Effect of transcutaneous electrical nerve stimulation on symptomatic diabetic peripheral neuropathy: a meta-analysis of randomized controlled trials.
OBJECTIVE
To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) on diabetic peripheral neuropathy (DPN).


METHODS
Randomized controlled trials (RCTs) comparing TENS with routine care, pharmacological interventions or placebo devices on patients with symptomatic DPN, were identified by electronic and manual searches. Studies were selected and available data were extracted independently by two investigators. Meta-analysis was performed by RevMan 4.2.8 software.


RESULTS
Three RCTs involving 78 patients were included in this study. The reductions in mean pain score were significantly greater in TENS group than in placebo TENS group in 4 weeks and 6 weeks follow-up [4 weeks, SMD-5.37, 95% CI (-6.97, -3.77); 6 weeks, SMD-1.01, 95% CI (-2.01, -0.01)], but not in 12 weeks follow-up [SMD-1.65, 95% CI (-4.02, 0.73)]. TENS therapy was associated with significantly subjective improvement in overall neuropathic symptoms in 12 weeks follow-up [WMD-0.18, 95% CI (-0.32, -0.051)]. No TENS-related adverse events were registered in TENS group.


CONCLUSIONS
TENS therapy may be an effective and safe strategy in treatment of symptomatic DPN. Due to small sample and short-term treatment duration, large multi-centre RCTs are needed to further evaluate the long-term effect of TENS on DPN.
Jin
Dong-mei
DM
Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Zhongshan University, Guangzhou, PR China.
Xu
Yun
Y
Geng
Deng-feng
DF
Yan
Tie-bin
TB
D003929:Diabetic Neuropathies / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome