Fernández-Tenorio E, Serrano-Muñoz D, Avendaño-Coy J, Gómez-Soriano J
Grupo de Investigación en Fisioterapia Toledo (GIFTO), E.U. Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha, Toledo, España.
Grupo de Función Sensitivomotora, Hospital Nacional de Parapléjicos de Toledo, Toledo, España.
Neurologia (Engl Ed). 2019 Sep;34(7):451-460. doi: 10.1016/j.nrl.2016.06.009. Epub 2016 Jul 26.
Although transcutaneous electrical nerve stimulation (TENS) has traditionally been used to treat pain, some studies have observed decreased spasticity after use of this technique. However, its use in clinical practice is still limited. Our purpose was twofold: to determine whether TENS is effective for treating spasticity or associated symptoms in patients with neurological involvement, and to determine which stimulation parameters exert the greatest effect on variables associated with spasticity.
Two independent reviewers used PubMed, PEDro, and Cochrane databases to search for randomised clinical trials addressing TENS and spasticity published before 12 May 2015, and selected the articles that met the inclusion criteria. Of the initial 96 articles, 86 were excluded. The remaining 10 articles present results from 207 patients with a cerebrovascular accident, 84 with multiple sclerosis, and 39 with spinal cord lesions.
In light of our results, we recommend TENS as a treatment for spasticity due to its low cost, ease of use, and absence of adverse reactions. However, the great variability in the types of stimulation used in the studies, and the differences in parameters and variables, make it difficult to assess and compare any results that might objectively determine the effectiveness of this technique and show how to optimise parameters.
尽管经皮电刺激神经疗法（TENS）传统上用于治疗疼痛，但一些研究观察到使用该技术后痉挛有所减轻。然而，其在临床实践中的应用仍然有限。我们的目的有两个：确定TENS对治疗神经受累患者的痉挛或相关症状是否有效，以及确定哪些刺激参数对与痉挛相关的变量产生最大影响。
两名独立评审员使用PubMed、PEDro和Cochrane数据库检索2015年5月12日前发表的关于TENS和痉挛的随机临床试验，并选择符合纳入标准的文章。在最初的96篇文章中，86篇被排除。其余10篇文章展示了207例脑血管意外患者、84例多发性硬化症患者和39例脊髓损伤患者的数据。
根据我们的研究结果，鉴于TENS成本低、使用方便且无不良反应，我们推荐将其作为治疗痉挛的方法。然而，研究中使用的刺激类型差异很大，参数和变量也存在差异，这使得难以评估和比较任何可能客观确定该技术有效性并展示如何优化参数的结果。
