title: A randomized clinical trial of TENS and exercise for patients with chronic neck pain.
abstract: OBJECTIVE
  To investigate the effect of transcutaneous electrical nerve stimulation (TENS) on acupuncture points and neck exercise in chronic neck pain patients.
  
  
  METHODS
  A randomized clinical trial.
  
  
  METHODS
  Hospital-based practice.
  
  
  METHODS
  Two hundred and eighteen patients with chronic neck pain.
  
  
  METHODS
  Subjects were randomized into three groups, receiving either (1) TENS over the acupuncture points plus infrared irradiation (TENS group); (2) exercise training plus infrared irradiation (exercise group); or (3) infrared irradiation alone (control); twice a week for six weeks.
  
  
  METHODS
  The values of verbal numeric pain scale, Northwick Park Neck Pain Questionnaire, and isometric neck muscle strength were assessed before, at the end of the six-week treatment, and at the six-month follow-up.
  
  
  RESULTS
  Results demonstrated that after the six-week treatment, significant improvement in the verbal numerical pain scale was found only in the TENS group (0.60+/-2.54, p = 0.027) and the exercise group (1.57+/-2.67, p < 0.001). Though significant reduction in Northwick Park Neck Pain Questionnaire score was found in all three groups, post-hoc tests showed that both the TENS and the exercise group produced better improvement (0.38+/-0.60% and 0.39+/-0.62% respectively) than the control group (0.23+/-0.63%). Significant improvement (p = < 0.001 to 0.03) in neck muscle strength was observed in all three groups, however, the improvement in the control group was not clinically significant and it could not be maintained at the six-month follow-up.
  
  
  CONCLUSIONS
  After the six-week treatment, patients in the TENS and exercise group had a better and clinically relevant improvement in disability, isometric neck muscle strength, and pain. All the improvements in the intervention groups were maintained at the six-month follow-up.
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong. rstchiu@polyu.edu.hk
authors.forename: Thomas T W
authors.initials: TT
authors.lastname: Chiu
authors.forename: Christina W Y
authors.initials: CW
authors.lastname: Hui-Chan
authors.forename: Gladys
authors.initials: G
authors.lastname: Chein
mesh_terms: D015669:Acupuncture Points; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000628:therapy*; D012720:Severity of Illness Index; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome