Literature ReviewTranscutaneous Electrical Nerve Stimulation for Management of Limb Spasticity A Systematic ReviewMills, Patricia Branco MD, MHSc, FRCPC; Dossa, Farhana BASc, MScAuthor Information From the ICORD (International Collaboration on Repair Discoveries) (PBM, FD); Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia (PBM); GF Strong Rehabilitation Center (PBM); and Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver Coastal Health, Vancouver, BC, Canada (PBM). All correspondence and requests for reprints should be addressed to: Patricia Branco Mills, MD, MHSc, FRCPC, GF Strong Rehabilitation Centre, 4255 Laurel St, Vancouver, BC, Canada V5Z 2G9. Dr Patricia B. Mills’ research salary was supported through funding from the Vancouver Coastal Health Research Institute, TD Grants in Medical Excellence, and VGH & UBC Hospital Foundation during the conduct of this study. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ajpmr.com). American Journal of Physical Medicine & Rehabilitation: April 2016 - Volume 95 - Issue 4 - p 309-318 doi: 10.1097/PHM.0000000000000437 Buy SDC Metrics Abstract ABSTRACT The purpose of this systematic review was to summarize the effect of transcutaneous electrical nerve stimulation (TENS) for management of limb spasticity. Randomized controlled trials were searched using electronic databases through July 2015. Fourteen randomized controlled trials were included, involving 544 participants. Intervention protocols fit within three categories: 1) TENS vs. no TENS or placebo TENS (n = 7), 2) TENS vs. another TENS protocol or another intervention for spasticity management (n = 7), and 3) TENS as an adjunct to another intervention for spasticity management (n = 4). There was level 1 and 2 evidence for TENS improving spasticity-related outcome measures within the International Classification of Functioning, Disability, and Health domains of body structure and function (e.g., Modified Ashworth Scale) as well as activity (e.g., gait). Better responses in outcome measures in the International Classification of Functioning, Disability, and Health activity domain were seen when TENS was used in combination with active therapy (e.g., exercise and task-related training) vs. as a single therapeutic modality. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.