Transcutaneous electrical nerve stimulation (TENS) for the treatment of XXXX in the hand.

@entity1 @entity32 @entity353 @entity1582 @entity158 @entity2720 @entity85 @entity925 @entity309
BACKGROUND: @entity309 ( @entity309 ) is a chronic, inflammatory, system disease. It commonly affects the small peripheral joints (such as fingers and wrist). The main goals of intervention for @entity309 are preventing @entity85 , preserving joint function, and reducing @entity32 and @entity158 . Transelectrical nerve stimulation (TENS) is a form of electrotherapy and is thought to produce analgesia according to the gate control theory. OBJECTIVES: To determine the efficacy and safety of TENS in the treatment of @entity309 of the hand. The primary outcomes of interest were relief of @entity158 and resting @entity158 intensity, relief of joint @entity925 , number of @entity2720 and @entity1 assessment of disease. The secondary objective was to determine the most effective mode of TENS application in @entity158 control. SEARCH STRATEGY: We searched for relevant studies, in English, in the Cochrane field of physical and related therapies, the Cochrane Controlled Trials Register, MEDLINE, EMBASE, HEALTHSTAR, Sports Discus, CINAHL, Current Contents, and the PEDro database, up to October 2002. SELECTION CRITERIA: Two independent reviewers selected the trials that met predetermined inclusion criteria. DATA COLLECTION AND ANALYSIS: Study results were extracted by two independent reviewers. Continuous outcomes were analyzed by @entity353 ( @entity353 ) using a fixed effects model. MAIN RESULTS: Three RCTs, involving 78 @entity1 , were included in this review. @entity1582 and C-TENS were compared to placebo and to each other. Administration of 15 minutes of @entity1582 a week, for 3 weeks, resulted in a significant decrease in @entity158 (67% relative benefit, 45 points absolute benefit on 100 mm VAS scale) but not in @entity158 compared to placebo. @entity1582 did result in a clinical beneficial improvement in muscle power scores with a relative difference of 55%, and an absolute benefit of 0.98, compared to placebo. No significant difference was found between one 20-minute treatment duration of C-TENS versus @entity1582 , or C-TENS versus placebo on decrease in mean scores for @entity158 or @entity158 , or on the number of @entity2720 . Results showed a statistically significant @entity2720 , but no clinical benefit from C-TENS over placebo in relief of joint @entity925 . No statistically significant difference was shown between 15 days of treatment with C-TENS or @entity1582 in relief of joint @entity158 , although there was a clinically important benefit of C-TENS over @entity1582 on @entity1 assessment of change in disease (risk difference 21%, NNT 5). REVIEWER'S CONCLUSIONS: There are conflicting effects of TENS on @entity158 outcomes in @entity1 with @entity309 . @entity1582 is beneficial for reducing @entity158 intensity and improving muscle power scores over placebo while, conversely, C-TENS resulted in no clinical benefit on @entity158 intensity compared with placebo. However C-TENS resulted in a clinical benefit on @entity1 assessment of change in disease over @entity1582 . More well designed studies with a standardized protocol and adequate number of subjects are needed to fully conclude the effect of C-TENS and @entity1582 in the treatment of @entity309 of the hand.
