Cheing Gladys L Y, Hui-Chan Christina W Y, Chan K M
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon.
Clin Rehabil. 2002 Nov;16(7):749-60. doi: 10.1191/0269215502cr549oa.
To evaluate the cumulative effect of repeated transcutaneous electrical nerve stimulation (TENS) on chronic osteoarthritic (OA) knee pain over a four-week treatment period, comparing it to that of placebo stimulation and exercise training given alone or in combination with TENS.
Sixty-two patients, aged 50-75, were stratified according to age, gender and body mass ratio before being randomly assigned to four groups.
Patients received either (1) 60 minutes of TENS, (2) 60 minutes of placebo stimulation, (3) isometric exercise training, or (4) TENS and exercise (TENS & Ex) five days a week for four weeks.
Visual analogue scale (VAS) was used to measure knee pain intensity before and after each treatment session over a four-week period, and at the four-week follow-up session.
Repeated measures ANOVA showed a significant cumulative reduction in the VAS scores across the four treatment sessions (session 1, 10, 20 and the follow-up) in the TENS group (45.9% by session 20, p < 0.001) and the placebo group (43.3% by session 20, p = 0.034). However, linear regression of the daily recordings of the VAS indicated that the slope in the TENS group (slope = -2.415, r = 0.943) was similar to the exercise group (slope = -2.625, r = 0.935), which were steeper than the other two groups. Note that the reduction of OA knee pain was maintained in the TENS group and the TENS & Ex group at the four-week follow-up session, but not in the other two groups.
The four treatment protocols did not show significant between-group difference over the study period. It was interesting to note that isometric exercise training of the quadriceps alone also reduced knee pain towards the end of the treatment period.
评估在为期四周的治疗期间，重复经皮电刺激神经疗法（TENS）对慢性骨关节炎（OA）膝关节疼痛的累积效果，并将其与单独使用安慰剂刺激、运动训练或TENS与运动训练联合使用的效果进行比较。
62名年龄在50 - 75岁之间的患者，在根据年龄、性别和体重比进行分层后，被随机分配到四组。
患者每周接受五天治疗，为期四周，治疗方式分别为：（1）60分钟的TENS；（2）60分钟的安慰剂刺激；（3）等长运动训练；（4）TENS与运动训练联合（TENS & Ex）。
使用视觉模拟评分法（VAS）在四周的治疗期间内，每次治疗前后以及四周随访时测量膝关节疼痛强度。
重复测量方差分析显示，TENS组（到第20次治疗时降低了45.9%，p < 0.001）和安慰剂组（到第20次治疗时降低了43.3%，p = 0.034）在四个治疗阶段（第1次、第10次、第20次治疗以及随访）的VAS评分均有显著的累积降低。然而，VAS每日记录的线性回归表明，TENS组的斜率（斜率 = -2.415，r = 0.943）与运动训练组（斜率 = -2.625，r = 0.935）相似，且这两组的斜率比另外两组更陡。值得注意的是，在四周随访时，TENS组和TENS与运动训练联合组的OA膝关节疼痛减轻情况得以维持，而另外两组则没有。
在研究期间，四种治疗方案在组间未显示出显著差异。有趣的是，仅股四头肌的等长运动训练在治疗期结束时也减轻了膝关节疼痛。
