title: Effectiveness of high-frequency transcutaneous electrical nerve stimulation at tender points as adjuvant therapy for patients with fibromyalgia.
abstract: BACKGROUND
  Fibromyalgia is a chronic pain syndrome associated with sleep disorders, fatigue and psychological symptoms. Combinations therapies, such as electrotherapy and therapeutic exercises have been used in the clinical practice.
  
  
  OBJECTIVE
  To assess the efficacy of high-frequency transcutaneous electrical nerve stimulation (TENS) as an adjuvant therapy to aerobic and stretching exercises, for the treatment of fibromyalgia.
  
  
  METHODS
  Controlled clinical trial.
  
  
  METHODS
  Unit of rehabilitation of a public hospital.
  
  
  METHODS
  Twenty-eight women aged 52.4±7.5 years, with fibromyalgia.
  
  
  METHODS
  A visual analogue scale measured pain intensity; tender points pain threshold, by dolorimetry; and quality of life, by the Fibromyalgia Impact Questionnaire. All subjects participated in an eight-week program consisting of aerobic exercises, followed by static stretching of muscle chains. In TENS group, high-frequency (150 Hz) was applied on bilateral tender points of trapezium and supraspinatus.
  
  
  RESULTS
  TENS group had a greater pain reduction (mean change score=-2.0±2.9 cm) compared to Without TENS group (-0.7±3.7 cm). There was a difference between mean change scores of each group for pain threshold (right trapezium: 0.2±1 kg/cm² in TENS group and -0.2±1.2 kg/cm² in Without TENS group). In the evaluation of clinically important changes, patients receiving TENS had relevant improvement of pain, work performance, fatigue, stiffness, anxiety and depression compared to those not receiving TENS.
  
  
  CONCLUSIONS
  It has suggested that high-frequency TENS as an adjuvant therapy is effective in relieving pain, anxiety, fatigue, stiffness, and in improving ability to work of patients with fibromyalgia.
  
  
  CONCLUSIONS
  High-frequency TENS may be used as a short-term complementary treatment of fibromyalgia.
authors.affiliation: Department of Speech Therapy, Physical Therapy and Occupational Therapy, Faculty of Medicine of the University of São Paulo, SP, Brazil. pasqual@usp.br
authors.forename: F
authors.initials: F
authors.lastname: Carbonario
authors.forename: L A
authors.initials: LA
authors.lastname: Matsutani
authors.forename: S L K
authors.initials: SL
authors.lastname: Yuan
authors.forename: A P
authors.initials: AP
authors.lastname: Marques
mesh_terms: D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D005356:Fibromyalgia / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D011788:Quality of Life; D011795:Surveys and Questionnaires; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome