The interplay between pulse width and activation depth in TENS: a computational study.

Several studies find that manual acupuncture and transcutaneous electrical nerve stimulation (TENS) are via different mechanisms and generate different effect on the central nervous system, therefore, the aim of the present study was to compare the effect of manual acupuncture (MA) and TENS on the spinal cord using H-reflex recordings. A total of 13 healthy adult volunteers were studied. The electrical stimuli were delivered to the posterior tibial nerve transcutaneously at the left popliteal fossa to evoke the soleus H-reflex. MA, 2Hz TENS, 100 Hz TENS, respectively, was applied to the surface of the right first dorsal interosseous muscle exactly at the Hegu acupoint (LI.4). Four assessments were performed randomly, separated by an interval of at least three days in all the subjects as follows: 1) Control assessment: a pair of electrodes placed on the surface of the right Hegu acupoint (LI.4), but no electrical stimulation was delivered throughout the test; 2) MA assessment: MA was done at the right Hegu acupoint (LI.4) for 15 minutes; 3) TENS assessment at 2Hz: electrical stimulation (40 mA in intensity) at 2Hz was applied to the surface of the right Hegu acupoint (LI.4) for 15 minutes; 4) TENS assessment at 100 Hz: electrical stimulation (20 mA in intensity) at 100 Hz was applied to the surface of the right Hegu acupoint (LI.4) for 15 minutes. Each assessment was divided into three periods as follows: 1) Baseline period: H-reflexes recorded prior to MA or TENS; 2) TENS period: six H-reflex recordings after MA or TENS for a duration of 4-5 min, 9-10 min and 14-15 min, respectively; 3) Post TENS period: H-reflex recordings of 6 after TENS period 4-5 min and 9-10 min, respectively. Our results indicate that both 2Hz TENS and 100 Hz TENS increased the amplitude of the H-reflex, and that these increases may be retained longer with 100 Hz TENS than with 2 Hz TENS, whereas MA could not increase the amplitude of the H-reflex. MA, TENS at 2 Hz or 100 Hz didn't change the latencies of the H-reflexes. We conclude that both 2Hz and 100 Hz TENS increased the amplitude of the H-reflex, suggesting that TENS enhances the excitability of the motoneuron pool in the spinal cord, and 100 Hz TENS has a greater effect than 2Hz TENS, whereas MA was not similar effect to TENS on spinal cord.

ORIGINAL RESEARCH—WOMEN'S SEXUAL HEALTH: Successful Transcutaneous Electrical Nerve Stimulation in Two Women with Restless Genital Syndrome: The Role of Aδ- and C-Nerve Fibers

Systematic review and meta-analysis on the role of transcutaneous electrical nerve stimulation in children with overactive bladder - Pooled analysis of nine randomized controlled trials.

Tissue and electrode capacitance reduce neural activation volumes during deep brain stimulation

Spasticity management is pivotal for achieving functional recovery of stroke patients. The purpose of this study was to investigate the effects of a single trial of transcutaneous electrical nerve stimulation (TENS) on spasticity and balance in chronic stroke patients. Forty-two chronic stroke patients were randomly allocated into the TENS (n = 22) or the placebo-TENS (n = 20) group. TENS stimulation was applied to the gastrocnemius for 60 min at 100 Hz, 200 µs with 2 to 3 times the sensory threshold (the minimal threshold in detecting electrical stimulation for subjects) after received physical therapy for 30 min. In the placebo-TENS group, electrodes were placed but no electrical stimulation was administered. For measuring spasticity, the resistance encountered during passive muscle stretching of ankle joint was assessed using the Modified Ashworth Scale, and the Hand held dynamometer was used to assess the resistive force caused by spasticity. Balance ability was measured using a force platform that measures postural sway generated by postural imbalance. The TENS group showed a significantly greater reduction in spasticity of the gastrocnemius, compared to the placebo-TENS group (p < 0.05). TENS resulted in greater balance ability improvements, especially during the eyes closed condition (p < 0.05). However, these effects returned to baseline values within one day. This study shows that TENS provides an immediately effective means of reducing spasticity and of improving balance in chronic stroke patients. The present data may be useful to establish the standard parameters for TENS application in the clinical setting of stroke.

Effects of thermotherapy and transcutaneous electrical nerve stimulation on patients with primary dysmenorrhea: A randomized, placebo-controlled, double-blind clinical trial

Hypoalgesic Effect of the Transcutaneous Electrical Nerve Stimulation Following Inguinal Herniorrhaphy: A Randomized, Controlled Trial

Background: Transcutaneous electrical nerve stimulation (TENS) is presently one of the main methods of treatment for neuropathic pain in type II diabetes mellitus. The discussion about which TENS frequency is more effective in the treatment of neuropathic pain has been ongoing for many years. Despite this, the response of different aspects of neuropathic pain to various TENS modalities has not been sufficiently studied. Aim: To analyze changes in characteristics of neuropathic pain depending on the frequency of TENS. Materials and methods: Seventy-five Russian diabetic patients with painful distal axonal neuropathy were enrolled in the study. Patients were assigned to three groups: in the HF TENS group, 25 patients received standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin) + high-frequency TENS (HF); in the LF TENS group, 25 patients received standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin) + low-frequency TENS (LF); in the control group, 25 patients underwent just standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin). Pain intensity was calculated before and after treatment with visual analogue scale (VAS), McGill pain questionnaire (MPQ), Douleur Neuropathique 4 Questions (DN4) and Pain Drawing. Results: TENS increased the therapeutic effect of standard drug therapy, in the treatment of neuropathic pain, by 65.9% and prolonged its efficacy by 31% for up to 6 months after treatment. HF TENS had a more pronounced analgesic effect than LF TENS based on VAS (34.7%), sensory (57.6%) MPQ dimensions and DN4 (21%). Affective MPQ dimension with the use of LF TENS was lower than HF TENS by 34.7% immediately after treatment, by 47.3% after 2 months and by 34.8% after 6 months of the follow-up period. Conclusion: There are significant differences between HF and LF TENS based on pain assessment using various pain scales. This reflects the distinctive effects of different TENS modalities on different aspects of neuropathic pain.

Application of High-Frequency Transcutaneous Electrical Nerve Stimulation in Muscle Tension Dysphonia Patients With the Pain Complaint: The Immediate Effect

<strong><em>Aim: </em></strong><em>The key purpose of our research was to assess efficiency of transcutaneous electrical nervous system stimulation (TENS) by means of the adjunctive to NSAID for pole-procedural aching in cases that endured pleurodesis for pneumothorax.</em> <strong><em>Methodology: </em></strong><em>Our current research was held at Allied Hospital Faisalabad Pakistan from May 2017 to January 2018. Seventy cases in oldness set of 21-61 years, prearranged for pleurodesis in operation theaters (OT) of the current hospital, remained separated into 2 sets of 35 apiece. Cases remained instead allocated to solitary of 2 sets. In Set 1 diclofenac sodium 70 mg in 110 ml of usual saline remained happening 4 afterward process, although transcutaneous nerve stimulation remained practical for 50 mins throughout the current period. In Set 2 (regulator set) diclofenac sodium remained happening afterwards process, also the device equal to transcutaneous nerve stimulation, nonetheless which did not distribute slightly electric current remained practical as dummy. The BP also Heart Rate (HR) remained distinguished at predefined intermissions i.e. directly subsequently process also then at 3, 5, 7 also 9 hours subsequently technique. The 1-12 VAS remained experienced to measure aching at steady intermissions. Once Visual Analog Score remained ≥4, inj. diclofenac sodium 55 mg remained recurrent intramuscularly.</em> <strong><em>Results: </em></strong><em>The SBP remained similar in equally sets directly also 3 h subsequently process nonetheless this remained expressively fewer in Set 1 at 5, 7 in addition 9 hours correspondingly (P&lt;0.06). The Heart rate remained similar in mutually sets instantly subsequently, nonetheless reduced pointedly in Set 1 at 2 hrz (P&lt;1.06), 5 hrz (P&lt;1.03), 7 hrz (P&lt;1.03) also 9 hrz (P&lt;1.03) subsequently technique. The Visual Analogue Score remained similar directly also at 3 hours in mutually sets (P=NS), nevertheless stayed meaningfully fewer in Set 1 at 5, 7 also 9 hours subsequently process (P&lt;0.002). Quantity of diclofenac sodium exercised in Set 1 remained meaningfully fewer as compared in Set 2 (P&lt;0.03).</em> <strong><em>Conclusion: </em></strong><em>Transcutaneous nerve stimulation remains beneficial by way of the adjunctive to NSAIDs for discomfort release in pleurodesis also this give way to decrease in succeeding necessity of NSAIDs. transcutaneous nerve stimulation remains very appreciated strategy to alleviate pain of pleurodesis through not any opposing belongings also through the decent hemodynamic steadiness.</em> <strong>Key Words: </strong><em>Pleurodesis; Sclerosing mediators; Transcutaneous electrical nerve stimulation; transcutaneous nerve stimulation; NSAIDs.</em>

Transcutaneous electrical nerve stimulation (TNS) was used on 20 patients with severe wrist pain due to rheumatoid arthritis. Three different stimulation frequencies were used: high 70 Hz stimulation (70 TNS), low frequency 3 Hz stimulation (3 TNS) and brief trains of stimuli with an internal frequency of 70 Hz and with a repetition rate of 3 Hz (3-70 TNS). The analgesic effect was evaluated on the patient's own estimate of pain relief and by means of a loading test in which the length of time the patient could hold a weight before and after TNS was used. The loading test and the patients' own estimate of pain relief corresponded well. After 70 TNS, 18 patients could double their loading time. The corresponding figure for 3-70 TNS was 16 patients and for 3 TNS 5 patients. The average duration of pain relief after cessation of stimulation was 18 h for 70 TNS and 15 h for 3-70 TNS, while those who responded to 3 TNS experienced pain relief for only 4 h on average.

BACKGROUND AND OBJECTIVES: Cryotherapy and transcutaneous electrical nerve stimulation are physiotherapeutic resources widely used for the treatment of pain, due to their analgesic actions proved by scientific evidence. The concomitant use of these two therapeutic modalities in clinical practice is becoming more and more recurrent, justified by the assumption of boosting the analgesic effect. However, some physiotherapists disagree with this practice and believe that the simultaneous use of cryotherapy and transcutaneous electrical nerve stimulation nullifies its effects. The objective of this study was to carry out a bibliographic review of studies on the effects of the simultaneous use of cryotherapy and transcutaneous electrical nerve stimulation in pain treatments. CONTENTS: We selected articles published between 2006-2018 in the databases Scielo, LILACS, Medline and Pubmed. The selection was based on the crossing of the keywords: transcutaneous electrical nerve stimulation, cryotherapy and analgesia. The final sample consisted of 6 articles. CONCLUSION: The results of the analysis of the selected articles showed that, as already scientifically proved, the effects of cryotherapy and transcutaneous electrical nerve stimulation alone have their analgesic efficacy. However, most of the studies did not demonstrate a significant improvement in pain with the associated use of transcutaneous electrical nerve stimulation and cryotherapy compared to the isolated use of these physiotherapeutic resources, reinforcing the need for further research to elucidate the issue.

Postherpetic neuralgia (PHN) is responsible for one of the most common types of neuropathic pain, described as a burning pain that shakes, hits, and tightens and includes allodynia and paresthesia. To evaluate the efficacy of Pregabalin when used during transcutaneous electric nerve stimulation (TENS) in patients with PHN and to analyze any changes in physical activity and sleep quality. Patients aged 50 to 80 years were included in this randomized study. We enrolled 15 male (average age 65+/-8.6 y) and 15 female patients (average age 64+/-8.2 y). The male patients had a history of neuropathic pain lasting 15.6+/-8.8 months whereas the female patients had a history of neuropathic pain lasting about 14.9+/-8.6 months. We began with 1 week of patient screening followed by a week of Pregabalin titration. Then, we established the dose of Pregabalin for each patient to obtain visual analog scale (VAS) of less than 60 mm. The eligible patients were randomly divided into 2 groups receiving Pregabalin + TENS or Pregabalin+TENS placebo for the following 4 weeks. Patients underwent 8 outpatient visits during which they completed VAS, SF-McGill Pain Questionnaire, and sleep interference questionnaire. The resulting data showed that Pregabalin administration associated with TENS reduced pain in patients with PHN. At the end of the treatment, all the observed groups presented a reduction of mean VAS. The group treated with Pregabalin 300 (P300)+TENS had a reduction of pain of 30% and the group treated with Pregabalin 600 (P600)+TENS had a reduction of pain of 40%. The comparison between group P300+TENS versus group P300+TENS placebo showed a statistically significant reduction of VAS (P300+TENS 25+/-0.67 vs. P300+TENS placebo 39+/-1.19 P<0.02). Moreover, the comparison between group P600+TENS versus group P600+TENS placebo has shown a statistically significant reduction of VAS (P600+TENS 23+/-0.78 vs. P600+TENS placebo 32+/-0.81 P<0.02). At the end of the study, all groups showed a statistically significant difference in terms of sleep interference, Short-Form McGill Pain Questionnaire total score, and Short-Form McGill Pain Questionnaire Present Pain Intensity. These data support the conclusion that Pregabalin gives better results when combined with TENS therapy, which is an analgesic nonpharmacologic procedure. Therefore, a multidisciplinary treatment should be considered for this kind of pain.

We randomly assigned 42 subjects for treatment with transcutaneous electrical nerve stimulation (TENS) to one of three groups: conventional TENS--80 Hz; low frequency TENS--2 Hz; and a control group--TENS without batteries. Pain threshold measurements and blood beta-endorphin levels were obtained at regular intervals before, during, and for 17 hours after TENS application. We found no significant difference in blood beta-endorphin levels between the groups before, during, or immediately after TENS application. The differences in pain threshold and beta-endorphin levels appeared to be a function of the patient-selection process and not the application of TENS. The results indicated that TENS, with the stimulation characteristics used in this study, did not significantly change the measured plasma levels of beta-endorphin. The blind administration of naloxone hydrochloride, an opiate antagonist, did not significantly alter the perceived experimental pain of these subjects. We could find no evidence that TENS altered experimental pain threshold or plasma beta-endorphin levels.

In this work, the ferroelectric thin-film transistor (Fe-TFT) with polycrystalline-silicon (poly-Si) channel and HfZrO x gate dielectric is fabricated to study the characteristics of non-volatile memory (NVM). Significant threshold voltage (V TH) modulation can be achieved with low pulse voltages less than ±3.5 V and pulse widths within 1 μs. In order to achieve the NVM characteristics of low voltage and high speed operation, the impact of the program/erase (PRG/ERS) pulse voltage (V PRG/V ERS) and pulse width on endurance is a critical consideration. In the study of the pulse width effect on endurance, it can be observed that the V TH in PRG-state exhibits the wake-up effect at both short and long pulse widths. In addition, with the increase of pulse width, the V TH in the PRG-state exhibits significant fatigue effect and subthreshold swing (SS) degradation effect. For V TH in the ERS-state, the increase of the pulse width also exhibits the fatigue effect and the SS degradation effect, which is dominated by the SS degradation effect at long pulse widths. In the study of the pulse voltage effect on endurance, the increase of V PRG shows the imprint effect that the V TH in either PRG- or ERS-state reveals a decreasing trend. When the V ERS increases, the SS of the PRG- and ERS-states is degraded, and the fatigue effect of the PRG-state is enhanced. Moreover, the retention characteristics of poly-Si Fe-TFTs exhibit stable characteristics at both room temperature and 50 °C.