L’utilisation du TENS en physiothérapie : la situation particulière des soins palliatifs oncologiques
Bibliographic record
Abstract
La stimulation nerveuse électrique transcutanée (TENS) est un traitement contre la douleur qui utilise l'application d'un courant électrique.Quelques études suggèrent que le TENS permettrait de réduire les douleurs associées à certains types de cancer et ce traitement est régulièrement utilisé en physiothérapie dans des contextes de pratique interdisciplinaire spécialisée en soins palliatifs oncologiques.Cependant, l'emploi du TENS dans les cas de cancer est un sujet de controverse, son application étant contrindiquée selon les normes canadiennes encadrant la pratique de la physiothérapie.Cet article a pour objectif de présenter, au moyen d'une étude de cas, certains principes pour guider la prise de décision quant au choix de cette thérapie dans les cas de cancer.Les évidences scientifiques, les normes de pratique et les principes éthiques qui devraient guider le choix de ce traitement sont discutés.L'utilisation du TENS en soins palliatifs en physiothérapie est un exemple paradigmatique d'une situation commune: le calcul nécessaire par le professionnel de la santé entre les bénéfices et les coûts potentiels, tels que les effets néfastes possibles d'un traitement.Dans le cas du TENS, les bénéfices sont associés à la réduction de la douleur, alors qu'un effet indésirable potentiel serait l'augmentation de la prolifération tumorale.Ce difficile calcul a des répercussions pour les différents acteurs impliqués tels que les patients et les professionnels de la santé.Trans-cutaneous electrical nerve stimulation (TENS) is a treatment against pain that uses the application of an electric current.Some studies suggest that TENS would reduce the pain associated with certain types of cancer and this treatment is regularly used in therapy in contexts of interdisciplinary practice specializing in palliative oncology.However, the use of TENS in cancer cases is a matter of controversy, and its application is contraindicated by Canadian standards governing the practice of physiotherapy.This article aims to present, through a case study, some principles to guide decision making regarding the choice of this therapy in cases of cancer.Scientific evidence, standards of practice and ethical principles that should guide the choice of therapy are discussed.The use of TENS therapy in palliative care is a paradigmatic example of a common situation: the weighing by health care professionals of the benefits and potential costs, such as potential adverse effects of treatment.In the case of TENS, the benefits are associated with the reduction of pain, while a potential adverse effect would increase tumour proliferation.This difficult calculation has implications for the various stakeholders such as patients and health professionals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.008 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".