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Clinical Journal of Pain:
doi: 10.1097/01.ajp.0000210935.73686.79
Original Articles

Efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low-back Pain in a Multiple Sclerosis Population: A Randomized, Placebo-controlled Clinical Trial

Warke, Kim PhD*; Al-Smadi, Jamal PhD; Baxter, David PhD; Walsh, Deirdre M. PhD*; Lowe-Strong, Andrea S. PhD*

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Abstract

Objective: This study was designed to investigate the hypoalgesic effects of self-applied transcutaneous electrical nerve stimulation (TENS) on chronic low-back pain (LBP) in a multiple sclerosis (MS) population.

Methods: Ninety participants with probable or definite MS (aged 21 to 78 y) presenting with chronic LBP were recruited and randomized into 3 groups (n=30 per group): (1) low-frequency TENS group (4 Hz, 200 μs); (2) high-frequency TENS group (110 Hz, 200 μs); and (3) placebo TENS. Participants self-applied TENS for 45 minutes, a minimum of twice daily, for 6 weeks. Outcome measures were recorded at weeks 1, 6, 10, and 32. Primary outcome measures included: Visual Analog Scale for average LBP and the McGill Pain Questionnaire. Secondary outcome measures included: Visual Analog Scale for worst and weekly LBP, back and leg spasm; Roland Morris Disability Questionnaire; Barthel Index; Rivermead Mobility Index; Multiple Sclerosis Quality of Life-54 Instrument, and a daily logbook. Data were analyzed blind using parametric and nonparametric tests, as appropriate.

Results: Results indicated a statistically significant interactive effect between groups for average LBP (P=0.008); 1-way analysis of covariance did not show any significant effects at any time point once a Bonferonni correction was applied (P>0.05). However, clinically important differences were observed in some of the outcome measures in both active treatment groups during the treatment and follow-up periods.

Discussion: Although not statistically significant, the observed effects may have implications for the clinical prescription and the use of TENS within this population.

© 2006 Lippincott Williams & Wilkins, Inc.

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