Additional effect of transcutaneous electrical nerve stimulation in a therapeutic exercise program for sedentary with chronic neck pain: A double-blind randomized controlled trial.

PURPOSE: To evaluate the additional effect of high frequency (HF) or low frequency (LF) transcutaneous electrical nerve stimulation (TENS) in a specific therapeutic exercise program for the treatment of patients with chronic neck pain. METHODS: A randomized controlled trial. Sixty participants of both sexes and with chronic neck pain were randomized into three groups: therapeutic exercise group + placebo TENS (n = 20), therapeutic exercise group + HF TENS (n = 20) and therapeutic exercise group + low TENS frequency (n = 20). The following assessment instruments were used: Numerical Pain Rating Scale, Neck Disability Index, Pain-Related Catastrophizing Thoughts Scale and Tampa Scale for Kinesiophobia. Participants were evaluated before the interventions, after eight treatment sessions and 1 month after the end of treatment. Primary outcome was disability measured after the eight treatment sessions. Secondary outcomes were pain intensity, catastrophizing, and kinesiophobia after eight treatment sessions and pain intensity 4 weeks after the end of the treatment sessions. RESULTS: The three groups were similar at baseline for personal and clinical characteristics. Regarding the main study analyses, there were no significant (p > 0.05) or clinical (d < 0.80) differences between the groups for the main variable (disability), nor for the secondary variables (pain intensity, catastrophizing and kinesiophobia). CONCLUSION: HF or LF TENS, compared to placebo TENS, does not provide additional clinical benefits to an exercise program for patients with chronic neck pain.

Program of therapeutic exercises associated with electrotherapy in patients with chronic neck pain: Protocol for a randomized controlled trial.

Conservative treatment is the most common clinical management for the proper rehabilitation of patients with chronic neck pain, and there is a trend towards the use of therapeutic exercise. However, some uncertainty about the efficacy of therapeutic exercises remains, and it is necessary to conduct more studies with high methodological rigor, especially in regard to multimodal treatment, as in the combination of therapeutic exercises with electrotherapy. Thus, the objective of this study will be to evaluate the clinical effects of adding high- and low-frequency transcutaneous electrical nerve stimulation (TENS) in a program of specific therapeutic exercises for the treatment of patients with chronic neck pain. Sixty participants will be randomized into three groups: therapeutic exercise + placebo TENS group (n = 20), therapeutic exercise + high-frequency TENS group (n = 20), and therapeutic exercise + low-frequency TENS group (n = 20). Eight treatment sessions will be performed, and participants will be evaluated before and after the eight sessions and four weeks after the end of treatment. The Numerical Rating Pain Scale, Neck Disability Index, Pain-Related Catastrophizing Thoughts Scale, and Tampa Scale for Kinesiophobia will be used for participant evaluations. In the statistical analysis, a linear mixed model will be applied considering interaction between time and group factors. The addition of this electrotherapeutic modality to a therapeutic exercise program is expected to generate clinical improvements for patients with chronic neck pain, and if the results demonstrate benefits in the treatment group, this form of care could be used.

Correlation Between Habitual Physical Activity and Central Sensitization, Pain Intensity, Kinesiophobia, Catastrophizing, and the Severity of Myogenous Temporomandibular Disorder.

OBJECTIVE: We sought to correlate habitual physical activity with central sensitization, pain intensity, kinesiophobia, catastrophizing, and the severity of chronic myogenous temporomandibular disorder (TMD). METHODS: This was an observational study. Fifty-five individuals, male and female, aged 18 to 45 years, with pain for at least 3 months (chronic) related to myogenous TMD were included in the study. Myogenous TMD was evaluated by means of the Numerical Rating Scale, Catastrophic Thoughts on Pain Scale, Tampa Scale for Kinesiophobia, Fonseca Anamnestic Index, Central Sensitization Inventory, and habitual physical activity by means of the Baecke Questionnaire (BQ). The Spearman correlation coefficient (r s) was applied to verify the association of the BQ score with the pain variables. RESULTS: No significant correlations (P > .05) were observed in the total or mean BQ scores (both r s = -0.17 to -0.04), nor in the analyses performed on the occupational (r s = -0.03 to 0.14), sport (r s = -0.16 to 0.01), and leisure domains (r s = -0.16 to -0.02). CONCLUSION: Habitual physical activity as measured by the BQ is not associated with pain intensity, catastrophizing, kinesiophobia, central sensitization, or the severity of chronic myogenous TMD.