Seenan Chris, McSwiggan Steve, Roche Patricia A, Tan Chee-Wee, Mercer Tom, Belch Jill J F
Chris Seenan, PhD Lecturer in Physiotherapy, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.Steve McSwiggan, PhD Senior Clinical Trials Manager, Division of Cardiovascular and Diabetes Medicine, University of Dundee, Dundee, United Kingdom.Patricia A. Roche, PhD Honorary Lecturer, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom.Chee-Wee Tan, PhD Lecturer in Physiotherapy, School of Health, Queen Margaret University, Edinburgh, United Kingdom.Tom Mercer, PhD Professor of Exercise Physiology and Rehabilitation, School of Health, Queen Margaret University, Edinburgh, United Kingdom.Jill J. F. Belch, PhD Dean of Research and NHS Tayside R&D Director, Division of Cardiovascular and Diabetes Medicine, University of Dundee, Dundee, United Kingdom.
J Cardiovasc Nurs. 2016 Jul-Aug;31(4):323-30. doi: 10.1097/JCN.0000000000000258.
The purpose of this study was to investigate the effects of 2 types of transcutaneous electrical nerve stimulation (TENS) on walking distance and measures of pain in patients with peripheral arterial disease (PAD) and intermittent claudication (IC). In a phase 2a study, 40 participants with PAD and IC completed a graded treadmill test on 2 separate testing occasions. Active TENS was applied to the lower limb on the first occasion; and placebo TENS, on the second. The participants were divided into 2 experimental groups. One group received high-frequency TENS; and the other, low-frequency TENS. Measures taken were initial claudication distance, functional claudication distance, and absolute claudication distance. The McGill Pain Questionnaire (MPQ) vocabulary was completed at the end of the intervention, and the MPQ-Pain Rating Index score was calculated. Four participants were excluded from the final analysis because of noncompletion of the experimental procedure. Median walking distance increased with high-frequency TENS for all measures (P < .05, Wilcoxon signed rank test, all measures). Only absolute claudication distance increased significantly with low-frequency TENS compared with placebo (median, 179-228; Ws = 39; z = 2.025; P = .043; r = 0.48). No difference was observed between reported median MPQ-Pain Rating Index scores: 21.5 with placebo TENS and 21.5 with active TENS (P = .41). Transcutaneous electrical nerve stimulation applied to the lower limb of the patients with PAD and IC was associated with increased walking distance on a treadmill but not with any reduction in pain. Transcutaneous electrical nerve stimulation may be a useful adjunctive intervention to help increase walking performance in patients with IC.
本研究旨在探讨两种经皮电刺激神经疗法（TENS）对周围动脉疾病（PAD）和间歇性跛行（IC）患者步行距离及疼痛指标的影响。在一项2a期研究中，40名患有PAD和IC的参与者在两个不同的测试场合完成了分级跑步机测试。第一次测试时，将有源TENS应用于下肢；第二次测试时，应用安慰剂TENS。参与者被分为两个实验组。一组接受高频TENS；另一组接受低频TENS。所采取的测量指标包括初始跛行距离、功能性跛行距离和绝对跛行距离。在干预结束时完成麦吉尔疼痛问卷（MPQ）词汇测试，并计算MPQ疼痛评分指数得分。由于未完成实验程序，4名参与者被排除在最终分析之外。所有测量指标中，高频TENS组的步行距离中位数均增加（P < .05，Wilcoxon符号秩检验，所有测量指标）。与安慰剂相比，只有低频TENS组的绝对跛行距离显著增加（中位数，179 - 228；Ws = 39；z = 2.025；P = .043；r = 0.48）。报告的MPQ疼痛评分指数中位数得分之间未观察到差异：安慰剂TENS组为21.5，有源TENS组为21.5（P = .41）。对患有PAD和IC的患者下肢应用经皮电刺激神经疗法可使跑步机上的步行距离增加，但疼痛未减轻。经皮电刺激神经疗法可能是一种有用的辅助干预措施，有助于提高IC患者的步行能力。
