García-Collado Agustín, Valera-Calero Juan A, Fernández-de-Las-Peñas César, Arias-Buría José L
Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain.
Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain.
J Clin Med. 2022 Jun 28;11(13):3753. doi: 10.3390/jcm11133753.
This paper assesses the effects of percutaneous electrical nerve stimulation (PENS) on pain- and function-related outcomes by means of a scoping review of studies with single cases, case-series, quasi-experimental, and randomized or non-randomized trial designs. We consulted the PubMed, MEDLINE and EMBASE databases. Data were extracted by two reviewers. The methodological quality of studies was assessed using the Physiotherapy Evidence Database (PEDro) scale for experimental studies and the Joanna Briggs Institute (JBI) tool for case reports or cases series. Mapping of the results included: (1), description of included studies; (2), summary of results; and, (3), identification of gaps in the existing literature. Eighteen articles (five randomized controlled trials, one trial protocol, nine case series and three case reports) were included. The methodological quality of the papers was moderate to high. The conditions included in the studies were heterogeneous: chronic low back pain, lower limb pain after lumbar surgery, chronic post-amputation pain, rotator cuff repair, foot surgery, knee arthroplasty, knee pain, brachial plexus injury, elbow pain and ankle instability. In addition, one study included a healthy athletic population. Interventions were also highly heterogeneous in terms of sessions, electrical current parameters, or time of treatment. Most studies observed positive effects of PENS targeting nerve tissue against the control group; however, due to the heterogeneity in the populations, interventions, and follow-up periods, pooling analyses were not possible. Based on the available literature, PENS interventions targeting peripheral nerves might be considered as a potential therapeutic strategy for improving pain-related and functional outcomes. Nevertheless, further research considering important methodological quality issues (e.g., inclusion of control groups, larger sample sizes and comparatives between electric current parameters) are needed prior to recommending its use in clinical practice.
本文通过对单病例、病例系列、准实验以及随机或非随机试验设计的研究进行范围综述，评估经皮电神经刺激（PENS）对疼痛和功能相关结局的影响。我们查阅了PubMed、MEDLINE和EMBASE数据库。由两名评审员提取数据。使用物理治疗证据数据库（PEDro）量表评估实验性研究的方法学质量，使用乔安娜·布里格斯研究所（JBI）工具评估病例报告或病例系列的方法学质量。结果梳理包括：（1）纳入研究的描述；（2）结果总结；以及（3）识别现有文献中的空白。纳入了18篇文章（5项随机对照试验、1项试验方案、9个病例系列和3篇病例报告）。这些论文的方法学质量为中等至高。研究中纳入的病症具有异质性：慢性下腰痛、腰椎手术后下肢疼痛、慢性截肢后疼痛、肩袖修复、足部手术、膝关节置换术、膝关节疼痛、臂丛神经损伤、肘部疼痛和踝关节不稳。此外，一项研究纳入了健康的运动员群体。干预措施在疗程、电流参数或治疗时间方面也高度异质。大多数研究观察到针对神经组织的PENS相对于对照组有积极效果；然而，由于人群、干预措施和随访期的异质性，无法进行汇总分析。基于现有文献，针对周围神经的PENS干预措施可能被视为改善疼痛相关和功能结局的一种潜在治疗策略。尽管如此，在推荐其用于临床实践之前，需要进一步研究考虑重要的方法学质量问题（例如，纳入对照组、更大的样本量以及电流参数之间的比较）。
