What is the evidence for TENS in the treatment of osteoarthritis of the knee?
AMSTAR Rating
Summary
Patient Population:
No information was provided on the patient population.
Intervention:
Interventions studied: high frequency TENS (6 studies), high frequency TENS + burst TENS (1 study), high frequency TENS + interferential current stimulation (1 study), low frequency, high frequent and modulation TENS with alternating low and high frequency current (1 study), one burst TENS (1 study), low frequency TENS (2 studies), interferential current stimulation (4 studies), pulsed electro-stimulation (3 studies). A single study did not specify which type of TENS would be used.
Comparison:
Comparison conditions: sham interventions (12 trials), no intervention (5 trials). One study had both a sham intervention and a no intervention group. 22 reported describing 18 completed trials and 2 trial protocols were identified as meeting the inclusion criteria for the present review. Only one trial reported both adequate generation of the randomization sequence and concealment of allocation. In many trials, the low quality of reporting made it difficult to judge whether items of interest had been completed satisfactorily and many of the ratings were “unclear”.
Outcome:
- Pain: TENS vs. sham/no intervention – significant difference in favour of TENS (SMD=-0.85; 95% CI -1.36 to -0.34; I2=83%).
- Function: TENS vs. sham/no intervention – significant difference in favour of TENS (SMD=-0.34; 95% CI -0.54 to -0.19).
- Safety: No significant risk was associated with the use of TENS (RR=1.02; 95% CI 0.53 t0 1.97; GRADE = low).
Guideline Recommendations
| Source | Recommendation |
|---|---|
| ACR (2019) | Strongly against |
| AAOS (2013) | Inconclusive |
Outcomes Assessed
- Benefit
- Harm
- Inconclusive
TENS
Pain
Function
Safety
