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Effect of active TENS versus de-tuned TENS on walking capacity in patients with lumbar spinal stenosis: a randomized controlled trial.

Chiropractic & manual therapies
January 1, 2019
Carlo Ammendolia et al. (9 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

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

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
AdultAgedAged, 80 and overCanadaFemaleHumansMaleMiddle AgedSpinal StenosisTranscutaneous Electric Nerve StimulationTreatment OutcomeWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy50/10
Quality85/10
Citation Metrics
Total Citations12
Citations/Year2.0
Relative Citation Ratio1.16
NIH Percentile55.8%
Research Impact Scores
APT Score0.75
Weight Score2.27
Normalized Score0.57
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