Date of Award

2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Abstract

Effect of High Frequency and Low Frequency TENS on Pain Threshold and Pain Tolerance in Patients with Knee Osteoarthritis Vallandingham RA, Valencia C, Demchak TJ, Idlewine T, Indiana State University, Terre Haute, Indiana Transcutaneous Electrical Nerve Stimulation (TENS) is a portable modality that is currently used to reduce the pain from orthopedic injuries and other conditions. There is limited available literature that compares high-frequency TENS (HF-TENS) and low-frequency TENS (LF-TENS) to determine hypoalgesic effects. The aim of this study was to investigate whether HF-TENS and LF-TENS had a differential effect on pain threshold and pain tolerance in patients with knee osteoarthritis and healthy controls. This analysis included 19 subjects (mean age=50.79, 13 healthy controls and 6 patients with knee osteoarthritis). Demographic information and validated questionnaires were collected at the beginning of each session. Heat pain threshold and heat pain tolerance were assessed with the thermal stimulus in both forearms. Subjects were randomly assigned to either HF-TENS (100 Hz) or LF-TENS (4 Hz) group; pulse duration was kept at 100 microseconds in all participants. Stimulation was delivered for 15 minutes for each subject and then reassessment started with the TENS still active. Descriptive statistics (mean, standard deviation) was calculated for all variables. The distribution of variables was tested for normality by visual examination and with Kolmogorov-Smirnof test before used in analysis. Repeated measure ANOVA models were used to assess group differences (HF-TENS and LF-TENS) on pain tolerance and pain threshold over time as well as change differences within cohorts (clinical and healthy). This analysis showed that the main effect of time for pain tolerance was significant [F(1,17)= 8.82, p= 0.01; n 2 =0.34], where the mean of tolerance temperature significantly increased between pre TENS application (mean= 48.78, SD= 1.68 ) and post TENS application (mean= 66.92; SD= 26.45). No statistical significance was found between pain threshold with HF-TENS or pain threshold and pain tolerance with LF-TENS (p>0.05). Transcutaneous electrical nerve stimulation should be considered for individuals who need short term instant relief of pain. The results of this study showed that, there was a statistical difference in pain tolerance between pre vs. post TENS application. TENS may be an effective modality to use in the clinic to help relieve pain. Further analyses with a larger sample size are needed to assess the true difference in pain threshold and pain tolerance between pre and post TENS application.

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