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TENS Effectiveness and Knee Osteoarthritis in Humans (TOPS)

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University of Iowa

Status

Completed

Conditions

Knee Osteoarthritis

Treatments

Procedure: Placebo TENS
Procedure: High Frequency TENS
Procedure: Low frequency TENS

Study type

Interventional

Funder types

Other

Identifiers

NCT01354054
TENS/tops/sluka/rakel

Details and patient eligibility

About

TENS is a non pharmacological intervention to control pain. Both high (>50 Hz) and low (<10 Hz) frequency TENS are used in the clinic and it is thought that each type works through different mechanisms (see for review Sluka and Walsh, 2003). Hyperalgesia, an increased response to a noxious stimuli, is one component of pain and occurs both at the site of injury, primary hyperalgesia, and outside the site of injury, secondary hyperalgesia. Recent studies in animals with arthritis of the knee show that low and high frequency TENS differentially modulate primary and secondary hyperalgesia.

Therefore the investigators hypothesize that TENS will reduce hyperalgesia and pain with movement resulting in increased function.

Full description

The following specific aims will address this hypothesis:

Specific Aim 1 will compare the effect of high frequency TENS, low frequency TENS, and placebo TENS in patients with osteoarthritis on a variety of outcome measures: primary and secondary hyperalgesia, subjective pain scores, and function.

Specific Aim 2 will determine the relationships among these multiple pain measures in people with osteoarthritis, and compare to age matched controls.

Specific Aim 3 will determine the genetic variability as it relates to osteoarthritis pain and response to TENS treatment

Specific Aim 4 will determine how body composition (BMI, fat mass, percent fat, lean mass, and bone mass) impacts the effectiveness of TENS

One of the long-term goals of the investigators is to determine the clinical effectiveness of non-pharmacological treatments for pain, like TENS. These studies will begin to address this issue by examining effects of TENS on a variety of outcome measures in patients with a specific controlled condition (i.e., knee osteoarthritis). This research is innovative because it will be the first to systematically examine the effects of TENS on a variety of physiological parameters (primary and secondary hyperalgesia) and clinical outcome measures (resting pain, movement-evoked pain, function) in a common, painful and limiting condition that is frequently seen in physical therapy clinics. These studies will further allow us to translate basic science experiments previously performed in animal models of arthritis to the clinic. This information is expected to assist the clinician in the treatment choice for a particular patient and guide future clinical research.

Enrollment

100 patients

Sex

All

Ages

30 to 95 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • diagnosis of medial compartment knee osteoarthritis
  • 18 and 60 years of age
  • being able to ambulate to the mail box and back
  • stable medication schedule over the last three weeks
  • pain rating > 3 on a 0-10 scale when verbally asked to rate knee pain in the weight bearing position
  • normal L1-S2 dermatomal screen and normal great toe and thumb proprioception.

Exclusion criteria

  • Knee surgery in the last six months
  • Knee injection in the last four weeks
  • serious medical condition, uncontrolled diabetes mellitus, hypertension
  • dementia or cognitive impairment
  • permanent lower extremity sensory
  • prior TENS use

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Triple Blind

100 participants in 4 patient groups

High frrequency TENS
Experimental group
Description:
100 Hz TENS, 100 usec
Treatment:
Procedure: High Frequency TENS
Low frequency TENS
Experimental group
Description:
4 Hz, 100 usec TENS
Treatment:
Procedure: Low frequency TENS
Placebo TENS
Experimental group
Description:
100 Hz, 100 usec, set at motor minus 10% then ramps to off in 45 sec, 40 minutes
Treatment:
Procedure: Placebo TENS
Control
No Intervention group
Description:
Age matched controls, no intervention

Trial contacts and locations

3

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Data sourced from clinicaltrials.gov

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