Accepted Manuscript Efficacy of Addition of Transcutaneous Electrical Nerve Stimulation to Standardized Physical Therapy in Subacute Spinal Spasticity: A Randomized Control Trial Win Min Oo, M.B,B.S; M.Med.Sc PII:
S0003-9993(14)00432-8
DOI:
10.1016/j.apmr.2014.06.001
Reference:
YAPMR 55866
To appear in:
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
Received Date: 7 May 2014 Revised Date:
10 June 2014
Accepted Date: 11 June 2014
Please cite this article as: Oo WM, Efficacy of Addition of Transcutaneous Electrical Nerve Stimulation to Standardized Physical Therapy in Subacute Spinal Spasticity: A Randomized Control Trial, ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION (2014), doi: 10.1016/j.apmr.2014.06.001. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
TENS and physical therapy in subacute spinal spasticity
ACCEPTED MANUSCRIPT Efficacy of Addition of Transcutaneous Electrical Nerve Stimulation to Standardized Physical Therapy in Subacute Spinal Spasticity: A Randomized Control Trial
Win Min Oo (M.B,B.S; M.Med.Sc)
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Department of Physical Medicine and Rehabilitation, Mandalay University of Medicine, Myanmar.
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Acknowledgement: I would like to thank Professor Dr. Win Nyi Shein, PhD, for management
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support, Professor Dr. Win Myint OO, PhD, for statistical advices, Sr. Consultant Dr. Soe Thein, Dr.Med.Sc, physiotherapists and the participating subjects from University Hospital of Mandalay for assisting in this study.
Disclaimers: I certify that the views expressed in the submitted article are my own and not an
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official position of the institution. I confirm that there was no presentation of this material to any journal.
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Source of support: There was no financial support for this study.
Conflict of interest: None
Correspondence: Win Min OO, Physiatrist, Department of Physical Medicine and Rehabilitation, Mandalay University of Medicine, Myanmar. Ph: 095991053012 E-mail:
[email protected];
[email protected] Reprint can be obtained from this author.
TENS and physical therapy in subacute spinal spasticity
ACCEPTED MANUSCRIPT Word count of abstract: 319 Word count of body of the text: 3163 Number of figure: 1
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Number of tables: 4
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Efficacy of Addition of Transcutaneous Electrical Nerve Stimulation to Standardized
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Physical Therapy in Subacute Spinal Spasticity: A Randomized Control Trial
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Objective: To study the immediate and short-term efficacy of adding transcutaneous
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electrical nerve stimulation (TENS) to standardized physical therapy on subacute spasticity
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within 6 months post-spinal cord injury
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Design: Randomized controlled trial for 3 weeks
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Setting: University hospital of Mandalay
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Subjects and intervention: Sixteen subjects with clinically determined spasticity were
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randomly assigned to experimental group (n=8, 60 minute sessions of TENS over the
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bilateral common peroneal nerves before 30 minutes of physical therapy) or control group
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(n=8, 30 minutes of physical therapy alone). All patients in both groups had access to
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standardized rehabilitation care.
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Outcome measures: Composite spasticity score as primary end point to assess plantar flexor
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spasticity which included three sub-scores: ankle jerk, muscle tone and ankle clonus scores.
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These sub-scores were designated as secondary end points. Serial evaluations were made at
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baseline before study entry, immediately after the first and last sessions in both groups.
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Results: On analysis for immediate effects, there was significant reduction only in composite
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spasticity score (mean difference 1.75 [99% confidence interval (CI) 0.47 to 3.03], p= 0.002)
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in the experimental group but no significant reduction was observed in all outcome variables
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in the control group. The significant difference of composite spasticity score (1.63[99% CI
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ACCEPTED MANUSCRIPT 0.14 to 3.11], p= 0.006) was observed between the two groups. After 15 sessions of
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treatment, significant reduction was determined in composite spasticity score (2.75[99% CI
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1.31 to 4.19], p