Eficácia analgésica e mecanismos de ação da estimulação elétrica nervosa transcutânea: revisão sistemática e ensaio clínico randomizado
Notice bibliographique
Résumé
Transcutaneous electrical nerve stimulation (TENS) is a non-invasive therapy that has been widely used for pathologies. However, this effect is correlated with opioid control and repeated stimulation of opioid receptors can lead to the development of analgesic tolerance with loss of therapeutic efficacy. The objective of study 1 was to carry out a systematic review to evaluate the action buttons induced by TENS with analgesic function in animals for a better understanding of their protocols and consequent results. Relevant articles were identified through a search of the following databases: PubMed, SCOPUS, Cochrane, Medline, Science Direct, Web of Science, CINAHL, Google Scholar, which was performed by two independent investigators through February 2021. Risk of bias included studies recording the RoB tool for animal intervention studies. To assess the quality of the study, the CAMARADES checklist was used. For meta-analyses with continuous results, we tested the effects of low- and high- frequency TENS compared to control groups, as well as low-frequency versus high-frequency TENS. A total of 6,984 titles were found and, after a thorough analysis, 53 studies were included for analysis. The results indicated that TENS has a substantial scientific basis for its hypoalgesic effect in preclinical studies. In addition, with the systematic analysis it was possible to assess the effectiveness, the limits of effectiveness, the need for further animal experiments and the design of any subsequent clinical trial, easing translational challenges. The aim of study 2 was to investigate whether repeated daily administration of TENS increasing intensity can delay analgesic tolerance in patients with chronic pain. This was a randomized, double-blind, placebo-controlled clinical trial that included 64 subjects with knee osteoarthritis allocated into two groups (active TENS or placebo TENS). High-frequency TENS treatment (100 Hz), 100 μs pulse duration at maximum sensory intensity tolerated was applied daily to the knee, five days a week, for four weeks, for 20 minutes. The intensity was increased with each session. Placebo stimulation (no stimulation) was of the same duration. The following were evaluated: pain intensity (11-point numeric scale), pressure pain threshold (LDP-algometry), motor performance (up and go test - TUG and multidimensional pain assessment (McGill Pain Questionnaire). of pain on each day of treatment when active TENS was used. However, it was necessary to increase the current intensity over time to maintain the effectiveness of TENS and reduce pain. In addition, the time required to complete the TUG test suffered significantly in the active TENS group compared to placebo TENS. These data suggest that repeated daily application of TENS decreases pain intensity in an intensity-increasing manner.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,004 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».