Shoulder transcutaneous electric nerve stimulation decreases heart rate via potentiating vagal tone

By enhancing vagal activity, auricle transcutaneous electric nerve stimulation (TENS) is developed as a non-invasive therapy for heart failure. Nevertheless, though shoulder TENS used for treating adhesive capsulitis could affect vagal tone, its potential impact on heart functions remains unclear. In this study, electrocardiogram (ECG) and heart rate (HR) of subjects in response to sham, right-sided, or left-sided shoulder TENS (TENS-S, TENS-R, and TENS-L, respectively; 5 min) were recorded and analyzed. During the stimulation period, TENS-R constantly and TENS-L transiently decreased the HR of subjects; both TENS-R and TENS-L increased powers of the low- and high-frequency spectra. While TENS-R exhibiting no effect, TENS-L increased the ratio of low/high-frequency power spectrum indicating TENS-R decreased the HR through potentiating cardiac vagal tone. Collectively, these results suggest TENS could be an early and non-invasive therapy for heart failure patients before considering implant devices or devices are not feasible; moreover, therapists/physicians need to carefully monitor the potential adverse events during treatment for patient safety.Trial registration: The study protocol was registered in ClinicalTrials.gov (NCT03982472; 11/06/2019).

Modest therapeutic effects of low-frequency transcutaneous electric nerve stimulation on insomnia among older adults: A 4-week multi-center, randomized controlled study

A 4-week, multi-center, randomized controlled study was conducted to evaluate the therapeutic efficacy and safety of low-frequency transcutaneous electric nerve stimulation (LF-TENS) for insomnia disorder. A total of 160 individuals aged 40 to 80 years with insomnia disorder were included and randomized to the experimental group receiving active device (n = 81) or control group receiving sham device (n = 79). Both groups used the device for four weeks, more than five days a week. The participants also completed pre- and post-intervention assessment with questionnaires, sleep diaries, wrist actigraphy, and blood tests. We found a significant improvement of subjective sleep quality, depressive/anxiety symptoms, and blood cortisol level in both experimental and control groups. Notably, among patients aged over 60 years, the experimental group showed better improvement after intervention in the change of PSQI score (2.60 ± 0.46 vs. 1.22 ± 0.46, p = 0.039; Cohen’s d = 0.99 vs 0.45) and blood cortisol level (-1.97 ± 0.53 µg/dl vs. -0.16 ± 0.53 µg/dl, p = 0.007; Cohen’s d = 0.56 vs 0.05). We found that LF-TENS was effective in improving subjective sleep quality in older adults aged over 60 years. The hypothalamic-pituitary-adrenal axis might be related to the therapeutic mechanism.

Ultra-low-frequency-transcutaneous electric nerve stimulation for recording cameo surface and detachable cheek plumpers for enhanced complete denture esthetics

Severely resorbed completely edentulous maxillary and mandibular arches from long-term complete edentulism may pose a treatment challenge for the treating prosthodontist. The loss of teeth, over a period of time, can lead to gross facial disfigurement and also has great psychological effect. The loss of teeth also has effect on the musculature and supporting tissues which may lead to muscle wasting and dystrophy. Ever since its introduction in 1971, Transcutaneous Electrical Nerve Stimulation (TENS) has been used in dentistry for various treatment modalities and it is especially indicated in management of tempo-mandibular dysfunctions (TMDs). TENS being a non-invasive, non-technique sensitive, and easy to use technique has evolved rapidly over the years as an adjunct in management of various dental therapies. Two case reports of completely edentulous patients are presented here, where ultra-low-frequency-TENS (ULF-TENS) was used as an aid in cameo surface recording and customizing the magnet retained cheek plumper within the physiological and functional limits of the orofacial musculature complex for rehabilitation with complete denture prosthesis.