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Low Back Pain Treatment by Athletic Trainers and Athletic Therapists: Biomedical or Biopsychosocial Orientation?

Author(s): MacDougall HL, George SZ, Dover GC

J Athl Train. 2019 Aug 06;: Authors: MacDougall HL, George SZ, Dover GC

Article GUID: 31386578
Expectancy Reduces Symptoms but not Functional Impairment Following Exercise-induced Musculoskeletal Injury.

Author(s): Hedderson WC, Dover GC, George SZ, Crow JA, Borsa PA

Clin J Pain. 2018 Jan;34(1):1-7 Authors: Hedderson WC, Dover GC, George SZ, Crow JA, Borsa PA

Article GUID: 28157138
Prolonged Reduction in Shoulder Strength after Transcutaneous Electrical Nerve Stimulation Treatment of Exercise-Induced Acute Muscle Pain.

Author(s): Butera KA, George SZ, Borsa PA, Dover GC

Pain Pract. 2018 11;18(8):954-968 Authors: Butera KA, George SZ, Borsa PA, Dover GC

Article GUID: 29505689
Title:Prolonged Reduction in Shoulder Strength after Transcutaneous Electrical Nerve Stimulation Treatment of Exercise-Induced Acute Muscle Pain.
Authors:Butera KA,  George SZ,  Borsa PA,  Dover GC
Link:https://www.ncbi.nlm.nih.gov/pubmed/29505689?dopt=Abstract
DOI:10.1111/papr.12690
Category:Pain Pract
PMID:29505689
Dept Affiliation: PERFORM
1 Department of Physical Therapy, Brooks-PHHP Research Collaboration, University of Florida, Gainesville, Florida, U.S.A.
2 Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A.
3 Musculoskeletal Research, Duke Clinical Research Institute, Durham, North Carolina, U.S.A.
4 Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, Florida, U.S.A.
5 Department of Exercise Science, Concordia University, Montreal, Quebec, Canada.
6 PERFORM Centre, Concordia University, Montreal, Quebec, Canada.

Description:

Prolonged Reduction in Shoulder Strength after Transcutaneous Electrical Nerve Stimulation Treatment of Exercise-Induced Acute Muscle Pain.

Pain Pract. 2018 11;18(8):954-968

Authors: Butera KA, George SZ, Borsa PA, Dover GC

Abstract

OBJECTIVES: Transcutaneous electrical nerve stimulation (TENS) is commonly used for reducing musculoskeletal pain to improve function. However, peripheral nerve stimulation using TENS can alter muscle motor output. Few studies examine motor outcomes following TENS in a human pain model. Therefore, this study investigated the influence of TENS sensory stimulation primarily on motor output (strength) and secondarily on pain and disability following exercise-induced delayed-onset muscle soreness (DOMS).

METHODS: Thirty-six participants were randomized to a TENS treatment, TENS placebo, or control group after completing a standardized DOMS protocol. Measures included shoulder strength, pain, mechanical pain sensitivity, and disability. TENS treatment and TENS placebo groups received 90 minutes of active or sham treatment 24, 48, and 72 hours post-DOMS. All participants were assessed daily.

RESULTS: A repeated measures analysis of variance and post-hoc analysis indicated that, compared to the control group, strength remained reduced in the TENS treatment group (48 hours post-DOMS, P < 0.05) and TENS placebo group (48 hours post-DOMS, P < 0.05; 72 hours post-DOMS, P < 0.05). A mixed-linear modeling analysis was conducted to examine the strength (motor) change. Randomization group explained 5.6% of between-subject strength variance (P < 0.05). Independent of randomization group, pain explained 8.9% of within-subject strength variance and disability explained 3.3% of between-subject strength variance (both P < 0.05).

DISCUSSION: While active and placebo TENS resulted in prolonged strength inhibition, the results were nonsignificant for pain. Results indicated that higher pain and higher disability were independently related to decreased strength. Regardless of the impact on pain, TENS, or even the perception of TENS, may act as a nocebo for motor output.

PMID: 29505689 [PubMed - indexed for MEDLINE]