Efficacy of Sensory Transcutaneous Electrical Nerve Stimulation on Perceived Pain and Gait Patterns in Individuals with Experimental Knee Pain

Publication date: Available online 23 June 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): S. Jun Son, Hyunsoo Kim, Matthew K. Seeley, J. Ty Hopkins
ObjectiveTo examine the influence of experimental knee pain on perceived knee pain and gait patterns, and examine efficacy of TENS on pain-induced knee gait mechanics.DesignCrossover.SettingBiomechanics laboratory.SubjectsRecreationally active, healthy subjects aged 18-35 years (n=30).InterventionsThirty able-bodied subjects were assigned to either a TENS (n=15) or placebo group (n=15). All subjects completed three experimental sessions in a counterbalanced order separated by two days: (i) hypertonic saline infusion (5% NaCl), (ii) isotonic saline infusion (0.9% NaCl), and (iii) control. Each group received sensory electrical stimulation or placebo treatment for 20 minutes, respectively.Main Outcome MeasuresPerceived pain was collected every two minutes using a 10-cm VAS for 50 minutes, and analyzed using a mixed model, analysis of covariance with repeated measures. Gait analyses were performed at baseline, infusion, and treatment. Sagittal- and frontal-plane knee angle and internal net joint torque across the entire stance were analyzed using a functional data analysis package in the statistical program "R".ResultsHypertonic saline infusion increased perceived pain (4/10 cm on a VAS; P < .05), and altered right knee angle (more flexion and less abduction; P < .05) and internal net joint torque (less extension and greater abduction; P < .05) across various stance phases. TENS treatment reduced perceived pain and improved right sagittal-plane gait abnormalities compared with placebo treatment (P < .05).ConclusionsThis pain model increases perceived pain and induces compensatory gait patterns in a way that indicates potential quadriceps weakness. TENS treatment, however, effectively reduces perceived pain and restores pain-induced gait abnormalities in sagittal knee mechanics.



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