MODERN ASPECTS OF TREATMENT WITH TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION

Abstract

With the development of the most modern equipment for different physical modalities in the application
of physical medicine and rehabilitation, many new methods and approaches to protocols and complementarity in the
execution of the rehabilitation process have been advanced. It contributes to creating a concept of rehabilitation
course, with non-invasive modalities from the field of physical medicine. Including kinesitherapy, the goal of
achieving full functionality is much more realistic due to the shorter time frame and reduced feeling of pain. The
parallel course of use of such modalities and kinesitherapy methods and techniques enables efficiency, economy and
a greater sense of comfort for the patients themselves. With the patenting of transcutaneous electrical nerve
stimulation (TENS) in 1974, research and development of high-frequency, low-frequency, acupuncture, and
conventional transcutaneous electrical nerve stimulation began. The type of modulation depends on the
corresponding parameters in terms of amplitude, pulse duration and their frequency. In general, the low frequency of
the transcutaneouse electrical nerve stimulation is considered to be 1-20 Hz, and the high frequency is greater than
70 Hz. The current strength is usually 10-20 mA. The pulse duration is 50-400 μs. Low-frequency modulation
stimulates primarily motor nerve fibers, and high-frequency acts through afferent nerve endings. The aim of the
research is to study the effects of this modality of the physical therapy and the implications over the rehabilitation
process. Materials and methods: This research study was carried out in a period of 3 working weeks, or 15 working
days, as long as the rehabilitation lasts. The statistical sample consists of three groups. One group is 15 patients who
are treated for predominantly arthritic degenerative pathologies in the acute and chronic phase, with localization of
upper and lower extremities; and patients who are in the acute and chronic phase of periarthritis, contusions and
joint dislocations, also on the upper and lower extremities. The other group is 15 patients with degenerative chronic
and acute pathological conditions of the musculoskeletal system of the spine. The third group is 15 patients in whom
transcutaneous electrical nerve stimulation is not included in the rehabilitation plan. Results: According to the
analysis and processing of the results of the active range of motion (AROM) goniometry of the joint structures of the
upper and lower limbs and the spine and the pain scale at the beginning and after the fifteenth day of the
rehabilitation procedures, results were obtained that after the statistical processing, show a significant improvement
if the transcutaneous electrical nerve stimulation is included. Conclusion: The non-invasiveness of this physical
procedure together with the specific application of its modulations according to the pathological condition allow for
a quick and efficient rehabilitation of patients.The reduced feeling of pain allows a greater will to perform the
exercises included in the overall rehabilitation, and thus a greater range of movements in the musculoskeletal
system.