Acupuncture-like Transcutaneous Electrical Nerve Stimulation for Pain, Function, and Biochemical Inflammation After Total Knee Arthroplasty

BeomRyong Kim, MSc, PT; Everett Lohman, DSc; JongEun Yim, DSc

Context • Clinical studies suggest that AL-TENS, acupuncture-like transcutaneous electrical nerve stimulation (TENS), is effective for treating many types of pain and physical dysfunction. To date, only a few studies have compared the TENS and AL-TENS forms of stimulation, and no studies have compared the efficacy of conventional TENS and AL-TENS in patients who have undergone total knee arthroplasty (TKA). Objectives • The study intended to determine (1) the efficacy of conventional TENS and AL-TENS for TKA patients and (2) which outcomes—pain at rest, movement-evoked pain, and physical function—were most likely to be affected by conventional TENS compared with AL-TENS for people with pain, to inform the design of future studies. Design • The research team designed a single-blind, randomized clinical trial with randomized treatment allocation. Setting • The study took place at the Orthopedic and Rehabilitation Hospital of Jeonju (Jeonju, South Korea). Participants • Participants were 30 patients at the hospital who had undergone TKA. Intervention • Participants were randomly assigned to 1 of 2 groups, TENS or AL-TENS, and received the relevant intervention at selected points for knee pain. Each group received treatment for 30 min per visit, 5 times per wk, for 2 wk during the study. Outcome Measures • Outcome measures were pain intensity, measured with a visual analogue scale; knee functional mobility, measured with the Western Ontario and McMaster Universities Osteoarthritis Index and with the Timed Up & Go Test; and inflammation, measured by the C-reactive protein level. Data were collected at baseline and postintervention. Results • Changes in pain, knee function, knee mobility, and inflammation between baseline and postintervention were statistically significant for both groups (P < .05). Changes in pain, stiffness, and inflammation between baseline and postintervention were significantly greater for the AL-TENS group compared with TENS group (P < .05). Conclusions • AL-TENS was more effective than TENS with respect to pain, stiffness, and inflammation relief for patients following TKA.

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