Methodological quality in randomised controlled trials of transcutaneous electric nerve stimulation for pain: Low fidelity may explain negative findings

@article{Bennett2011MethodologicalQI,
  title={Methodological quality in randomised controlled trials of transcutaneous electric nerve stimulation for pain: Low fidelity may explain negative findings},
  author={Michael I. Bennett and Nicola Hughes and Mark I. Johnson},
  journal={PAIN},
  year={2011},
  volume={152},
  pages={1226-1232}
}

Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study)

There was moderate-certainty evidence that pain intensity is lower during or immediately after TENS compared with placebo and without serious adverse events.

The clinical efficacy of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain: a protocol for a meta-analysis of randomised controlled trials (RCTs)

This systematic review with meta-analysis will identify all randomised controlled trials (RCTs) on the use of TENS in adults for any type of pain including acute pain, chronic pain and cancer-related pain from inception to the present day.

Resolving Long-Standing Uncertainty about the Clinical Efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) to Relieve Pain: A Comprehensive Review of Factors Influencing Outcome

It is argued that patients will continue to use TENS irrespective of the views of clinicians, policy makers, funders or guideline panel recommendations, because TENS generates a pleasant sensory experience that is similar to easing pain using warming and cooling techniques; and technological developments such as smart wearable TENS devices will improve usability in the future.

Foundational Research Could Improve Future Transcutaneous Electrical Nerve Stimulation Evaluations

It is suggested that research is required to develop consensus about the content and delivery of training in TENS use for patients who live with pain, informed by the experience of patients, clinicians, and researchers.

Transcutaneous electrical nerve stimulation for acute pain.

There was a high risk of bias associated with inadequate sample sizes in treatment arms and unsuccessful blinding of treatment interventions, and the analgesic effectiveness of TENS, as a sole treatment, for acute pain in adults was tentative.

Transcutaneous electrical nerve stimulation for acute pain (Review)

This Cochrane Review update includes seven new trials, in addition to the 12 trials reviewed in the first update in 2011, and provides tentative evidence that TENS reduces pain intensity over and above that seen with placebo.

Transcutaneous electrical nerve stimulation for acute pain.

To assess the analgesic effectiveness of TENS for acute pain in adults to see if it had any clear analgesic effect in its own right, 1479 studies were searched and 132 were identified as relevant.

Transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults: an extended analysis of excluded studies from a Cochrane systematic review

Low quality evidence suggests TENS is safe and acceptable to patients for the treatment of phantom limb pain and stump pain, and an adequately powered randomized control trial is needed to establish efficacy.

Characterising the Features of 381 Clinical Studies Evaluating Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Relief: A Secondary Analysis of the Meta-TENS Study to Improve Future Research

Clinical studies on TENS are dominated by small parallel group evaluations of high frequency TENS that are often contaminated by concurrent treatment(s) and study reports tended focus on physiological and clinical implications rather than the veracity of methodology and findings.
...

References

SHOWING 1-10 OF 76 REFERENCES

Does transcutaneous electrical nerve stimulation (TENS) produce 'dose-responses'? A review of systematic reviews on chronic pain

Recommendations are made for future systematic reviews and randomised controlled trials regarding the clinical efficacy of transcutaneous electrical nerve stimulation in reducing pain in patients with chronic pain conditions, including the need for more comprehensive and rigorous tools in assessing substantive trials within systematic reviews.

Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain.

There was conflicting evidence about whether TENS was beneficial in reducing back pain intensity and consistent evidence in two trials that it did not improve back-specific functional status, and the evidence does not support the use of TENS in the routine management of chronic LBP.

Transcutaneous electrical nerve stimulation for acute pain.

To assess the analgesic effectiveness of TENS for acute pain in adults to see if it had any clear analgesic effect in its own right, 1479 studies were searched and 132 were identified as relevant.

Outcome of transcutaneous electrical nerve stimulation in chronic pain: short-term results of a double-blind, randomised, placebo-controlled trial

Only for patients satisfied with treatment results pain intensity gradually decrease equally both for TENS and sham TENS with repeated treatment application, and no differences in pain intensity were found for patients treated with TENS orSham TENS.

Feasibility study of Transcutaneous Electrical Nerve Stimulation (TENS) for cancer bone pain.

Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.

This updated systematic review of the effectiveness of Transcutaneous Electric Nerve Stimulation in cancer-related pain in adults suggested that TENS may improve bone pain on movement in a cancer population.

Effects of Intensity of Transcutaneous Electrical Nerve Stimulation (TENS) on Pressure Pain Threshold and Blood Pressure in Healthy Humans: A Randomized, Double-blind, Placebo-controlled Trial

These results affirm that high levels of intensity are of fundamental importance in effective TENS dosage, and also applies for low frequency, segmental stimulation.
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