The Efficacy of Transcutaneous Electrical Nerve Stimulation in Rehabilitation of Patients with Advanced Knee Osteoarthritis: A Systematic

Background and Objective: Osteoarthritis is the most common joint disease. Patients with knee osteoarthritis, often have symptoms like pain, muscle atrophy, inflammation,and deformity. Pain is the major symptom of knee osteoarthritis and usually comes from the use of joint and it is alleviated by taking rest. By progressing osteoarthritis, thepain severity will get higher and higher and can occur even at rest. Adults with OA who have not tolerated the traditional analgesics may have few therapeutic alternatives.Transcutaneous Electrical Nerve Stimulation (TENS) is a method of electrical stimulation, which aims to provide some kind of symptomatic pain relief by exciting sensory nerves and stimulating the opioid system and the pain gate mechanism. This study aims to evaluate the efficacy of TENS in the rehabilitation of patients with advanced knee OA. Search Method: A literature search was conducted on online databases such as Web of Science, Pubmed, Embase and Google scholar to identify the efficacy of TENS in therehabilitation of patients with advanced knee OA. The references in relevant reviews and published clinical trials are included in the study. Findings: This study reveals that TENS significantly increases the Pressure Pain Threshold (PPT) at the affected knee but placebo TENS does not change PPT significantly. Pairwise comparisons of the treatment groups showed a significant difference in the mean changes of PPT between TENS and placebo TENS. Pain at rest and pain during the TUG decreased in the 2 groups significantly. TENS and placebo TENS didn’t change in any function. In another study, patients in the TENS cohort group improved in their subjective and functional outcomes significantly as compared to their initial status, while the control group did not have a significant change. Conclusion: This study determines the efficacy and safety of TENS for improving outcomes and its effectiveness on pain induced by osteoarthritis. Using various outcome measures, and an improved placebo will provide better insight into themanagement of knee OA pain with TENS. Also, there wasn’t any study that measures the pain during physical function tasks. So there is needed some studies to evaluate thissubject to reach a valuable insight into the management of OA.

Keywords:

Transcutaneous Electrical Nerve Stimulation , Osteoarthritis , Knee Osteoarthritis , Efficacy