1. Development of a method to maximize the transcutaneous electrical nerve stimulation intensity in women with fibromyalgia
- Author
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Barbara A. Rakel, Kathleen A. Sluka, Ericka N. Merriwether, Dana L. Dailey, Katharine M. Geasland, Carol G.T. Vance, Jonathan M. Williams, Ruth L. Chimenti, M. Bridget Zimmerman, Leslie J. Crofford, Katherine Hadlandsmyth, and Li Alemo Munters
- Subjects
TENS ,Stimulation ,Transcutaneous electrical nerve stimulation ,dosage ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,transcutaneous electrical nerve stimulation ,Randomized controlled trial ,law ,Fibromyalgia ,Sensory threshold ,medicine ,pain ,030212 general & internal medicine ,Journal of Pain Research ,Original Research ,business.industry ,medicine.disease ,3. Good health ,Intensity (physics) ,Anesthesiology and Pain Medicine ,Anesthesia ,Anxiety ,fibromyalgia ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Carol GT Vance,1 Ruth L Chimenti,1 Dana L Dailey,1 Katherine Hadlandsmyth,2 M Bridget Zimmerman,3 Katharine M Geasland,1 Jonathan M Williams,4 Ericka N Merriwether,1,5 Li Alemo Munters,4 Barbara A Rakel,6 Leslie J Crofford,4 Kathleen A Sluka1 1Department of Physical Therapy and Rehabilitation Science, The University of Iowa Carver College of Medicine, Iowa City, IA, USA; 2Department of Anesthesia, College of Medicine, University of Iowa, Iowa City, IA, USA; 3Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA; 4Department of Medicine/Rheumatology & Immunology, Vanderbilt University, Nashville, TN, USA; 5Department of Physical Therapy, New York University, New York, NY, USA; 6College of Nursing, University of Iowa, Iowa City, IA, USA Introduction: Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological intervention clinically used for pain relief. The importance of utilizing the adequate stimulation intensity is well documented; however, clinical methods to achieve the highest possible intensity are not established. Objectives: Our primary aim was to determine if exposure to the full range of clinical levels of stimulation, from sensory threshold to noxious, would result in higher final stimulation intensities. A secondary aim explored the association of pain, disease severity, and psychological variables with the ability to achieve higher final stimulation intensity. Methods: Women with fibromyalgia (N=143) were recruited for a dual-site randomized controlled trial – Fibromyalgia Activity Study with TENS (FAST). TENS electrodes and stimulation were applied to the lumbar area, and intensity was increased to sensory threshold (ST), then to “strong but comfortable” (SC1), then to “noxious” (N). This was followed by a reduction to the final stimulation intensity of “strong but comfortable” (SC2). We called this the Setting of Intensity of TENS (SIT) test. Results: There was a significant increase from SC1 (37.5 mA IQR: 35.6–39.0) to SC2 (39.2 mA IQR: 37.1–45.3) (p
- Published
- 2018