The Short-Term Outcomes of Multiwave Locked System (MLS) Laser Therapy versus a Combination of Transcutaneous Nerve Stimulation and Ultrasound Treatment for Subacromial Pain Syndrome

The purpose of this study was to compare the short-term outcomes of the Multiwave Locked System (MLS) laser therapy versus the combined Transcutaneous nerve stimulation (TENS) and ultrasound therapy in the treatment of the subacromial pain syndrome (SAPS). Forty-seven patients with SAPS were included in the study. Two different rehabilitation protocols were tested: Group 1 (n = 22)–MLS laser therapy and physical exercises and Group 2 (n = 25)–TENS, ultrasound and physical exercises. The analyzed outcomes were levels of pain, functionality and disability, assessed with visual analog scale (VAS), Constant Shoulder Score (CSS) and the Shoulder Pain and Disability Index (SPADI). The post-treatment evaluations showed significantly better scores in Group 1 patients for VAS score (p = 0.03) and SPADI (p = 0.04). Significant improvement was seen in both groups for all scores. Both treatment regimens showed to be efficient in the treatment of SAPS, improving functionality and reducing pain and disability in the short term. Multiwave Locked System laser therapy in conjunction with physical exercise therapy exercises may have advantages over TENS, ultrasound and physical exercise therapy in the treatment of subacromial pain syndrome. Future studies assessing both short- and long-term outcomes in patients with SAPS treated with different electrotherapy procedures added to the physical therapy are needed.

Therapeutic Effects of Manual Therapy, Transcutaneous Electric Nerve Stimulation, and Forearm Brace on Lateral Epicondylitis: A Randomized Controlled Trial

Background: Epicondylopathia humeri radialis is often diagnosed by general practitioners. Usually, the therapy comprises transcutaneous electrical nerve stimulation and the application of a forearm brace. Manual therapy is prescribed beyond transcutaneous electrical nerve stimulation and forearm brace, and it is performed by specialized physiotherapists. However, data comparing the effectiveness of all methods are scarce. In this study, the therapeutic effects of manual therapy were compared to those of transcutaneous electrical nerve stimulation and forearm brace along with a combination of all three. Methods: Fifty-two patients diagnosed with epicondylopathia humeri radialis by a general practitioner were randomized into three treatment arms: 19 patients received a combination of manual therapy, transcutaneous nerve stimulation, and forearm brace; 18 patients received manual therapy only; and 15 patients wore a forearm brace and received transcutaneous nerve stimulation. The primary outcomes included the range of motion and pain intensity. The secondary outcomes were elbow function and psychological well-being. Primary and secondary outcomes were measured before treatment (0), and 4- and 8-weeks post-treatment using the Patient Rated Tennis Elbow Evaluation Questionnaire and the Short Form Health Survey Questionnaire. Results: The range of motion and pain intensity did not differ between the intervention groups.Conclusions: Manual therapy alone is as effective as combination therapy with transcutaneous nerve stimulation and the use of a forearm brace for epicondylopathia humeri radialis. Hence, there is evidence supporting the inclusion of manual therapy in the guidelines for treating patients with epicondylopathia humeri radialis. Trial registration: German Clinical Trial Register: DRKS, trial registration number: 00021137, date of registration: 24/03/2020 (retrospectively registered)

Sensory stimulation enhances phantom limb perception and movement decoding

ObjectiveA major challenge for controlling a prosthetic arm is communication between the device and the user’s phantom limb. We show the ability to enhance amputees’ phantom limb perception and improve movement decoding through targeted transcutaneous electrical nerve stimulation (tTENS).ApproachTranscutaneous nerve stimulation experiments were performed with four amputee participants to map phantom limb perception. We measured myoelectric signals during phantom hand movements before and after amputees received sensory stimulation. Using electroencephalogram (EEG) monitoring, we measure the neural activity in sensorimotor regions during phantom movements and stimulation. In one participant, we also tracked sensory mapping over 2 years and movement decoding performance over 1 year.Main resultsResults show improvements in the amputees’ ability to perceive and move the phantom hand as a result of sensory stimulation, which leads to improved movement decoding. In the extended study with one amputee, we found that sensory mapping remains stable over 2 years. Remarkably, sensory stimulation improves within-day movement decoding while performance remains stable over 1 year. From the EEG, we observed cortical correlates of sensorimotor integration and increased motor-related neural activity as a result of enhanced phantom limb perception.SignificanceThis work demonstrates that phantom limb perception influences prosthesis control and can benefit from targeted nerve stimulation. These findings have implications for improving prosthesis usability and function due to a heightened sense of the phantom hand.

Acupoint transcutaneous electrical nerve stimulation in hospitalized copd patients with severe dyspnoea: study protocol for a randomized controlled trial.

Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause of hospital admissions and dyspnoea is its main symptom. Some studies have concluded that a new modality of acupuncture called Acupuncture transcutaneous nerve stimulation (acuTENS) could reduce dyspnoea in COPD patients by increasing beta-endorphin levels, however those trials have mainly been conducted on patients with stable condition. This study aims to determinate if the administration of acuTENS can reduce dyspnoea in patients hospitalized for AECOPD. Methods A multicentric randomized control trial with patient- and assessor-blinded will be conducted. A sample of 60 patients will be randomised to receive 45 minutes of either real acuTENS or sham acuTENS treatment once a day during 5 consecutive days. The trial will be conducted at the “Hospital del Mar” of Barcelona (Spain) and the “Hospital Sant Joan de Déu de Manresa” in Manresa (Spain). The Borg scale at baseline, and day 1 to 5 will be the primary outcome. Secondary outcomes will be the duration of the hospitalization, quantity of drugs administrated, expiratory peck flow adverse effects and mortality and readmissions at 3 months. Discussion AcuTENS is non-pharmacological, non-invasive and cheap intervention. This trial will help to understand acuTENS potential role in the treatment of AECOPD.

ACUPOINT TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION IN HOSPITALIZED COPD PATIENTS WITH SEVERE DYSPNOEA: STUDY PROTOCOL FOR A RANDOMIZED CONTROLED TRIAL

Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause of hospital admissions and dyspnoea is its main symptom. Some studies have concluded that a new modality of acupuncture called Acupuncture transcutaneous nerve stimulation (acuTENS) could reduce dyspnoea in COPD patients by increasing beta-endorphin levels, however those trials have mainly been conducted on patients with stable condition. This study aims to determinate if the administration of acuTENS can reduce dyspnoea in patients hospitalized for AECOPD. Methods A multicentric randomized control trial with patient- and assessor-blinded will be conducted. A sample of 60 patients will be randomised to receive 45 minutes of either real acuTENS or sham acuTENS treatment once a day during 5 consecutive days. The trial will be conducted at the “Hospital del Mar” of Barcelona (Spain) and the “Hospital Sant Joan de Déu de Manresa” in Manresa (Spain). The Borg scale at baseline, and day 1 to 5 will be the primary outcome. Secondary outcomes will be the duration of the hospitalization, quantity of drugs administrated, expiratory peck flow adverse effects and mortality and readmissions at 3 months. Discussion AcuTENS is non-pharmacological, non-invasive and cheap intervention. This trial will help to understand acuTENS potential role in the treatment of AECOPD.