Knowledge, Attitudes, and Practices on New Treatment Modalities for Temporomandibular Dysfunctions and Orofacial Pain / Conocimientos, Actitudes y Prácticas sobre Nuevas Nodalidades de Tratamiento de las Disfunciones Tempomanibulares y el Dolor Orofacial

The present study proposed to describe, through a literature review, the use of new therapeutic management which allows for offering a better quality of life to individuals affected by these pathologies. A bibliographic search was conducted in the main health databases PUBMED (www.pubmed.gov) and Scholar Google (www.scholar.google.com.br), in which studies published from 1987 to 2023 were collected. In the first stage, the list of retrieved articles was examined by reading the titles and abstracts. In the second stage, the studies were selected by reading the full contents. Two authors (JDMM and DAQ) performed stages 1 and 2. Experimental, clinical, case-control, randomized controlled, and laboratory cohort studies, case reports, systematic reviews, and literature reviews, which were developed in living individuals, were included. Therefore, articles that did not deal with the subject in question, letters to the editor, opinion articles, duplicated literature in databases, and literature that did not address the variables under study, we re excluded. Contemporary dentistry uses alternative treatments capable of improving the patient's condition since a cure is not always possible. Therefore, the possibility of improving the quality of life becomes an important point to be reached. Evidence-based healthcare has made great advances in recent decades, especially in the areas of orofacial pain, TMD, and occlusion, especially related to orthodontic, prosthetic, and restorative care.

En el presente estudio se propuso describir, a través de una revisión bibliográfica, el uso de nuevos manejos terapéuticos que permitan brindar una mejor calidad de vida a los individuos afectados por estas patologías. Se realizó una búsqueda bibliográfica en las principales bases de datos de salud PUBMED (www.pubmed.gov) y Scholar Google (www.scholar.google.com.br), en las que se recopilaron estudios publicados entre 1987 y 2023. En la primera etapa, se examinó la lista de artículos recuperados mediante la lectura de los títulos y resúmenes. En la segunda etapa, los estudios fueron seleccionados mediante la lectura del contenido completo. Dos autores (JDMM y DAQ) realizaron las etapas 1 y 2. Se incluyeron estudios de cohortes experimentales, clínicos, de casos y controles, controlados aleatorios y de laboratorio, informes de casos, revisiones sistemáticas y revisiones de la literatura, que se desarrollaron en individuos vivos. Por lo tanto, se excluyeron artículos que no trataran el tema en cuestión, cartas al editor, artículos de opinión, literatura duplicada en bases de datos y literatura que no abordara las variables en estudio. La odontología contemporánea utiliza tratamientos alternativos capaces de mejorar el estado del paciente, ya que no siempre es posible la curación. Por lo tanto, la posibilidad de mejorar la calidad de vida se convierte en un objetivo importante. La atención médica basada en la evidencia ha logrado grandes avances en las últimas décadas, especialmente en las áreas de dolor orofacial, TMD y oclusión, especialmente en relación con la atención de ortodoncia, prótesis y restauración.

Transcutaneous electrical acupoint stimulation combined with electroacupuncture for rapid recovery after abdominal surgery: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with electroacupuncture (EA) on rehabilitation after abdominal surgery.@*METHODS@#A total of 320 patients undergoing abdominal surgery were randomly divided into a combination group (80 cases), a TEAS group (80 cases, 1 case discontinued), an EA group (80 cases, 1 case discontinued) and a control group (80 cases, 1 case discontinued). The patients in the control group received enhance recovery after surgery (ERAS) standardized perioperative management. On the basis of the treatment in the control group, the TEAS group was treated with TEAS at Liangmen (ST 21) and Daheng (SP 15); the EA group was treated with EA at Neiguan (PC 6), Hegu (LI 4), Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39); the combination group was treated with TEAS combined with EA, with continuous wave, 2-5 Hz in frequency, and the intensity was tolerable to the patients, 30 min each time, once a day, from the first day after surgery, until the anus resumed spontaneous defecation and the oral intake of solid food was tolerated. The gastrointestinal-2 (GI-2) time, first exhaust time, first defecation time, first tolerance of oral intake of solid food time, time of first get out of bed and hospital stay were observed in all the groups; the pain visual analogue scale (VAS) score and incidence rates of nausea and vomiting 1, 2, 3 days after surgery were compared in all the groups; after treatment, the acceptability of each treatment was evaluated by patients in each group.@*RESULTS@#Compared with the control group, the GI-2 time, first exhaust time, first defecation time, first tolerance of oral intake of solid food time were shortened (P<0.05), the VAS scores 2, 3 days after surgery were decreased (P<0.05) in the combination group, the TEAS group and the EA group; those in the combination group were shorter and lower than the TEAS group and the EA group (P<0.05). Compared with the control group, the time of hospital stay in the combination group, the TEAS group and the EA group were shortened (P<0.05), and that in the combination group was shorter than the TEAS group (P<0.05).@*CONCLUSION@#TEAS combined with EA can accelerate the recovery of gastrointestinal function in patients after abdominal surgery, relieve postoperative pain, and shorten hospital stay.

Effect of transcutaneous auricular vagus nerve stimulation on functional connectivity in the related brain regions of patients with depression based on the resting-state fMRI / 中国针灸

OBJECTIVE@#To explore the brain effect mechanism and the correlation between brain functional imaging and cognitive function in treatment of depressive disorder (DD) with transcutaneous auricular vagus nerve stimulation (taVNS) based on the resting-state functional magenetic reasonance imaging (rs-fMRI).@*METHODS@#Thirty-two DD patients were included in a depression group and 32 subjects of healthy condition were enrolled in a normal group. In the depression group, the taVNS was applied to bilateral Xin (CO15) and Shen (CO10), at disperse-dense wave, 4 Hz/20 Hz in frequency and current intensity ≤20 mA depending on patient's tolerance, 30 min each time, twice daily. The duration of treatment consisted of 8 weeks. The patients of two groups were undertaken rs-fMRI scanning. The scores of Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) and Wisconsin card sorting test (WCST) were observed in the normal group at baseline and the depression group before and after treatment separately. The differential brain regions were observed before and after treatment in the two groups and the value of degree centrality (DC) of fMRI was obtained. Their correlation was analyzed in terms of HAMD, HAMA and WCST scores.@*RESULTS@#The scores of HAMD and HAMA in the depression group were all higher than those in the normal group (P<0.05). After treatment, the scores of HAMD and HAMA were lower than those before treatment in the depression group; the scores of total responses, response errors and perseverative errors of WCST were all lower than those before treatment (P<0.05). The brain regions with significant differences included the left inferior temporal gyrus, the left cerebellar peduncles region 1, the left insula, the right putamen, the bilateral supplementary motor area and the right middle frontal gyrus. After treatment, the value of DC in left supplementary motor area was negatively correlated to HAMD and HAMA scores respectively (r=-0.324, P=0.012; r=-0.310, P=0.015); the value of DC in left cerebellar peduncles region 1 was negatively correlated to the total responses of WCST (r=-0.322, P=0.013), and the left insula was positively correlated to the total responses of WCST (r=0.271, P=0.036).@*CONCLUSION@#The taVNS can modulate the intensity of the functional activities of some brain regions so as to relieve depressive symptoms and improve cognitive function.

Research advances in neuromodulation techniques for blood glucose regulation and diabetes intervention / 生物医学工程学杂志

Diabetes and its complications that seriously threaten the health and life of human, has become a public health problem of global concern. Glycemic control remains a major focus in the treatment and management of patients with diabetes. The traditional lifestyle interventions, drug therapies, and surgeries have benefited many patients with diabetes. However, due to problems such as poor patient compliance, drug side effects, and limited surgical indications, there are still patients who fail to effectively control their blood glucose levels. With the development of bioelectronic medicine, neuromodulation techniques have shown great potential in the field of glycemic control and diabetes intervention with its unique advantages. This paper mainly reviewed the research advances and latest achievements of neuromodulation technologies such as peripheral nerve electrical stimulation, ultrasound neuromodulation, and optogenetics in blood glucose regulation and diabetes intervention, analyzed the existing problems and presented prospects for the future development trend to promote clinical research and application of neuromodulation technologies in the treatment of diabetes.

Estimulação elétrica nervosa transcutânea (tens) e ultrassom para os sintomas da síndrome do intestino irritável: um estudo de caso / Transcutaneous nervous electrical stimulation (tens) and ultrasound for irritable bowel syndrome symptoms: a case study / Estimulación nerviosa eléctrica transcutánea (tens) y ultrasonido para los síntomas del síndrome del intestino irritable: un estudio de casos

Introdução: O intestino é um órgão vital, entretanto, seu mau funcionamento pode gerar alguns distúrbios como por exemplo, "A síndrome do intestino irritável". O quadro desses pacientes são dores na barriga, inchaço abdominal e alteração na frequência das evacuações e na consistência das fezes. A fisioterapia tem apresentado meios que favorecem analgesia. Objetivo: Verificar os efeitos da Estimulação Elétrica Nervosa Transcutânea (TENS) e do Ultrassom (US) nos sintomas da síndrome do intestino irritável. Método: Foi utilizado o TENS na região abdominal, durante 15 minutos. O Ultrassom foi usado durante 3 minutos em cada região abdominal, somando 12 minutos ao total. O tratamento foi realizado durante um mês, com 9 sessões. Utilizou-se a Escala Visual Analógica (EVA) e o questionário Inflammatory Bowel Disease Questionnaire (IBDQ). Resultados: Nos sintomas intestinais obteve-se progresso de 5 pontos no questionário IBDQ e nos sintomas emocionais houve uma evolução de 9 pontos, sendo este, estatisticamente significante. Na escala EVA a média de escore diminui de 5,6 para 3,6 ao final da intervenção. Conclusão: A intervenção fisioterapêutica surtiu efeitos positivos e contribuiu para a diminuição da dor e os outros sintomas como: inchaço abdominal e diminuição na quantidade de evacuações e essa evolução auxiliou na qualidade de vida do voluntário.

Introduction: The intestine is a vital organ, however, due to its malfunction, some disorders appear, for example, "The irritable bowel syndrome", patients with this syndrome experience pain in the belly, abdominal swelling, changes in the frequency of bowel movements and stool consistency. Physiotherapy uses means that help to cause analgesia. Objective: To verify the effects of TENS and Ultrasound on the symptoms of the individual with irritable bowel syndrome, contributing to the quality of life. Method: TENS was used in the abdominal region in Burst mode with a frequency of 150Hz with amplitude until it caused a slight contraction, for 15 minutes. Ultrasound was used in continuous mode with a frequency of 1MHZ, with a dose of 0.5w / cm2, for 3 minutes in each abdominal region, adding 12 minutes to the total. The treatment was carried out for one month, with 9 sessions. The EVA scale and the IBDQ questionnaire were used. Results: In the intestinal symptoms there was an improvement of 5 points in the IBDQ questionnaire and in the emotional aspect there was an improvement of 9 points and in the emotional aspect it was statistically significant, passing through the Wilcoxon test, P (est.) = 0.031 P (exact) ) = 0.031. On the EVA scale, the mean score before the intervention was 5.6 and at the end 3.6. Conclusion: The physical therapy intervention had positive effects, helping to reduce pain and other symptoms such as:abdominal swelling, decrease in the amount of bowel movements and this improvement helped the individual's emotional state, however a study on the subject is still necessary.

Introducción: El intestino es un órgano vital, sin embargo, su mal funcionamiento puede generar algunos trastornos como el "síndrome del intestino irritable". Los síntomas de estos pacientes son dolor de estómago, hinchazón abdominal y alteración de la frecuencia de las deposiciones y de la consistencia de las heces. La fisioterapia ha presentado medios que favorecen la analgesia. Objetivo: Verificar los efectos de la Estimulación Nerviosa Eléctrica Transcutánea (TENS) y el Ultrasonido (US) en los síntomas del síndrome del intestino irritable. Método: Se utilizó TENS en la región abdominal durante 15 minutos. Los ultrasonidos se utilizaron durante 3 minutos en cada región abdominal, sumando 12 minutos en total. El tratamiento se llevó a cabo durante un mes, con 9 sesiones. Se utilizaron la Escala Visual Analógica (EVA) y el Cuestionario de Enfermedad Inflamatoria Intestinal (IBDQ). Resultados: En los síntomas intestinales hubo una progresión de 5 puntos en el cuestionario IBDQ y en los síntomas emocionales hubo una evolución de 9 puntos, siendo esto, estadísticamente significativo. En la escala VAS, la puntuación media disminuyó de 5,6 a 3,6 al final de la intervención. Conclusión: La intervención fisioterapéutica tuvo efectos positivos y contribuyó a la reducción del dolor y de otros síntomas como: hinchazón abdominal y disminución de la cantidad de deposiciones y esta evolución ayudó a la calidad de vida del voluntario.

O uso da estimulação transcraniana como tratamento na reabilitação motora de criança com paralisia cerebral - projeto de estudo de caso / El uso de la estimulación transcraneal como tratamiento en la rehabilitación motora de un niño con parálisis cerebral -un proyecto de estudio de caso / The use of transcranial stimulation as a treatment in the motor rehabilitation of a child with cerebral palsy -a case study projec

RESUMO A Paralisia Cerebral (PC) também denominada como encefalopatia crônica não-progressiva da infância é consequência de lesões não progressivas que aconteceram no cérebro imaturo no período pré, peri ou pós-natal, afetando o sistema nervoso central em fase de maturação estrutural e funcional. O presente trabalho trata-se de um estudo de caso com características de Pesquisa Experimental, Intervencional, onde foi realizado um protocolo de duas sessões semanais, com tempo de atendimento de 40 minutos, num total de 20 (vinte) sessões. O protocolo terapêutico consistiu de estimulação transcraniana e teve como objetivo geral investigar os efeitos da ETCC, associada à cinesioterapia e ativação dos neurônios espelhos, na reabilitação de uma criança com paralisia cerebral, sexo masculino, 54 meses de idade cronológica, grau moderado de hipotonia muscular em membros inferiores, movimentos voluntários com debilidade de força muscular; escoliose dorso-lombar e pontuação zero na Escala de Mobilidade Funcional e Asworth Modificada. O Sistema de Classificação da Função Motora Grossa (GMFCS) apresentou-se com classificação nível V, limitação na habilidade de manter as posturas anti-gravitacionais da cabeça e tronco e de controlar os movimentos de braços e pernas. Índice de Barthel Modificado com pontuação 11- classificação de dependência severa. A escala Denver II com prejuízos significativos nos domínios: pessoal-social, motor fino adaptativo, linguagem e motor grosso.

RESUMEN La parálisis cerebral (PC) también denominada como encefalopatía crónica no progresiva de la infancia es consecuencia de lesiones no progresivas que ocurrieron en el cerebro inmaduro en el periodo pre, peri o post-natal, afectando el sistema nervioso central en la fase de maduración estructural y funcional. El presente trabajo trata de un estudio de caso con características de investigación experimental, intervencional, donde fue realizado un protocolo de dos sesiones semanales de cuarenta minutos, con un total de veinte (20) sesiones. El protocolo terapéutico consistió en una estimulación transcraniana y tuvo como objetivo general, investigar los efectos de la ETCC, asociada a la cinesioterapia y activación de las neuronas espejo, en la rehabilitación de un niño con parálisis cerebral de 54 meses de edad cronológica, grado moderado de hipertonía muscular en miembros inferiores, movimientos voluntarios con debilidad de fuerza muscular; escoliosis dorsolumbar y puntuación cero en la escala de Movilidad Fun.

ABSTRACT Cerebral Palsy (CP) also known as chronic non-progressive encephalopathy of childhood is a consequence of non-progressive lesions that occurred in the immature brain in the pre, peri or postnatal period, affecting the central nervous system in a phase of structural maturation and functional. The present work is a case study with characteristics of Experimental, Interventional Research, where a protocol of two weekly sessions was carried out, with a service time of 40 minutes, in a total of 20 (twenty) sessions. The therapeutic protocol consisted of transcranial stimulation and aimed to investigate the effects of tDCS, associated with kinesiotherapy and activation of mirror neurons, in the rehabilitation of a 54-month-old male child with cerebral palsy, moderate degree of muscular hypotonia in the lower limbs, voluntary movements with weak muscular strength; dorsolumbar scoliosis and zero score on the Functional Mobility and Modified Asworth Scale. The Gross Motor Function Classification System (GMFCS) has a level V classification, limiting the ability to maintain antigravity postures of the head and trunk and to control arm and leg movements. Modified Barthel Index with score 11- severe dependency rating. The Denver II scale with significant impairments in the following domains: personal-social, adaptive fine motor, language and gross motor.

High frequency transcutaneous electrical stimulation in the immediate postoperative period of anterior cruciate ligament reconstruction: a randomized clinical trial / Estimulação elétrica transcutânea de alta frequência no pós operatório imediato de reconstrução do ligamento cruzado anterior: um ensaio clínico randomizado

INTRODUCTION: The anterior cruciate ligament (ACL) is an important structure for knee stability. Transcutaneous electrical nerve stimulation (TENS) is an electrical current applied for significant pain relief. OBJECTIVE: To evaluate the effects of high-frequency TENS on the immediate postoperative period of ACL reconstruction. METHODS: 46 patients in the postoperative period of ACL reconstruction were randomly assigned to a control group (CG=23) and a TENS group (TG=23). Knee range of motion (ROM), pain, muscle strength, and drug intake were assessed before surgery and 24 and 48 hours after surgery. The TENS intervention protocol started in the recovery room, shortly after surgery, and was maintained continuously for the first 48 hours after surgery. RESULTS: The TENS group (TG) significantly controlled the increased level of postoperative pain (p<0.05) and significantly increased flexion ROM (p<0.05). When compared to the Control group (CG), the TENS group had a lower intake of ketoprofen (48.27%), diazepam (256.98%), and dipyrone (121.21%), morphine (320.77%), and tramadol (437.46%). CONCLUSION: Continuous high-frequency TENS significantly reduced pain intensity and significantly improved ROM, muscle strength, and drug intake in the postoperative period of ACL reconstruction.

Acute whole-body electromyostimulation associated with dynamic exercises did not alter cardiac autonomic modulation and oxygen uptake in obese and eutrophic men

Abstract Aim: To contrast the acute effects of whole-body electromyostimulation (WB-EMS) with sham associated with dynamic exercises on cardiovascular, ventilatory, metabolic, and autonomic responses in men with obesity and controls. Methods: A randomized cross-over and double-blind trial with nine eutrophic (23.6 years; 23 ± 1.4 kg/m2) and ten men with obesity (26 ± 4 years; 38 ± 7 kg/m2), who were randomized to receive WB-EMS-Sham or Sham-WB-EMS with 30 min of rest between protocols. WB-EMS protocol (Miha Bodytec®) was applied at the motor level, frequency = 85 Hz, pulse duration = 350 μs, cycle on = 6′; cycle off = 4′. Sham group performed the same exercises with the electric current turned off. Throughout both protocols, subjects executed two dynamic exercises of 5 minutes each (step-up and step down associated with shoulder flexion, and lunge exercise associated with elbow flexion) in the same order. R-R intervals and breath-by-breath respiratory gases analysis were collected during the protocols. Heart rate variability (HRV) indexes were obtained using linear and nonlinear analysis. The level of statistical significance was set at p < 0.05. Results: Regarding both exercises, participants with obesity presented reduced oxygen uptake, higher ventilation, respiratory rate, blood pressure, and Borg scores (p < 0.05) when contrasted with controls, as expected. However, no significant differences were found for HRV indexes between groups (p > 0.05). In addition, WB-EMS did not increase oxygen uptake or altered autonomic modulation when contrasted with sham in both groups (p < 0.05). Conclusion: Obesity has a negative impact on symptoms and functional capacity. However, WB-EMS did not acutely enhance oxygen uptake or HRV during exercise in a population with obesity.

La electroestimulación neuromuscular como mecanismo complementario en el entrenamiento deportivo de predominancia anaeróbica / Neuromuscular electro-stimulation as a complementary mechanism in sports training of anaerobic predominance

Introducción: La electroestimulación neuromuscular puede dar un valor agregado a los programas de ejercicio físico de rehabilitación, siempre y cuando se contemplen aspectos como los objetivos propios de cada persona, la tolerancia a la intensidad y las necesidades de recuperación y descanso. Así mismo, puede ser un elemento interesante a agregar en la planificación deportiva con miras a mejorar la recuperación, así como en el aumento del rendimiento físico. Objetivo: El objetivo principal de la presente investigación fue determinar los efectos del ejercicio combinado de electroestimulación neuromuscular y ejercicios de alta intensidad y corta duración en hombres sanos y físicamente activos sobre el índice de fatiga. Metodología: 34 hombres sanos, físicamente activos y estudiantes de educación física (19,4 ± 2,60 años) fueron aleatorizados y organizados en cuatro grupos: G1, programa de electroestimulación neuromuscular; G2, entrenamiento de alta intensidad y corta duración: G3, ejercicio combinado de alta intensidad y corta duración y, electroestimulación neuromuscular; y G4, grupo control. Se aplicó un test de Wingate antes y después del periodo de entrenamiento. Resultados: En el grupo G3 se evidencian aumentos en el rendimiento anaeróbico con diferencias significativas en la potencia promedio relativa al peso (p=0,027), con un aumento de 7,36% y con una disminución de 12,2% en el índice de fatiga (p=0,048). En el grupo G4 se evidencian disminuciones en el rendimiento, evidenciado a través de las diferencias significativas en la potencia media (p=0,030), con una disminución en el rendimiento de 6,32% y una disminución en el rendimiento en la potencia media relativa al peso con diferencia significativa (p=0,010) de 3,92%. Conclusiones: Un programa combinado de electroestimulación neuromuscular y ejercicio intervalico de alta intensidad mejora el rendimiento anaeróbico en la potencia media y relativa al peso, evidenciado a través de un test de Wingate. Así mismo, disminuye el porcentaje de caída del rendimiento anaeróbico, mostrando mejores resultados frente a un entrenamiento de solo ejercicio intervalico de alta intensidad

Introduction: Neuromuscular electrostimulation can add value to rehabilitation physical exercise programs, as long as aspects such as the objectives of each person, tolerance to intensity, and the needs for recovery and rest are considered. Likewise, it can be an interesting element to add in sports planning with a view to improving recovery, as well as increasing physical performance. Objective: The main objective of this research was to determine the effects of combined neuromuscular electrostimulation exercise and high intensity and short duration exercises in healthy and physically active men on the fatigue index. Methodology: 34 healthy, physically active, and physical education male students (19.4 ± 2.60 years) were randomized and organized into four groups: G1, neuromuscular electrostimulation program; G2, high intensity and short duration training; G3, combined exercise of high intensity and short duration, and neuromuscular electrostimulation; and G4, control group, A Wingate test was applied before and after the training period. Results: In the G3 group, there are increases in anaerobic performance with significant differences in the average power relative to weight (p=0.027), with an increase of 7.36%, and a decrease of 12.2% in the fatigue index (p=0.048). In the G4 group there are decreases in performance, evidenced through the significant differences in the average power (p = 0.030), with a decrease in performance of 6.32% and a decrease in the performance in mean power relative to weight with a significant difference (p=0.010) of 3.92%. Conclusions: A combined program of neuromuscular electrostimulation and high-intensity interval exercise improves anaerobic performance in mean power and relative to weight, evidenced through a Wingate test. Likewise, it decreases the percentage of drop in anaerobic performance, showing better results in comparison to training with only high-intensity interval training

Sex and age differences in sensory threshold for transcutaneous electrical stimulation / Diferenças de sexo e idade no limiar sensitivo para estimulação elétrica transcutânea

Abstract Introduction Pain is one of the main symptoms prevalent in most pathologies. Transcutaneous Electrical Nerve Stimulation (TENS) represents not only a therapeutic measure, but also a mean to quantify the neurosensory and pain perception in patients with chronic pain. Objective To evaluate the relationship between sex and age with neurosensory thresholds (sensory threshold and tolerance threshold) in the application of therapeutic current in patients with chronic pain. Methods Forty-five patients with chronic pain (30 women and 15 men) aged between 24 and 87 years were selected. Each patient answered the Individual Questionnaire, McGill Pain Questionnaire (MPQ) and Beck Depression Inventory (BDI). Subsequently, the electric current was applied, through which the sensory and pain thresholds were analyzed, as well as the perception of activation of the neurosensory pathways for each individual. Data were analyzed using the SPSS 24.0 for Windows. Results There was no significant correlation (p > 0.05) between a possible depressive diagnosis and the perception of current by the sensory and pain thresholds. Regarding sex, there was a significant difference in sensory thresholds (p = 0.003) between men and women, while no statistical differences were observed between sexes for pain complaint and pain threshold (p > 0.05). For the correlational analysis, a significant correlation (p = 0.05) was identified between the variables BMI and pain tolerance threshold (r = 0.68) for females and age and sensory threshold (r = 0.65) for males. Conclusion The sex and age variables are important in the measurement of TENS parameters because they lead to significant differences in sensory and pain thresholds.

Resumo Introdução A dor é um dos principais sintomas preva-lentes na maioria das patologias. A estimulação elétrica ervosa transcutânea (TENS) se apresenta não apenas como medida terapêutica, como também um meio de quantificar a percepção neurossensitiva e dolorosa em pacientes com dores crônicas. Objetivo Avaliar a relação entre sexo e idade com os limiares neurossensitivos (limiar sensitivo e limiar de tolerância) na aplicação da corrente terapêutica TENS, em pacientes com dores crônicas. Métodos Foram selecionados 45 pacientes com dores crônicas (30 mulheres), com idade entre 24 e 87 anos. Cada paciente respondeu ao Questionário Individual, ao Questionário McGill de Dor (MPQ) e ao Inventário de Depressão de Beck (BDI). Posteriormente, aplicou-se a corrente elétrica TENS, pela qual foram analisados o limiar sensitivo e doloroso, bem como a percepção de acionamento das vias neurossensitivas para cada indivíduo. Os dados foram analisados pelo pacote SPSS 24.0 for Windows. Resultados Não houve correlação significativa (p > 0,05) entre possível diagnós-tico depressivo e a percepção da corrente pelos limiares de sensibilidade e dor. Em relação ao sexo, houve diferença significativa nos limiares sensitivos (p = 0,003) entre homens e mulheres. Já para a queixa de dor e limiar de dor, não foram observadas diferenças estatísticas entre os sexos (p > 0,05). Para as análises correlacionais, identificou-se correlação significativa (p = 0,05) entre as variáveis de índice de massa corporal e limiar de tolerância à dor (r = 0,68) para o sexo feminino e idade e limiar sensitivo (r = 0,65) paro o sexo masculino. Conclusão As diferenças identificadas entre os limiares de sensibilidade entre os sexos, onde as mulheres identificaram o estímulo elétrico significativamente primeiro que os homens, podem auxiliar nas doses de intensidade ou tipo de corrente terapêutica dos pacientes.

Scrambler Therapy no Controle da Dor Oncológica Crônica: Revisão Integrativa da Literatura / Scrambler Therapy for the Management of Chronic Oncologic Pain: Integrative Literature Review / Scrambler Therapy para el Manejo del Dolor Oncológico: Revisión Integradora de la Literatura

Introdução: A Scrambler therapy é uma nova e não invasiva modalidade de eletroanalgesia com a intenção de organizar a má adaptação dos sinais elétricos de nervos periféricos. Objetivo: Avaliar o benefício clínico da Scrambler therapy no controle de intensidade da dor em pacientes oncológicos. Método: Revisão da literatura conforme a metodologia Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) nas bases de dados eletrônicas LILACS, PEDro, SciELO e PubMed. Foram combinados aleatoriamente os descritores: "Scrambler therapy", "cancer", "pain", assim como o uso dos operadores booleanos AND e OR, em português, inglês e espanhol, sem limite de tempo. Resultados: Foram incluídos 15 estudos que, após avaliação crítica, demonstraram benefício clínico na redução na intensidade da dor. A Scrambler therapy é baseada em cinco neurônios artificiais controlados por um algoritmo otimizado para fornecer segurança e eficácia. O hardware recebe informações do algoritmo que cria as sequências de caracteres "não-dor" e as processa, transformando-as em fluxos potenciais de ação sintéticos (isto é, criados pela tecnologia) funcionalmente compatíveis com os potenciais endógenos. Conclusão: Os resultados positivos encontrados nos estudos preliminares com a Scrambler therapy indicam benefícios no controle da dor oncológica

Introduction: Scrambler therapy is a novel, non-invasive pain modifying technique that utilizes transcutaneous electrical stimulation of pain fibers with the intent of re-organizing maladaptive signaling pathways. Objective: Evaluate the benefits of Scrambler therapy to manage the intensity of pain in oncologic patients. Method: Integrative literature review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the electronic databases LILACS, PEDro, SciELO and PubMed. The descriptors "Scrambler therapy", "cancer", "pain" were randomly combined in addition to the Boolean operators AND, OR in Portuguese, English and Spanish with no time limitation. Results: For this review, 15 articles were found relevant. The Scrambler therapy machine is based on 5 artificial neurons controlled by an optimized algorithm to provide safety and effectiveness. The hardware receives information from the algorithm that creates the strings of "non-pain," and processes them by transforming into potential flows of synthetic action (i.e. created by technology) functionally compatible with endogenous flows. Pain scrambler therapy had a potential to decrease pain in cancer patients. Conclusion: The positive findings from preliminary studies with Scrambler therapy endorses the benefits this device provides to manage oncologic pain

Introducción: Scrambler therapy es una modalidad nueva y no invasiva de electroanalgesia con la intención de organizar la pobre adaptación de las señales eléctricas de los nervios periféricos. Objetivo: Estudiar si la Scrambler therapy influye en la intensidad del dolor en pacientes con cáncer. Método: Revisión integradora de la Literatura según la Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), mediante búsqueda realizada en las bases de datos LILACS, PEDro, SciELO y PubMed, utilizando las palabras clave "terapia Scrambler", "cáncer", "dolor", así como el uso de los operadores booleanos AND y OR, en portugués, inglés y español, sin límite de tiempo. Resultados: Se incluyeron 15 artículos relevantes para la revisión, que muestran una reducción en la intensidad del dolor. La Scrambler therapy se basa en cinco neuronas artificiales controladas por un algoritmo optimizado para proporcionar seguridad y eficacia. El hardware recibe información del algoritmo que crea las cadenas de "no dolor" y las procesa transformándolas en flujos de potenciales de acción sintéticos (es decir, creados por la tecnología) funcionalmente compatibles con los endógenos. Conclusión: Los resultados positivos encontrados en los estudios preliminares con la Scrambler therapy indican beneficios en el control del dolor por cáncer

Transcutaneous Electrical Stimulation, Interferential Current and Photobiomodulation May Lead to the Recurrence of Breast Cancer in Rats? / Estimulação Elétrica Transcutânea, Corrente Interferencial e Fotobiomodulação podem levar à Recorrência do Câncer de Mama em Ratas? / ¿La Estimulación Eléctrica Transcutánea, la Corriente Interferencial y la Fotobiomodulación pueden Provocar la Recurrencia del Cáncer de Mama en Ratas?

Introduction: Transcutaneous electrical nerve stimulation (TENS), interferential current therapy (IFC) and photobiomodulation therapy (PBMT) have been used in the management of cancer-related pain in adults. However, there are still some controversy regarding the effects of this therapy on tumor cells that may remain after cancer treatment. Objective: To evaluate the risk of recurrence of breast cancer in rats when using TENS, IFC or PBMT. Method: An experimental, randomized, controlled and cross-sectional study. With 90 days of age, 7,12-dimetylbenz(a)anthracene (7,12-DMBA) was administered to rats by gastric gavage to induce mammary cancer. After 120 days the mammary glands of the rats belonging to the group with mammary cancer were removed. Results: 39 female Sprague-Dawley rats were studied: 9 rats without induction of mammary carcinoma; 9 rats with induction of mammary carcinoma and without surgery; 9 rats with induction of mammary carcinoma with surgery and placebo application of TENS, IFC, PBMT; 9 rats with induction of mammary carcinoma, surgery and the application of TENS, IFC and PBMT. Conclusion: This study demonstrated that there was local recurrence of tumors in rats that were stimulated with TENS or IFC, however no evidence of local recurrence with PBMT

Introdução: Estimulação elétrica nervosa transcutânea (TENS), corrente interferencial (IFC) e fotobiomodulação (PBMT) são usadas no tratamento da dor relacionada ao câncer em adultos. No entanto, ainda existem algumas controvérsias sobre os efeitos dessa terapia nas células tumorais que podem permanecer após o tratamento do câncer. Objetivo: Avaliar o risco de recorrência de câncer de mama em ratos ao usar TENS, IFC ou PBMT. Método: Estudo experimental, randomizado, controlado e transversal. Com 90 dias de idade, 7,12-dimetilbenz(a)antraceno (7,12-DMBA) foi administrado em ratos por gavagem gástrica para induzir câncer mamário. Após 120 dias, as glândulas mamárias das ratas pertencentes ao grupo com câncer mamário foram retiradas. Resultados: Foram estudados 39 ratos-fêmeas Sprague-Dawley: nove ratos sem indução de carcinoma mamário; nove ratos com indução de carcinoma mamário e sem cirurgia; nove ratos com indução de carcinoma mamário com cirurgia e placebo, aplicação de TENS, IFC, PBMT; nove ratos com indução de carcinoma mamário, cirurgia e aplicação de TENS, IFC e PBMT. Conclusão: Este estudo demonstrou que houve recorrência local de tumores em ratos que foram estimulados com TENS ou IFC, no entanto, nenhuma evidência de recorrência local com PBMT

Introducción: Estimulación nerviosa eléctrica transcutánea (TENS), interferencial corriente (IFC) y la terapia de fotobiomodulación (PBMT) en el tratamiento del dolor relacionado con el cáncer en adultos. Sin embargo, todavía quedan algunas controversias sobre los efectos de esta terapia en las células tumorales que pueden permanecer después del tratamiento del cáncer. Objetivo: Evaluar el riesgo de recurrencia del cáncer de mama en ratos cuando se usa TENS, IFC o PBMT. Método: Estudio experimental, aleatorizado, controlado y transversal. Con 90 días de edad, se administró 7,12-dimetilbenz(a)antraceno (7,12-DMBA) a ratos por sonda gástrica para inducir cáncer de mama. Después de 120 días, las glándulas mamarias de las ratas pertenecientes al grupo con cáncer de mama fueron extraídas. Resultados: Se estudiaron 39 ratos-hembras Sprague-Dawley: nueve ratos sin inducción de carcinoma de mama; nueve ratos con inducción de carcinoma mamario y sin cirugía; nueve ratos con inducción de carcinoma mamario con cirugía y placebo aplicación de TENS, IFC, PBMT; nueve ratos con inducción de carcinoma mamario, cirugía y la aplicación de TENS, IFC y PBMT. Conclusión: Este estudio demostró que hubo recurrencia local de tumores en ratos que fueron estimulados con TENS o IFC, sin embargo, no hay evidencia de recurrencia local con PBMT

Transcutaneous Electrical Stimulation, Interferential Current and Photobiomodulation May Lead to the Recurrence of Breast Cancer in Rats? / Estimulação Elétrica Transcutânea, Corrente Interferencial e Fotobiomodulação podem levar à Recorrência do Câncer de Mama em Ratas? / ¿La Estimulación Eléctrica Transcutánea, la Corriente Interferencial y la Fotobiomodulación pueden Provocar la Recurrencia del Cáncer de Mama en Ratas?

Introduction: Transcutaneous electrical nerve stimulation (TENS), interferential current therapy (IFC) and photobiomodulation therapy (PBMT) have been used in the management of cancer-related pain in adults. However, there are still some controversy regarding the effects of this therapy on tumor cells that may remain after cancer treatment. Objective: To evaluate the risk of recurrence of breast cancer in rats when using TENS, IFC or PBMT. Method: An experimental, randomized, controlled and cross-sectional study. With 90 days of age, 7,12-dimetylbenz(a)anthracene (7,12-DMBA) was administered to rats by gastric gavage to induce mammary cancer. After 120 days the mammary glands of the rats belonging to the group with mammary cancer were removed. Results: 39 female Sprague-Dawley rats were studied: 9 rats without induction of mammary carcinoma; 9 rats with induction of mammary carcinoma and without surgery; 9 rats with induction of mammary carcinoma with surgery and placebo application of TENS, IFC, PBMT; 9 rats with induction of mammary carcinoma, surgery and the application of TENS, IFC and PBMT. Conclusion: This study demonstrated that there was local recurrence of tumors in rats that were stimulated with TENS or IFC, however no evidence of local recurrence with PBMT

Introdução: Estimulação elétrica nervosa transcutânea (TENS), corrente interferencial (IFC) e fotobiomodulação (PBMT) são usadas no tratamento da dor relacionada ao câncer em adultos. No entanto, ainda existem algumas controvérsias sobre os efeitos dessa terapia nas células tumorais que podem permanecer após o tratamento do câncer. Objetivo: Avaliar o risco de recorrência de câncer de mama em ratos ao usar TENS, IFC ou PBMT. Método: Estudo experimental, randomizado, controlado e transversal. Com 90 dias de idade, 7,12-dimetilbenz(a)antraceno (7,12-DMBA) foi administrado em ratos por gavagem gástrica para induzir câncer mamário. Após 120 dias, as glândulas mamárias das ratas pertencentes ao grupo com câncer mamário foram retiradas. Resultados: Foram estudados 39 ratos-fêmeas Sprague-Dawley: nove ratos sem indução de carcinoma mamário; nove ratos com indução de carcinoma mamário e sem cirurgia; nove ratos com indução de carcinoma mamário com cirurgia e placebo, aplicação de TENS, IFC, PBMT; nove ratos com indução de carcinoma mamário, cirurgia e aplicação de TENS, IFC e PBMT. Conclusão: Este estudo demonstrou que houve recorrência local de tumores em ratos que foram estimulados com TENS ou IFC, no entanto, nenhuma evidência de recorrência local com PBMT

Introducción: Estimulación nerviosa eléctrica transcutánea (TENS), interferencial corriente (IFC) y la terapia de fotobiomodulación (PBMT) en el tratamiento del dolor relacionado con el cáncer en adultos. Sin embargo, todavía quedan algunas controversias sobre los efectos de esta terapia en las células tumorales que pueden permanecer después del tratamiento del cáncer. Objetivo: Evaluar el riesgo de recurrencia del cáncer de mama en ratos cuando se usa TENS, IFC o PBMT. Método: Estudio experimental, aleatorizado, controlado y transversal. Con 90 días de edad, se administró 7,12-dimetilbenz(a)antraceno (7,12-DMBA) a ratos por sonda gástrica para inducir cáncer de mama. Después de 120 días, las glándulas mamarias de las ratas pertenecientes al grupo con cáncer de mama fueron extraídas. Resultados: Se estudiaron 39 ratos-hembras Sprague-Dawley: nueve ratos sin inducción de carcinoma de mama; nueve ratos con inducción de carcinoma mamario y sin cirugía; nueve ratos con inducción de carcinoma mamario con cirugía y placebo aplicación de TENS, IFC, PBMT; nueve ratos con inducción de carcinoma mamario, cirugía y la aplicación de TENS, IFC y PBMT. Conclusión: Este estudio demostró que hubo recurrencia local de tumores en ratos que fueron estimulados con TENS o IFC, sin embargo, no hay evidencia de recurrencia local con PBMT

Parasacral transcutaneous electrical nerve stimulation in children with overactive bladder: comparison between sessions administered two and three times weekly

ABSTRACT Purpose: This study compares the results achieved following parasacral TENS administered using two different weekly schedules. Materials and Methods: Children of at least four years of age with a diagnosis of pure overactive bladder were included in this randomized clinical trial and treated with parasacral TENS (2 versus 3 sessions per week). All the participants also underwent standard urotherapy. Results: Sixteen children were included in the twice-weekly group and eighteen in the three times weekly group. There were no statistically significant differences between the two groups with respect to sex; however, there was a difference in age. There were no significant differences regarding complete resolution of urinary symptoms, with 8 children (50%) in the twice-weekly group and 11 children (61%) in the three times weekly group having their symptoms completely resolved (p=0.73). There was a significant difference in the DVSS score in both groups following TENS treatment compared to baseline (p=0.0001 for both groups), but not between groups. Evaluation of the bladder diary showed no difference between the groups before or after treatment. Conclusion: For children with overactive bladder who are unable to undergo parasacral TENS treatment three times weekly, the method can be administered successfully at twice-weekly sessions.

Terapias físicas en pacientes con trastornos de la articulación temporomandibular / Physical therapies in patients with temporomandibular joint disorders

RESUMEN Introducción: Se denomina trastorno temporomandibular al conjunto de condiciones musculoesqueléticas que afectan la articulación temporomandibular, los músculos de la masticación y las estructuras anatómicas adyacentes. Objetivo: Evaluar la efectividad de las terapias físicas en pacientes con trastornos de la articulación temporomandibular. Métodos: Se efectuó una intervención terapéutica en la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, desde junio de 2016 hasta febrero de 2020. La muestra quedó conformada por 264 pacientes distribuidos en 4 grupos con 66 integrantes cada uno, a quienes se les aplicaron diferentes terapias físicas, tales como ultrasonido, laserterapia, magnetoterapia y técnica de estimulación eléctrica transcutánea, respectivamente. Se analizaron las siguientes variables: edad, grado de trastorno de la articulación temporomandibular y efectividad terapéutica. Se empleó el porcentaje como medida de resumen y el estadígrafo de Ji al cuadrado con un nivel de significación de 0,05. Resultados: Predominó el sexo femenino en todas las terapias aplicadas con más de 75,0 % y el grupo etario de 40 - 49 años. Al finalizar el tratamiento se observó que en los grupos donde se empleó ultrasonido, láser y magneto, la respuesta fue efectiva en más de 90,0 % de los pacientes, con primacía del primero (96,6 %); sin embargo, en el grupo donde se utilizó la técnica de estimulación eléctrica transcutánea solo se logró en 89,4 % de los afectados. Conclusiones: La ultrasonoterapia fue más efectiva en pacientes con trastornos de la articulación temporomandibular.

ABSTRACT Introduction: A temporomandibular disorder is a group of musculoskeletal conditions that affect the temporomandibular joint, the mastication muscles and the adjacent anatomical structures. Objective: To evaluate the effectiveness of the physical therapies in patients with temporomandibular joint disorders. Methods: A therapeutic intervention was carried out in Mártires del Moncada Teaching Provincial Stomatological Clinic from Santiago de Cuba, from June, 2016 to February, 2020. The sample was formed by 264 patients distributed in 4 groups with 66 members each one, to whom different physical therapies were applied, such as ultrasound, laser therapy, magnetotherapy and technique of transcutaneous electric stimulation, respectively. The following variables were analyzed: age, grade of dysfunction of the temporomandibular joint and therapeutic effectiveness. The percentage as summary measure and the chi-squared test were used with a significance level of 0.05. Results: There was a prevalence of the female sex in all the therapies applied with more than 75.0 % and the 40 - 49 age group. When concluding the treatment it was observed that in the groups where ultrasound, laser and magneto was used, the response was effective in more than 90.0 % of the patients, with primacy of the first one (96.6 %); however, in the group where the technique of transcutaneous electric stimulation was used it was just achieved in 89.4 % of the affected patients. Conclusions: The ultrasonotherapy was more effective in patients with temporomandibular joint disorders.

Estimulação elétrica neural transcutânea (tens) na paroxismia do tronco cerebral: relato de caso / Transcutaneous electrical nerve stimulation (tens) in brain stem paroxysms: case report

INTRODUÇÃO: A paroxismia de tronco encefálico, descrita em pacientes com esclerose múltipla (EM), caracteriza-se por episódios rápidos de vertigem e nistagmos evocados por movimentos cefálicos. A neuromodulação tem apresentado sucesso terapêutico em várias disfunções da EM, mas ainda não foi utilizada na paroxismia. OBJETIVO: Avaliar o efeito aditivo da neuromodulação por estimulação elétrica neural transcutânea (TENS) na musculatura periocular em paciente com EM e paroxismia de tronco encefálico não responsiva à reabilitação clássica associada à medicação. MATERIAL E MÉTODOS: Avaliação do nistagmo com videonistagmógrafo, da sensibilidade cutânea facial com estesiômetro, do blefaroclônus por gravação em vídeo e da sensação dolorosa de forma subjetiva (descrição pessoal da paciente); execução de 10 sessões consecutivas semanais de exercícios oculares associados à TENS na musculatura do oblíquo inferior e reto lateral direitos. RESULTADO: Melhora da algia, do blefaroclônus, da vertigem e do nistagmo ocular direito. CONCLUSÃO: A neuromodulação com TENS parece ser uma terapia complementar válida para pacientes com EM e paroxismia de tronco não responsivos aos demais tratamentos clínicos, porém mais estudos são necessários para confirmar esse achado.

INTRODUCTION: Brainstem paroxysmia has been described in patients with multiple sclerosis, characterized by rapid episodes of nystagmus and vertigo evoked by cephalic movements. Neuromodulation has shown therapeutic success for several dysfunctions of multiple sclerosis, but it has not yet been used in paroxysmia. OBJECTIVE: To assess the additive effect of neuromodulation by transcutaneous electrical neural stimulation (TENS) on the periocular musculature in a patient with multiple sclerosis and brain stem paroxysmia that is not responsive to classical rehabilitation associated with medication. MATERIAL AND METHODS: Nystagmus evaluation with video nystagmography, facial skin sensitivity analysis with esthesiometer, video recording of blepharoclonus, and pain sensation subjectively quantification (by a personal description of the patient); execution of 10 eyes consecutive exercises sessions associated with TENS in the right lower oblique and lateral rectus muscles. RESULT: Improvement in pain, blepharoclonus, and right eye nystagmus. CONCLUSION: Neuromodulation with TENS seems to be a valid complementary therapy for patients with brainstem paroxysmia unresponsive to other clinical treatments, but more studies are needed to confirm this finding.

Estimulação elétrica nervosa transcutânea interativa e convencional em mulheres com dismenorreia primária / Interactive and conventional transcutaneous electrical nerve stimulation in women with primary dysmenorrhoea

A dismenorreia primária é uma dor na região inferior do abdômen, antes ou durante a menstruação e independente de patologias pélvicas. Tratamentos fisioterapêuticos são alternativas para a melhora dos sintomas, dentre esses recursos, a estimulação elétrica nervosa transcutânea (TENS). O objetivo deste estudo foi comparar o efeito terapêutico e analgésico da TENS interativa e convencional na dor secundária à dismenorreia primária. A aplicação da TENS, em ambos os grupos, foi realizada no primeiro dia do período menstrual por 35 minutos. Na TENS interativa todas as voluntárias optaram pelos seguintes parâmetros: frequência de 250 Hz, duração de pulso de 25 µs e intensidade conforme nível sensorial, sendo essa ou a duração do pulso reajustado, a cada 5 minutos, conforme houvesse necessidade. Na TENS convencional foi utilizado os seguintes parâmetros: frequência de 100 Hz, duração de pulso de 50 µs e com a intensidade conforme grupo anterior. A análise estatística foi realizada por meio do software GraphPadPrism®, versão 5.0, sendo empregado o teste t de Student e com nível de significância de p < 0,05. Obteve-se como resultado uma redução da dor entre as participantes de ambos os grupos logo após o tratamento. Porém não houve diferença na analgesia promovida pelos dois métodos de tratamento. (AU)

Primary dysmenorrhea (PD) is a lower region of the abdomen pain, before or during menstruation and independent of pathologies. Physical therapy treatments are alternatives to improve symptoms, among these resources, transcutaneous electrical nerve stimulation (TENS). The aim of this study was to compare the therapeutic and analytical effect of interactive and conventional TENS in high school in PD. The application of TENS, in both groups, was performed on the first day of the menstrual period for 35 minutes. In the interactive TENS all the volunteers chose the following parameters: frequency of 250 Hz, pulse duration of 25 µs and intensity according to sensory level, whether this or the duration of the readjustment of the pulse, every 5 minutes, according to the need for use. In conventional TENS, the following parameters were used: frequency of 100 Hz, pulse duration of 50 µs and intensity according to the previous group. A statistical analysis was performed using the GraphPadPrism® software, version 5.0, being employed Student's test with a significance level of p < 0.05. The result is a reduction in pain among participants in both groups right after treatment. However, there was no difference in the analgesia promoted by the two treatment methods. (AU)