Effects of transcutaneous electrical nerve stimulation via peroneal nerve or soleus muscle on venous flow

Abstract

Background:Transcutaneous electrical nerve stimulation (TENS) is used to prevent venous stasis and thromboembolism. However, best electrostimulation parameters have yet to be established. The aim of the study was to compare the hemodynamic effects and the participants’ relative discomfort of 3 TENS sequences at the maximum tolerated intensity stimulus.Methods:Twenty-four healthy university students (50% male) participated in a cross-over, randomized study. Each participant received 2 TENS sequences on peroneal nerve at 1 and 5 Hz, and the third one on soleus muscle at 5 Hz. Popliteal flow volume (FV) and peak velocity (PV) were measured using Doppler ultrasound and the relative change from basal values was recorded. Discomfort questionnaires -visual analogue scale (VAS) and verbal rating scale (VRS)- were also administered to compare sensations among the three applications.Results:All interventions produced significant hemodynamic responses compared to baseline. Both 5 Hz applications obtained higher FV increments than 1 Hz TENS (P < .001). The muscle application resulted in the lowest PV increment (P < .001). TENS at 5 Hz on nerve location was the worst tolerated, with higher values in VRS (P = .056) and VAS (P = .11), although not significant.Conclusion:TENS at 5 Hz on soleus site may be the most appropriate protocol for enhancing venous return.

Is Low-Frequency Electrical Stimulation a Tool for Recovery after a Water Rescue? A Cross-Over Study with Lifeguards

“…A 20-min charge-balanced biphasic square wave at 5 Hz with a phase duration of 0.25 milliseconds was employed. The current amplitude was set beyond the motor threshold at the maximum comfortable level (without pain) [10]. Every 5 min, the participant's sensation was reassessed, and if it had decreased, then the amplitude was increased until the participant reported the same feeling last 5 min.…”

“…It has been suggested that low-frequency ES could enhance recovery because of two main mechanisms: increasing blood flow due to the muscle pump effect, or reducing the muscle pain through central and peripheral mechanisms [ 9 ]. Motor-level, low-frequency ES at 5 Hz has shown to improve venous return in healthy people [ 10 ], and high amplitudes (strong not painful intensities) may be the key for acute pain relief [ 11 ]. In addition, ES can increase both peak venous velocity and venous volume flow up to over 600% [ 12 ] and improve microcirculation, so it may help reduce inflammation or edema [ 13 ] after intense exercise.…”

Effects on venous flow of transcutaneous electrical stimulation, neuromuscular stimulation, and sham stimulation on soleus muscle: A randomized crossover study in healthy subjects

“…A study testing soleus muscle and common peroneal nerve locations seemed to find better blood flow when TENS was applied at muscle site. [ 17 ] Therefore, the aim of this research is to compare TENS, NMES and sham stimulation on soleus muscle of young healthy individuals regarding hemodynamics improvements on venous return and tolerance parameters. The results may help selecting the type of ES more appropriated for stasis prevention.…”

Effect of Active and Passive Mechanical Thromboprophylaxis and Consensual Effect on the Venous Blood Flow Velocity Among Hemiparetic Patients

“…The alleviation of venous stasis can be achieved by the constriction of the vein, by enhancing lymphokinesis, and by regulating the skin-muscle-fascia tone. [6][7][8] The components of mechanical prophylaxis are passive techniques: positioning, elevation of the limbs, 9 massage, compression treatments (continuous elastic compression treatment, intermittent pneumatic compression stocking), [10][11][12] electric nerve stimulation, transcutaneous electrical nerve stimulation, 10,13 electrical foot stimulation, 7 electric muscle stimulation, 9 passive movement, and active methods. 14,15 The active mechanical methods include breathing exercises, 16,17 leg pedal exercises, novel leg exercise apparatus, 18 and venous exercise with the lower limbs.…”

“…The components of mechanical prophylaxis are passive techniques: positioning, elevation of the limbs, 9 massage, compression treatments (continuous elastic compression treatment, intermittent pneumatic compression stocking), 10 –12 electric nerve stimulation, transcutaneous electrical nerve stimulation, 10,13 electrical foot stimulation, 7 electric muscle stimulation, 9 passive movement, and active methods. 14,15…”