Transcutaneous electrostimulation for osteoarthritis of the knee

Abstract

Background Osteoarthritis is the most common form of joint disease and the leading cause of pain and physical disability in the elderly. Transcutaneous electrical nerve stimulation (TENS), interferential current stimulation and pulsed electrostimulation are used widely to control both acute and chronic pain arising from several conditions, but some policy makers regard efficacy evidence as insufficient. Objectives To compare transcutaneous electrostimulation with sham or no specific intervention in terms of effects on pain and withdrawals due to adverse events in patients with knee osteoarthritis. Search strategy We updated the search in CENTRAL, MEDLINE, EMBASE, CINAHL and PEDro up to 5 August 2008, checked conference proceedings and reference lists, and contacted authors. Selection criteria Randomised or quasi-randomised controlled trials that compared transcutaneously applied electrostimulation with a sham intervention or no intervention in patients with osteoarthritis of the knee. Data collection and analysis We extracted data using standardised forms and contacted investigators to obtain missing outcome information. Main outcomes were pain and withdrawals or dropouts due to adverse events. We calculated standardised mean differences (SMDs) for pain and relative 4 Transcutaneous electrostimulation for osteoarthritis of the knee (Review)

How Do Physical Therapists Treat People with Knee Osteoarthritis, and What Drives Their Clinical Decisions? A Population-Based Cross-Sectional Survey

“…9,10 However, physical therapists in the United Kingdom made frequent use of ice, heat, and electrotherapy. Little evidence supports the effectiveness of these interventions (and, in fact, all of them appear to be less frequently used by U.S. physical therapists); [18][19][20] consequently, this leads to weaker recommendations regarding their use. 9 The differences in approach may be accounted for by the fact that Holden and colleagues' study was conducted almost 10 years ago; practice is always evolving, and new evidence is incorporated into practice over time.…”

The effectiveness of pulsed electrical stimulation in the management of osteoarthritis of the knee: Results of a double‐blind, randomized, placebo‐controlled, repeated‐measures trial

“…While often being grouped with transcutaneous electrical nerve stimulation (TENS) (9), it does differ from TENS and interferential therapy in its specific electrical current parameters and its proposed method of action (6). In particular, it is delivered at subsensory intensity.…”

Selective outcome reporting: telling and detecting true lies. The state of the science

“…The adoption of reporting guidelines and quality assessment tools such as those promoted by the EQUA-TOR Network, The Cochrane Collaboration and the GRADE working Group [29] may improve the conduct and reporting of trials. All new Cochrane reviews--like the ones about osteoarthritis [3]--will include a risk of bias assessment step to ascertain the likeliness of outcome reporting bias, following the guidelines presented in the Cochrane Handbook (Chap 8.13) [16]. Finally policy makers should defend open access to research.…”

“…Besides nonsteroidal anti-inflammatory drugs, the mainstay of management for osteoarthritic pain, transcutaneous electrostimulation (TENS), ultrasound and opioids have been advocated as viable treatment options [1][2][3]. However, the evidence for their effectiveness and safety is contradictory.…”

“…In many of these instances, the overall quality of evidence is rated as low because, among other reasons, only a small proportion of included studies report a specific outcome (i.e., 8 out of 18 studies report the number of patients withdrawn because of adverse events) [3]. In these cases, the authors warn readers against the likely risk of selective outcome reporting bias.…”