Clinical trial NCT01528228: Effects of TENS Therapy Following Arthroscopic Knee Surgery
Official title: Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Postoperative Pain and Function Following Arthroscopic Knee Surgery: A Prospective Randomized Clinical Trial Pilot Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Meniscus Tear
Lead sponsor: A.T. Still University of Health Sciences
Sponsor class: OTHER
First posted: 2012-02-07
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: Following standard of care procedures for arthroscopy knee surgery it is anticipated that Transcutaneous Electrical Nerve Stimulation (TENS) will provide improved pain relief and improve functional outcomes.


Eligibility criteria: Inclusion Criteria:

* Age 18-60
* BMI\<50
* No significant joint malalignment
* No significant ligamentous instability
* No significant radiographic joint space narrowing
* No prior significant knee surgery
* Unilateral knee surgery
* Not workman's compensation
* Planned knee arthroscopy for meniscectomy, chondroplasty or synovectomy

Exclusion Criteria:

* Age \<18 or \>60
* BMI \> 50
* Significant joint malalignment
* Significant ligamentous instability
* Significant radiographic joint space narrowing
* Prior significant knee surgery
* Bilateral knee surgery planned
* Worker's Compensation
* No planned knee arthroscopy for menisectomy, chondroplasty or synovectomy

Primary outcomes:
measure: Patient's Perception of Pain in the Early Post-operative Period While Utilizing Structured TENS Therapy.
timeFrame: Two weeks postoperatively.
Secondary outcomes:
Other outcomes:
Locations:
city: Kirksville
country: United States
facility: North Missouri Sports Medicine and Orthopaedic Surgery
state: Missouri
Study officials:
affiliation: A.T. Still University
name: Kevin Marberry, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Breit R, Van der Wall H. Transcutaneous electrical nerve stimulation for postoperative pain relief after total knee arthroplasty. J Arthroplasty. 2004 Jan;19(1):45-8. doi: 10.1016/s0883-5403(03)00458-3.
citation: Lewek M, Stevens J, Snyder-Mackler L. The use of electrical stimulation to increase quadriceps femoris muscle force in an elderly patient following a total knee arthroplasty. Phys Ther. 2001 Sep;81(9):1565-71. doi: 10.1093/ptj/81.9.1565.
citation: Paternostro-Sluga T, Fialka C, Alacamliogliu Y, Saradeth T, Fialka-Moser V. Neuromuscular electrical stimulation after anterior cruciate ligament surgery. Clin Orthop Relat Res. 1999 Nov;(368):166-75.
citation: Wang B, Tang J, White PF, Naruse R, Sloninsky A, Kariger R, Gold J, Wender RH. Effect of the intensity of transcutaneous acupoint electrical stimulation on the postoperative analgesic requirement. Anesth Analg. 1997 Aug;85(2):406-13. doi: 10.1097/00000539-199708000-00029.
citation: Hargreaves A, Lander J. Use of transcutaneous electrical nerve stimulation for postoperative pain. Nurs Res. 1989 May-Jun;38(3):159-61.
citation: Arvidsson I, Eriksson E. Postoperative TENS pain relief after knee surgery: objective evaluation. Orthopedics. 1986 Oct;9(10):1346-51. doi: 10.3928/0147-7447-19861001-06.
citation: Tyler E, Caldwell C, Ghia JN. Transcutaneous electrical nerve stimulation: an alternative approach to the management of postoperative pain. Anesth Analg. 1982 May;61(5):449-56. No abstract available.
citation: Neary JM. Transcutaneous electrical nerve stimulation for the relief of post-incisional surgical pain. AANA J. 1981 Apr;49(2):151-5. No abstract available.
citation: Cooperman AM, Hall B, Mikalacki K, Hardy R, Sardar E. Use of transcutaneous electrical stimulation in the control of postoperative pain. Am J Surg. 1977 Feb;133(2):185-7. doi: 10.1016/0002-9610(77)90077-0.
citation: Selfe TK, Taylor AG. Acupuncture and osteoarthritis of the knee: a review of randomized, controlled trials. Fam Community Health. 2008 Jul-Sep;31(3):247-54. doi: 10.1097/01.FCH.0000324482.78577.0f.
citation: Eyigor S, Karapolat H, Ibisoglu U, Durmaz B. [Does transcutaneous electrical nerve stimulation or therapeutic ultrasound increase the effectiveness of exercise for knee osteoarthritis: a randomized controlled study]. Agri. 2008 Jan;20(1):32-40. Turkish.
citation: Cetin N, Aytar A, Atalay A, Akman MN. Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial. Am J Phys Med Rehabil. 2008 Jun;87(6):443-51. doi: 10.1097/PHM.0b013e318174e467.
citation: Burch FX, Tarro JN, Greenberg JJ, Carroll WJ. Evaluating the benefits of patterned stimulation in the treatment of osteoarthritis of the knee: a multi-center, randomized, single-blind, controlled study with an independent masked evaluator. Osteoarthritis Cartilage. 2008 Aug;16(8):865-72. doi: 10.1016/j.joca.2007.11.013. Epub 2008 Feb 8.
citation: Kang RW, Lewis PB, Kramer A, Hayden JK, Cole BJ. Prospective randomized single-blinded controlled clinical trial of percutaneous neuromodulation pain therapy device versus sham for the osteoarthritic knee: a pilot study. Orthopedics. 2007 Jun;30(6):439-45. doi: 10.3928/01477447-20070601-11. No abstract available.
citation: Paker N, Tekdos D, Kesiktas N, Soy D. Comparison of the therapeutic efficacy of TENS versus intra-articular hyaluronic acid injection in patients with knee osteoarthritis: a prospective randomized study. Adv Ther. 2006 Mar-Apr;23(2):342-53. doi: 10.1007/BF02850139.
citation: Bjordal JM, Lopes-Martins RA, Bogen B, Johnson M. Physical treatments have valuable role in osteoarthritis. BMJ. 2006 Apr 8;332(7545):853. doi: 10.1136/bmj.332.7545.853. No abstract available.
citation: Casimiro L, Barnsley L, Brosseau L, Milne S, Robinson VA, Tugwell P, Wells G. Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2005 Oct 19;2005(4):CD003788. doi: 10.1002/14651858.CD003788.pub2.
citation: Law PP, Cheing GL, Tsui AY. Does transcutaneous electrical nerve stimulation improve the physical performance of people with knee osteoarthritis? J Clin Rheumatol. 2004 Dec;10(6):295-9. doi: 10.1097/01.rhu.0000147047.77460.b0.
citation: Law PP, Cheing GL. Optimal stimulation frequency of transcutaneous electrical nerve stimulation on people with knee osteoarthritis. J Rehabil Med. 2004 Sep;36(5):220-5. doi: 10.1080/16501970410029834.
citation: Cheing GL, Hui-Chan CW. Would the addition of TENS to exercise training produce better physical performance outcomes in people with knee osteoarthritis than either intervention alone? Clin Rehabil. 2004 Aug;18(5):487-97. doi: 10.1191/0269215504cr760oa.
citation: Talbot LA, Gaines JM, Ling SM, Metter EJ. A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee. J Rheumatol. 2003 Jul;30(7):1571-8.
citation: Cheing GL, Tsui AY, Lo SK, Hui-Chan CW. Optimal stimulation duration of tens in the management of osteoarthritic knee pain. J Rehabil Med. 2003 Mar;35(2):62-8. doi: 10.1080/16501970306116.
citation: Hopkins J, Ingersoll CD, Edwards J, Klootwyk TE. Cryotherapy and Transcutaneous Electric Neuromuscular Stimulation Decrease Arthrogenic Muscle Inhibition of the Vastus Medialis After Knee Joint Effusion. J Athl Train. 2002 Mar;37(1):25-31.
citation: Cheing GL, Hui-Chan CW, Chan KM. Does four weeks of TENS and/or isometric exercise produce cumulative reduction of osteoarthritic knee pain? Clin Rehabil. 2002 Nov;16(7):749-60. doi: 10.1191/0269215502cr549oa.
citation: Osiri M, Welch V, Brosseau L, Shea B, McGowan J, Tugwell P, Wells G. Transcutaneous electrical nerve stimulation for knee osteoarthritis. Cochrane Database Syst Rev. 2000;(4):CD002823. doi: 10.1002/14651858.CD002823.
citation: Yurtkuran M, Kocagil T. TENS, electroacupuncture and ice massage: comparison of treatment for osteoarthritis of the knee. Am J Acupunct. 1999;27(3-4):133-40.
citation: Brandt KD. The importance of nonpharmacologic approaches in management of osteoarthritis. Am J Med. 1998 Jul 27;105(1B):39S-44S. doi: 10.1016/s0002-9343(98)00075-8.
citation: Hunt SA, Jazrawi LM, Sherman OH. Arthroscopic management of osteoarthritis of the knee. J Am Acad Orthop Surg. 2002 Sep-Oct;10(5):356-63. doi: 10.5435/00124635-200209000-00007.
citation: Taylor P, Hallett M, Flaherty L. Treatment of osteoarthritis of the knee with transcutaneous electrical nerve stimulation. Pain. 1981 Oct;11(2):233-240. doi: 10.1016/0304-3959(81)90008-7.
citation: Drosos GI, Stavropoulos NI, Katsis A, Kesidis K, Kazakos K, Verettas DA. Post-operative pain after knee arthroscopy and related factors. Open Orthop J. 2008 Jun 13;2:110-4. doi: 10.2174/1874325000802010110.
citation: Sinatra RS, Torres J, Bustos AM. Pain management after major orthopaedic surgery: current strategies and new concepts. J Am Acad Orthop Surg. 2002 Mar-Apr;10(2):117-29. doi: 10.5435/00124635-200203000-00007.
citation: Phillips WJ, Currier BL. Analgesic pharmacology: II. Specific analgesics. J Am Acad Orthop Surg. 2004 Jul-Aug;12(4):221-33. doi: 10.5435/00124635-200407000-00003.
citation: Phillips WJ, Currier BL. Analgesic pharmacology: I. Neurophysiology. J Am Acad Orthop Surg. 2004 Jul-Aug;12(4):213-20. doi: 10.5435/00124635-200407000-00002.
citation: Suzuki M, Yamada S, Inamura A, Omori Y, Kirimoto H, Sugimura S, Miyamoto M. Reliability and validity of measurements of knee extension strength obtained from nursing home residents with dementia. Am J Phys Med Rehabil. 2009 Nov;88(11):924-33. doi: 10.1097/PHM.0b013e3181ae1003.
citation: Mahony K, Hunt A, Daley D, Sims S, Adams R. Inter-tester reliability and precision of manual muscle testing and hand-held dynamometry in lower limb muscles of children with spina bifida. Phys Occup Ther Pediatr. 2009;29(1):44-59. doi: 10.1080/01942630802574858.
citation: Katz-Leurer M, Rottem H, Meyer S. Hand-held dynamometry in children with traumatic brain injury: within-session reliability. Pediatr Phys Ther. 2008 Fall;20(3):259-63. doi: 10.1097/PEP.0b013e3181824782.
citation: Bell DR, Padua DA, Clark MA. Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement. Arch Phys Med Rehabil. 2008 Jul;89(7):1323-8. doi: 10.1016/j.apmr.2007.11.048.
citation: Lu TW, Hsu HC, Chang LY, Chen HL. Enhancing the examiner's resisting force improves the reliability of manual muscle strength measurements: comparison of a new device with hand-held dynamometry. J Rehabil Med. 2007 Nov;39(9):679-84. doi: 10.2340/16501977-0107.
citation: Crompton J, Galea MP, Phillips B. Hand-held dynamometry for muscle strength measurement in children with cerebral palsy. Dev Med Child Neurol. 2007 Feb;49(2):106-11. doi: 10.1111/j.1469-8749.2007.00106.x.
citation: O'Shea SD, Taylor NF, Paratz JD. Measuring muscle strength for people with chronic obstructive pulmonary disease: retest reliability of hand-held dynamometry. Arch Phys Med Rehabil. 2007 Jan;88(1):32-6. doi: 10.1016/j.apmr.2006.10.002.
citation: Bohannon RW. Hand-held dynamometry: adoption 1900-2005. Percept Mot Skills. 2006 Aug;103(1):3-4. doi: 10.2466/pms.103.1.3-4.
citation: Li RC, Jasiewicz JM, Middleton J, Condie P, Barriskill A, Hebnes H, Purcell B. The development, validity, and reliability of a manual muscle testing device with integrated limb position sensors. Arch Phys Med Rehabil. 2006 Mar;87(3):411-7. doi: 10.1016/j.apmr.2005.11.011.
citation: Roy MA, Doherty TJ. Reliability of hand-held dynamometry in assessment of knee extensor strength after hip fracture. Am J Phys Med Rehabil. 2004 Nov;83(11):813-8. doi: 10.1097/01.phm.0000143405.17932.78.
citation: Piao C, Yoshimoto N, Shitama H, Makino K, Wada F, Hachisuka K. Validity and reliability of the measurement of the quardriceps femoris muscle strength with a hand-held dynamometer on the affected side in hemiplegic patients. J UOEH. 2004 Mar 1;26(1):1-11. doi: 10.7888/juoeh.26.1.
citation: Taylor NF, Dodd KJ, Graham HK. Test-retest reliability of hand-held dynamometric strength testing in young people with cerebral palsy. Arch Phys Med Rehabil. 2004 Jan;85(1):77-80. doi: 10.1016/s0003-9993(03)00379-4.
citation: Wright RW. Knee injury outcomes measures. J Am Acad Orthop Surg. 2009 Jan;17(1):31-9. doi: 10.5435/00124635-200901000-00005.