TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS): THE EFFECT OF ELECTRODE PLACEMENT UPON CUTANEOUS BLOOD FLOW AND SKIN TEMPERATURE

Abstract Background and Purpose. Based on changes in skin temperature alone, some authors have proposed that postganglionic sympathetic vasoconstrictor fibers can be stimulated transcutaneously. Our goal was to determine the effects of low-frequency (2 bursts per second), burst-mode transcutaneous electrical nerve stimulation (TENS) on calf vascular resistance, a more direct marker of sympathetic vasoconstrictor outflow than skin temperature, in subjects with no known pathology. Subjects. Fourteen women and 6 men (mean age=31 years, SD=13, range=18–58) participated in this study. Methods. Calf blood flow, arterial pressure, and skin temperature were measured while TENS was applied over the common peroneal and tibial nerves. Results. Blood flow immediately following stimulation was not affected by TENS applied just under or just above the threshold for muscle contraction. Transcutaneous electrical nerve stimulation applied at 25% above the motor threshold caused a transient increase in calf blood flow. Regardless of stimulation intensity, TENS had no effect on arterial pressure; therefore, calf vascular resistance decreased only during the trial that was 25% above the motor threshold. Regardless of stimulation intensity, TENS failed to alter dorsal or plantar skin temperature. Discussion and Conclusion. These results demonstrate that the effects of TENS on circulation depend on stimulation intensity. When the intensity was sufficient to cause a moderate muscle contraction, a transient, local increase in blood flow occurred. Cooling of the dorsal and plantar skin occurred in both the stimulated and control legs, most likely because skin temperature acclimatized to ambient room temperature, rather than because of any effect of TENS on circulation. The data, therefore, call into question the idea that postganglionic sympathetic efferent fibers are stimulated when TENS is applied at clinically relevant intensities to people without symptoms of cardiovascular or neuromuscular pathology.

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Transcutaneous electric nerve stimulation: The effect of intensity on local and distal cutaneous blood flow and skin temperature in healthy subjects

Archives of Physical Medicine and Rehabilitation ◽

10.1053/apmr.2002.27478 ◽

2002 ◽

Vol 83 (1) ◽

pp. 5-9 ◽

Cited By ~ 43

Author(s):

Fiona L. Cramp ◽

Gillian R. McCullough ◽

Andrea S. Lowe ◽

Deirdre M. Walsh

Keyword(s):

Blood Flow ◽

Skin Temperature ◽

Nerve Stimulation ◽

Healthy Subjects ◽

Cutaneous Blood Flow ◽

Transcutaneous Electric Nerve Stimulation ◽

Electric Nerve Stimulation ◽

Cutaneous Blood

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Relation of local skin temperature and local sweating to cutaneous blood flow

Journal of Applied Physiology ◽

10.1152/jappl.1963.18.4.781 ◽

1963 ◽

Vol 18 (4) ◽

pp. 781-785 ◽

Cited By ~ 6

Author(s):

Leo C. Senay ◽

Leon D. Prokop ◽

Leslie Cronau ◽

Alrick B. Hertzman

Keyword(s):

Blood Flow ◽

Skin Temperature ◽

Sweat Gland ◽

Cutaneous Blood Flow ◽

Local Skin ◽

Cutaneous Vasodilatation ◽

Local Skin Temperature ◽

Relationship Of ◽

The Relationship ◽

Cutaneous Blood

The relationship of local skin temperature and the onset of sweating to the local cutaneous blood flow was studied in the forearm and calf. The purpose of the investigation was to appraise the possible relation of sweat gland activity to the cutaneous vasodilatation which has been attributed to bradykinin or to intracranial temperatures. The onset of sweating was not marked by any apparently related increases in the rate of cutaneous blood flow. On the contrary, the onset of sweating was followed often by a stabilization or even a decrease in the level of cutaneous blood flow. The relations of the latter to the local skin temperature were complex, particularly in the forearm. There appeared to be additional unidentified influences, possibly vasomotor, operating on the skin vessels during transitional phases in the relation of skin temperature to blood flow. Submitted on October 15, 1962

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Frostbite

PEDIATRICS ◽

10.1542/peds.73.4.571 ◽

1984 ◽

Vol 73 (4) ◽

pp. 571-571

Author(s):

FORST E. BROWN

Keyword(s):

Blood Flow ◽

Nerve Stimulation ◽

Transcutaneous Electrical Nerve Stimulation ◽

Reflex Sympathetic Dystrophy ◽

Electrical Nerve Stimulation ◽

Blood Flow Increase ◽

Sympathetic Blocks

In Reply.— Rowlingson and Carron suggest consideration of transcutaneous electrical nerve stimulation (TENS) in the management of frostbite. As they mentioned, sympathetic blocks have been effective in the management of early frostbite; blood flow increase has resulted in the salvage of damaged digits. Interarterial reserpine and prostacycline also have been shown to overcome digital vasoconstriction. In the two patients we described, persistent vasoconstriction as seen in reflex sympathetic dystrophy (RSD) was not the problem. Moreover, the changes seen in the radiographs were not comparable to those seen in RSD.

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Roasted Barley Extract Affects Blood Flow in the Rat Tail and Increases Cutaneous Blood Flow and Skin Temperature in Humans

Journal of Agricultural and Food Chemistry ◽

10.1021/acs.jafc.7b04930 ◽

2018 ◽

Vol 66 (5) ◽

pp. 1251-1257 ◽

Cited By ~ 3

Author(s):

Hiroshi Ashigai ◽

Yoshimasa Taniguchi ◽

Yasuko Matsukura ◽

Emiko Ikeshima ◽

Keiko Nakashima ◽

...

Keyword(s):

Blood Flow ◽

Skin Temperature ◽

Cutaneous Blood Flow ◽

Cutaneous Blood ◽

Rat Tail

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Low Level Continuous Heat Wraps can Increase the Efficiency of Transcutaneous Electrical Nerve Stimulation for Pain Management

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1126-4436 ◽

2020 ◽

Vol 30 (05) ◽

pp. 290-298

Author(s):

Jerrold Petrofsky ◽

Michael Laymon ◽

Haneul Lee

Keyword(s):

Blood Flow ◽

Pain Management ◽

Range Of Motion ◽

Skin Blood Flow ◽

Nerve Stimulation ◽

Transcutaneous Electrical Nerve Stimulation ◽

Electrical Nerve Stimulation ◽

Low Level ◽

Significant Difference ◽

Continuous Heat

AbstractBoth transcutaneous electrical nerve stimulation and superficial heat have been used for pain management. While heat has been shown to have a beneficial effect on pain, transcutaneous electrical nerve stimulation remains controversial. The purpose of the present study was to see if heat, when added to transcutaneous electrical nerve stimulation, would provide more consistent relief. A total of 180 subjects participated in this study and were randomly divided into 12 groups. Low level continuous heat was applied while electrical stimulation was applied at 2 intensities, 2 frequencies and with 2 waveforms for 4 h. Outcome measures were subjective pain scale, range of motion of the back and skin blood flow of the back. The control groups had no significant difference in pain, range of motion or skin blood flow comparing the data at the beginning and 4 h after (p> 0.05). There was a small reduction in pain with transcutaneous electrical nerve stimulation alone while all other groups had a significant improvement in range of motion free of pain, reduction in pain, and increase in skin blood flow from the beginning to the end of the 4-hour period. Since transcutaneous electrical nerve stimulation with low level continuous heat showed better outcomes then transcutaneous electrical nerve stimulation alone or low level continuous heat alone, combining the 2 interventions seems to offer better outcomes for pain management for health care professionals.

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