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      Estimulação elétrica nervosa transcutânea nas modalidades convencional e acupuntura na dor induzida pelo frio Translated title: Conventional and acupuncture-like transcutaneous electrical nerve stimulation on cold-induced pain

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          Abstract

          A estimulação elétrica nervosa transcutânea (TENS) é um recurso não-farmacológico já consagrado na modulação de dores agudas e crônicas. O objetivo deste estudo foi verificar o efeito da TENS convencional e na modalidade TENS-acupuntura na dor induzida pelo frio. Trinta indivíduos saudáveis com idade entre 18 e 40 anos foram distribuídos ao acaso em três grupos: placebo, TENS convencional e TENS-acupuntura. Foi utilizado um protocolo de indução de dor pelo frio composto por seis ciclos: dois pré-tratamento, dois durante e dois após o tratamento. A TENS foi aplicada por 20 minutos por dois canais, sendo a modalidade convencional, no nível sensorial, na freqüência de 80 Hz e a modalidade acupuntura, no nível motor, a 4 Hz. Foram medidos limiar de dor, tolerância à dor e intensidade da dor. Não foi encontrada diferença estatisticamente significante nos valores medidos durante a após o tratamento quando comparados aos dos ciclos pré-tratamento, em todas as variáveis. Nas duas modalidades estudadas pois, a TENS, nos parâmetros de aplicação utilizados, não modificou a dor induzida por frio, sugerindo-se novos estudos com maior tempo de aplicação da TENS e diferentes modelos de dor experimental.

          Translated abstract

          Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological method already established in the modulation of acute and chronic pain. The purpose of this study was to assess the effect of conventional TENS and acupuncture-like TENS on cold-induced pain. Thirty healthy subjects aged 18 to 40 years old were randomized into in three groups: placebo, conventional TENS, and acupuncture-like TENS. A cold-induced pain protocol was used, in six cycles (two pre-treatment, two during, and two after treatment); TENS was applied for 20 minutes through 2 channels, the conventional modality at sensory level at 80 Hz, and the acupuncture modality at motor level at 4 Hz. Variables analysed were pain threshold, tolerance to pain, and pain intensity. No statistically significant differences were found in any variable between post and pre-treatment measures in all groups. Hence neither conventional or acupuncture-like TENS had any effect on cold-induced pain. Further studies are suggested, with different experimental pain models, and with longer time of TENS application.

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          Most cited references38

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          Pain mechanisms: a new theory.

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            Effect of low- and high-frequency TENS on Met-enkephalin-Arg-Phe and dynorphin A immunoreactivity in human lumbar CSF.

            Transcutaneous nerve stimulation (TENS) treatment was given for 30 min to 37 patients divided into 3 groups of 10 patients and 1 group of 7 patients. Two groups received low-frequency (2 Hz) and the other 2 groups high-frequency (100 Hz) stimulation. A diagnostic lumbar cerebrospinal fluid (CSF) sample was obtained immediately before and after stimulation. The CSF samples were subjected to analysis of immunoreactive (ir) opioid peptides, Met-enkephalin-Arg-Phe (MEAP) from preproenkephalin and dynorphin A (Dyn A) from preprodynorphin, respectively. Low frequency TENS applied on the hand and the leg resulted in a marked increase (367%, P less than 0.05) of ir-MEAP but not ir-Dyn A, whereas high-frequency (100 Hz) TENS produced a 49% increase in ir-Dyn A (P less than 0.01) but not ir-MEAP. This is the first report in humans that 2 Hz and 100 Hz peripheral stimulation induces differential release of peptides from preproenkephalin and preprodynorphin, respectively.
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              Alternating frequencies of transcutaneous electric nerve stimulation: does it produce greater analgesic effects on mechanical and thermal pain thresholds?

              To determine whether alternating frequency transcutaneous electric nerve stimulation (TENS) at 2 and 100Hz (2/100Hz) has a more potent hypoalgesic effect than a fixed frequency at 2 or 100Hz in healthy participants. A single-blind randomized controlled trial with a convenience sample. University physiotherapy department. Sixty-four healthy volunteers (32 men [mean age, 28.1+/-5.9y], 32 women [mean age, 27.7+/-5.6y]) were recruited and randomly divided into 4 groups. The 4 groups received TENS delivered at (1) 2Hz; (2) 100Hz; (3) 2/100Hz alternating frequency; and (4) no treatment (control group), respectively. Electric stimulation was applied over the anterior aspect of the dominant forearm for 30 minutes. Mechanical pain thresholds (MPTs) and heat pain thresholds (HPTs) were recorded before, during, and after TENS stimulation. The data were analyzed using linear mixed models, with group treated as a between-subject factor and time a within-subject factor. During and shortly after electric stimulation, HPT increased significantly in the alternating frequency stimulation group (P=.024). MPT increased significantly in both the 100Hz (P=.008) and the alternating frequency groups (P=.012), but the increase was substantially larger in the 100Hz group. Alternating frequency stimulation produced a greater elevation in the HPT, but a greater increase in the MPT was achieved using 100Hz stimulation.
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                Author and article information

                Journal
                fp
                Fisioterapia e Pesquisa
                Fisioter. Pesqui.
                Universidade de São Paulo (São Paulo, SP, Brazil )
                1809-2950
                2316-9117
                June 2009
                : 16
                : 2
                : 148-154
                Affiliations
                [01] orgnameUnicid
                Article
                S1809-29502009000200010 S1809-2950(09)01600210
                0635e772-3ea9-4c34-a73f-ac07d8dafb8e

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : December 2008
                : May 2009
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 7
                Product

                SciELO Brazil

                Self URI: Texto completo somente em PDF (PT)
                Categories
                Pesquisa Original

                Transcutaneous electric nerve stimulation,Pain,Pain threshold,Dor,Estimulação elétrica nervosa transcutânea,Limiar da dor

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