Effect of active TENS versus de-tuned TENS on walking capacity in patients with lumbar spinal stenosis: a randomized controlled trial.
Study Goal
The researchers aimed to determine whether active para-spinal transcutaneous electrical nerve stimulation (TENS) was more effective than de-tuned TENS in improving walking ability in patients with lumbar spinal stenosis (LSS).
Results Summary
Both active and de-tuned TENS groups showed significant improvement in walking distance, but there was no significant difference between the two groups. Active TENS was not superior to de-tuned TENS for improving walking ability in LSS patients.
Population
104 participants aged 50 or older with neurogenic claudication, imaging-confirmed LSS, and limited walking ability.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
superficial para-spinal electrical stimulation of the skin | increase | blood flow to the spinal nerves and spinal cord | Animal studies | - | demonstrated increased blood flow | #1 |
active para-spinal transcutaneous electrical nerve stimulation (TENS) | no change | walking distance | participants 50 years of age or older with neurogenic claudication, imaging confirmed LSS and limited walking ability | - | no significant difference between groups | #2 |
de-tuned TENS | no change | walking distance | participants 50 years of age or older with neurogenic claudication, imaging confirmed LSS and limited walking ability | - | no significant difference between groups | #3 |
active TENS | increase | walking distance | participants 50 years of age or older with neurogenic claudication, imaging confirmed LSS and limited walking ability | - | showed significant improvement | #4 |
de-tuned TENS | increase | walking distance | participants 50 years of age or older with neurogenic claudication, imaging confirmed LSS and limited walking ability | - | showed significant improvement | #5 |
active TENS | increase | walking distance | participants 50 years of age or older with neurogenic claudication, imaging confirmed LSS and limited walking ability | 46.9 m | mean difference | #6 |
active TENS applied while walking | no change | walking ability | patients with degenerative LSS | - | is no better than de-tuned TENS | #7 |
BACKGROUND CONTEXT: Lumbar spinal stenosis (LSS) leads to diminished blood flow to the spinal nerves causing neurogenic claudication and impaired walking ability. Animal studies have demonstrated increased blood flow to the spinal nerves and spinal cord with superficial para-spinal electrical stimulation of the skin. PURPOSE: The aim of this study was to assess the effectiveness of active para-spinal transcutaneous electrical nerve stimulation (TENS) compared to de-tuned TENS applied while walking, on improving walking ability in LSS. STUDY DESIGN: This was a two-arm double-blinded (participant and assessor) randomized controlled trial. PATIENT SAMPLE: We recruited 104 participants 50 years of age or older with neurogenic claudication, imaging confirmed LSS and limited walking ability. OUTCOME MEASURES: The primary measure was walking distance measured by the self-paced walking test (SPWT) and the primary outcome was the difference in proportions among participants in both groups who achieved at least a 30% improvement in walking distance from baseline using relative risk with 95% confidence intervals. METHODS: The active TENS group ( RESULTS: From August 2014 to January 2016 a total of 640 potential participants were screened for eligibility; 106 were eligible and 104 were randomly allocated to active TENS or de-tuned TENS. Both groups showed significant improvement in walking distance but there was no significant difference between groups. The mean difference between active and de-tuned TENS groups was 46.9 m; 95% CI (- 118.4 to 212.1); CONCLUSIONS: Active TENS applied while walking is no better than de-tuned TENS for improving walking ability in patients with degenerative LSS and therefore should not be a recommended treatment in clinical practice. REGISTRATION: ClinicalTrials.gov ID: NCT02592642. Registration October 30, 2015.