度PA时间显著减少。所有组别在干预前后的膝关节疼痛和爬楼梯能力均有明显改善：结论：使用 TENS 的组别在早期减轻膝关节疼痛方面显示出更好的效果，当与运动疗法相结合时，减少了久坐等轻强度活动所花费的时间。因此，结合传统运动疗法使用 TENS 有可能减少运动疗法的心理障碍。它还能促进和确保运动疗法的安全实施和持续进行。

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来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.