ORIJINAL ARAŞTIRMA
Transkutanöz Elektrik Sinir Stimülasyonu ve İnterferansiyel Akımın Kombine Tedavisinin Kronik Bel Ağrısına Etkisi: Randomize, Çift Kör, Sham Kontrollü Çalışma
The Effectiveness of Combined Transcutaneous Electrical Nerve Stimulation and Interferential Current Therapy on Chronic Low Back Pain: A Randomized, Double-Blind, Sham-Controlled Study
Received Date : 17 Sep 2019
Accepted Date : 09 Dec 2019
Available Online : 19 Dec 2019
Sibel KİBARa, Hatice Ecem KONAKa, Saime AYa, Beyza DOĞANAY ERDOĞANc, Deniz EVCİKb
aUfuk University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara, TURKEY
bAnkara University Haymana Vocational Faculty, Department of Physical Therapy and Rehabilitation, Ankara, TURKEY
cAnkara University Graduate Faculty of Health Sciences, Department of Statistics, Ankara, TURKEY
Doi: 10.31609/jpmrs.2019-71464 - Makale Dili: EN
J PMR Sci. 2020;23(1):32-40
ÖZET
Amaç: Transkütanöz elektriksel sinir stimülasyonu (TENS) ve interferansiyel
akım (IF) ile ilgili birçok elektroterapi çalışmalar bulunmaktadır,
fakat bunların hiçbiri sinerjistik etkilerini incelememiştir. Bu
araştırmada, TENS ve IF'nin kronik bel ağrısını azaltmadaki etkinliğini değerlendirmek
amaçlandı. Gereç ve Yöntemler: Bu çift kör, plasebo kontrollü
çalışmada toplam 123 hasta bilgisayar yöntemi kullanılarak dört gruba
ayrıldı. Grup 1 TENS, Grup 2 IF, Grup 3 kombine TENS ve IFT ve Grup 4
sham olarak haftada beş kez 3 hafta boyunca tedavi aldılar. Tüm katılımcılar
ayrıca sıcak paket tedavisi aldılar. Lomber hareket aralığı (EHA) inkilinometre
ve modifiye Schober testi ile değerlendirildi. Aktivite sırasındaki
ağrı ise hasta ve doktorun global görsel analog skalası (VAS) birlikte kullanılarak
değerlendirildi. Fonksiyonel kapasiteyi belirlemek için Rolland-
Morris Engellilik Anketi (RMEA) uygulandı.Bulgular: Grup 1, 2 ve 3
anlamlı düzelme gösterirken, Grup 4’te hiçbir düzelme gözlenmedi
(p˂0,001). Grup 3 için değerlendirilen RMEA, hasta ve doktor global ağrı
skorları Grup 2'den daha üstündü (p˂0,001). Sonuç: Kombine TENS ve IF
tedavisi, kronik bel ağrılı hastalarda fonksiyonel seviyeyi arttırmada ve aktivite
sırasındaki ağrıyı azaltmada IF'den daha etkiliydi, ancak sadece TENS
tedavisinden daha üstün bulunmadı. Bu çalışma bize, farklı uygulama sıklıkları
ve modları ile uygulanacak olan kombine TENS / IF tedavisi veya
diğer kombine tedavilerle ilgili gelecekteki araştırmalara bir öngörü sunabilmektedir.
Anahtar Kelimeler: Transkutanöz elektrik sinir stimulasyonu (TENS); interferansiyel akım; bel ağrısı
ABSTRACT
Objective: There are some electrotherapy studies regarding
transcutaneous electrical nerve stimulation (TENS) and interferential current
therapy (IFT), but none have examined their synergistic effects. This
investigation was performed to assess the effectiveness of TENS/IFT in relieving
chronic low back pain (LBP). Material and Methods: In this double-blind,
placebo-controlled study, a total of 123 patients were divided into four groups
using a computer method. Group 1 received TENS, Group 2 IFT, Group 3 combined
TENS/IFT, and Group 4 sham TENS/IFT five times a week for 3 weeks.
All participants also received hotpack therapy. Lumbar range of motion (ROM)
was assessed via an inclinometer and the modified Schober test, and pain during
activity was evaluated using a Visual Analog Scale (VAS) along with patient
and physician global assessments. The Rolland-Morris Disability Questionnaire
(RMDQ) was administered to determine functional capacity. Results: Groups 1,
2, and 3 showed significant improvement, but Group 4 showed none (p˂0.001).
Group 3 was superior to Group 2 with regard to the RMDQ, VAS, and global assessments
(p˂0.001). Conclusion: Combined TENS/IFT was more effective
than IFT in improving functional level and decreasing pain during activity in patients
with chronic LBP, however it was not superior to TENS therapy alone.
The findings of this study offer insight that can be applied to future investigations
concerning combined TENS/IFT therapy with different application frequencies
and modes or other combined therapies. We observed marked improvement in
function and pain during activity with the combination of both therapies; however,
improvement was not significantly greater to that achieved with TENS therapy
alone. Combined therapy was also superior to the other treatments with
respect to doctor and patient global assessments, but this was not significantly
different compared with that in the TENS and IFT alone groups. No improvements
were found in the control (sham) group.
Keywords: Transcutaneous electrical nerve stimulation (TENS); interferential current; low back pain
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