Document Type : Review
Authors
1
Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of medicine, Hazrat Fatemeh Hospital, Iran University of Medical Science, Tehran, Iran
2
Resident of Physical Medicine and Rehabilitation, Iran University of Medical Science, Tehran, Iran
3
Professor of Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
4
Associate Professor of Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Shafa Yahyaeian Orthopedics Hospital, Iran University of Medical Sciences, Tehr
5
Department of Physical Medicine and Rehabilitation, School of medicine, Nueromusculoskeletal Research Center, Firozgar General Hospital, Iran University of Medical Science, Tehran, Iran
Abstract
Background: Transcutaneous electrical nerve stimulation (TENS) is a common conservative treatment for knee osteoarthritis. However, no study has examined its effects on alleviating symptoms.
Objectives: This meta-analysis evaluated the effects of TENS on knee osteoarthritis symptoms.
Methods: Two investigators searched Pubmed, Embase, Scopus, Web of Knowledge, and the Cochrane database. They extracted the data and assessed them with the Cochrane risk-of-bias tool. Standardized mean difference (SMD) was analyzed by RevMan 5.4.1 with a 95% confidence interval. Subgroup analyses were based on control group, follow-up, TENS type, electrode location, number of sessions, combining TENS with exercise, sample size, and publication year.
Results: A total of 32 articles were included in the qualitative review, and 23 were included in the meta-analysis. TENS was more effective in reducing pain compared to sham TENS (I2: 76%; P<0.0001) and was as effective as an active intervention (I2: 70%; P=0.71). Active intervention improved function immediately (I2: 0%; P=0.04), compared to TENS. TENS significantly increased the active knee range of motion compared to sham TENS immediately (I2: 0%; P=0.002).
Conclusion: TENS reduces pain and increases active range of motion compared to sham TENS, but it does not have a significant effect on joint function and stiffness. TENS has similar effectiveness to active interventions in reducing pain. The duration of follow-up, the location of the TENS electrode, and combining TENS with other routine treatments can change the pain reduction rate.
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