Transcutaneous Electrical Nerve Stimulation Improves Walking Performance in Patients With Intermittent Claudication.
The purpose of this study was to investigate the effects of 2 types of transcutaneous electrical nerve stimulation (TENS) on walking distance and measures of pain in patients with peripheral arterial disease (PAD) and intermittent claudication (IC). In a phase 2a study, 40 participants with PAD and IC completed a graded treadmill test on 2 separate testing occasions. Active TENS was applied to the lower limb on the first occasion; and placebo TENS, on the second. The participants were divided into 2 experimental groups. One group received high-frequency TENS; and the other, low-frequency TENS. Measures taken were initial claudication distance, functional claudication distance, and absolute claudication distance. The McGill Pain Questionnaire (MPQ) vocabulary was completed at the end of the intervention, and the MPQ-Pain Rating Index score was calculated. Four participants were excluded from the final analysis because of noncompletion of the experimental procedure. Median walking distance increased with high-frequency TENS for all measures (P < .05, Wilcoxon signed rank test, all measures). Only absolute claudication distance increased significantly with low-frequency TENS compared with placebo (median, 179-228; Ws = 39; z = 2.025; P = .043; r = 0.48). No difference was observed between reported median MPQ-Pain Rating Index scores: 21.5 with placebo TENS and 21.5 with active TENS (P = .41). Transcutaneous electrical nerve stimulation applied to the lower limb of the patients with PAD and IC was associated with increased walking distance on a treadmill but not with any reduction in pain. Transcutaneous electrical nerve stimulation may be a useful adjunctive intervention to help increase walking performance in patients with IC.
Chris Seenan, PhD Lecturer in Physiotherapy, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.Steve McSwiggan, PhD Senior Clinical Trials Manager, Division of Cardiovascular and Diabetes Medicine, University of Dundee, Dundee, United Kingdom.Patricia A. Roche, PhD Honorary Lecturer, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom.Chee-Wee Tan, PhD Lecturer in Physiotherapy, School of Health, Queen Margaret University, Edinburgh, United Kingdom.Tom Mercer, PhD Professor of Exercise Physiology and Rehabilitation, School of Health, Queen Margaret University, Edinburgh, United Kingdom.Jill J. F. Belch, PhD Dean of Research and NHS Tayside R&D Director, Division of Cardiovascular and Diabetes Medicine, University of Dundee, Dundee, United Kingdom.
Chris
C
Seenan
Steve
S
McSwiggan
Patricia A
PA
Roche
Chee-Wee
CW
Tan
Tom
T
Mercer
Jill J F
JJ
Belch
D006801:Humans; D007383:Intermittent Claudication / Q000628:therapy*; D010147:Pain Measurement; D058729:Peripheral Arterial Disease; D004561:Transcutaneous Electric Nerve Stimulation; D016138:Walking