TENS Effectiveness and Knee Osteoarthritis in Humans

NCT ID: NCT01354054

Last Updated: 2011-05-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-11-30

Study Completion Date

2009-06-30

Brief Summary

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TENS is a non pharmacological intervention to control pain. Both high (\>50 Hz) and low (\<10 Hz) frequency TENS are used in the clinic and it is thought that each type works through different mechanisms (see for review Sluka and Walsh, 2003). Hyperalgesia, an increased response to a noxious stimuli, is one component of pain and occurs both at the site of injury, primary hyperalgesia, and outside the site of injury, secondary hyperalgesia. Recent studies in animals with arthritis of the knee show that low and high frequency TENS differentially modulate primary and secondary hyperalgesia.

Therefore the investigators hypothesize that TENS will reduce hyperalgesia and pain with movement resulting in increased function.

Detailed Description

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The following specific aims will address this hypothesis:

Specific Aim 1 will compare the effect of high frequency TENS, low frequency TENS, and placebo TENS in patients with osteoarthritis on a variety of outcome measures: primary and secondary hyperalgesia, subjective pain scores, and function.

Specific Aim 2 will determine the relationships among these multiple pain measures in people with osteoarthritis, and compare to age matched controls.

Specific Aim 3 will determine the genetic variability as it relates to osteoarthritis pain and response to TENS treatment

Specific Aim 4 will determine how body composition (BMI, fat mass, percent fat, lean mass, and bone mass) impacts the effectiveness of TENS

One of the long-term goals of the investigators is to determine the clinical effectiveness of non-pharmacological treatments for pain, like TENS. These studies will begin to address this issue by examining effects of TENS on a variety of outcome measures in patients with a specific controlled condition (i.e., knee osteoarthritis). This research is innovative because it will be the first to systematically examine the effects of TENS on a variety of physiological parameters (primary and secondary hyperalgesia) and clinical outcome measures (resting pain, movement-evoked pain, function) in a common, painful and limiting condition that is frequently seen in physical therapy clinics. These studies will further allow us to translate basic science experiments previously performed in animal models of arthritis to the clinic. This information is expected to assist the clinician in the treatment choice for a particular patient and guide future clinical research.

Conditions

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Knee Osteoarthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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High frrequency TENS

100 Hz TENS, 100 usec

Group Type EXPERIMENTAL

High Frequency TENS

Intervention Type PROCEDURE

100 usec, 100 Hz, pulse amplitude motor - 10%, 30-40 minutes

Low frequency TENS

4 Hz, 100 usec TENS

Group Type EXPERIMENTAL

Low frequency TENS

Intervention Type PROCEDURE

100 usec, 4 Hz, pulse amplitude motor - 10%, 30-40 minutes

Placebo TENS

100 Hz, 100 usec, set at motor minus 10% then ramps to off in 45 sec, 40 minutes

Group Type EXPERIMENTAL

Placebo TENS

Intervention Type PROCEDURE

100 usec, 100 Hz, motor - 10%, pulse amplitude adjusted and maintained for 30 seconds then ramping down to zero in 15 seconds

Control

Age matched controls, no intervention

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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High Frequency TENS

100 usec, 100 Hz, pulse amplitude motor - 10%, 30-40 minutes

Intervention Type PROCEDURE

Low frequency TENS

100 usec, 4 Hz, pulse amplitude motor - 10%, 30-40 minutes

Intervention Type PROCEDURE

Placebo TENS

100 usec, 100 Hz, motor - 10%, pulse amplitude adjusted and maintained for 30 seconds then ramping down to zero in 15 seconds

Intervention Type PROCEDURE

Other Intervention Names

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Electrical stimulation Electrical stimulation Placebo electrical stimulation

Eligibility Criteria

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Inclusion Criteria

* diagnosis of medial compartment knee osteoarthritis
* 18 and 60 years of age
* being able to ambulate to the mail box and back
* stable medication schedule over the last three weeks
* pain rating \> 3 on a 0-10 scale when verbally asked to rate knee pain in the weight bearing position
* normal L1-S2 dermatomal screen and normal great toe and thumb proprioception.

Exclusion Criteria

* Knee surgery in the last six months
* Knee injection in the last four weeks
* serious medical condition, uncontrolled diabetes mellitus, hypertension
* dementia or cognitive impairment
* permanent lower extremity sensory
* prior TENS use
Minimum Eligible Age

30 Years

Maximum Eligible Age

95 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Iowa

OTHER

Sponsor Role lead

Responsible Party

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University of Iowa

Principal Investigators

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Barbarb A Rakel, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa College of Nursing

Kathleen A Sluka, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa Physical Therapy and Rehabilitation Science Graduate Program

Locations

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University of Iowa

Iowa City, Iowa, United States

Site Status

Department of Physical Therapy Federal university of Sergipe

Aracaju, , Brazil

Site Status

Health and Rehabilitation Science Research Institute, University of Ulster , UK

Newtownabbey, Northern Ireland, United Kingdom

Site Status

Countries

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United States Brazil United Kingdom

References

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Sluka KA, Walsh D. Transcutaneous electrical nerve stimulation: basic science mechanisms and clinical effectiveness. J Pain. 2003 Apr;4(3):109-21. doi: 10.1054/jpai.2003.434.

Reference Type BACKGROUND
PMID: 14622708 (View on PubMed)

Vance CG, Rakel BA, Blodgett NP, DeSantana JM, Amendola A, Zimmerman MB, Walsh DM, Sluka KA. Effects of transcutaneous electrical nerve stimulation on pain, pain sensitivity, and function in people with knee osteoarthritis: a randomized controlled trial. Phys Ther. 2012 Jul;92(7):898-910. doi: 10.2522/ptj.20110183. Epub 2012 Mar 30.

Reference Type DERIVED
PMID: 22466027 (View on PubMed)

Other Identifiers

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TENS/tops/sluka/rakel

Identifier Type: -

Identifier Source: org_study_id

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