None listed
Conditions
Brief summary
Background: Interferential therapy (IFT) is regularly used to manage musculoskeletal pain. The use of IFT is based on minimising skin impedance and producing maximum stimulation at the point of intersection of the two alternating currents, deep in tissue. Traditionally, IFT has been applied in a quadripolar way so that the two currents intersect in the painful area despite the highest voltage of IFT is being induced outside the intersection area of the two used currents. Clinically, no clear reduction effect of pain has been confirmed with this application method of IFT. It is probably true that placing the painful area outside the intersection spot of the two currents would reveal a significant pain reduction. Purpose: To investigate the pain reduction effect while placing the pain spot outside the crossing point of the two currents compared to the traditional method of applying IFT. Methods: 162 subjects with subacute low back pain were randomly assigned to one 4 groups which were: 1- external IFT application (where the most tender pain spot was located between the two electrodes at 2 cm outside of the external borders of the electrodes) 2- placebo external IFT application 3- traditional IFT application (where the most tender pain point was placed at the crossing area of the two currents of IFT) 4- placebo traditional IFT application. Subjects were assessed for their pain before and after IFT session using visual analogue scale (VAS), pressure pain threshold (PPT), pain distribution and ROM. Groups 1 and 3 received 20 min of IFT at 100 Hz and comfortable stimulation intensity. Groups 2 and 4 received sham IFT for 20 min. Results: Results: VAS and ROM improved with all groups,P= 0.04 respectively. No statistical differences appeared between groups, for VAS P= 0.15 - 0.95 and for ROM P= 0.10 - 0.83. Active applications improved VAS and ROM to same extent, for VAS; external mean difference 5.36 (0.38) and traditional mean difference 5.33 (0.39), and for ROM; external mean difference 17.57 (2.12) and traditional mean difference 17.77 (2.27).There was a trend of better VAS reduction with active IFTs compared to placebos. Oppositely, PPT and pain distribution did not significantly change with any of the groups,P=0.48 respectively. No statistical difference between groups for PPT; P= 0.10 - 0.83, but between placebo groups for pain distribution (P=0.04). Both active applications changed PPT and pain distribution closely, for PPT; external mean difference 539.48 and traditional mean difference 551.99 (42.57)and for pain distribution; external mean difference 13.66 (3.67) and traditional mean difference 16.22 (3.74) Conclusions: No therapeutic difference between external and traditional applications
Interventions
The intervention is a routine electrical stimulation modality called interferential therapy (IFT) used for the management of musculoskeletal pain in physiotherapy clinics. IFT is used via applying 4 rubber electrodes placed around the painful area and conducting two medium-frequency currents, around 4000Hz, to the painful area with the premise of producing a low-frequency effect deep inside the body with minimum skin irritation. IFT is adjusted to produce a strong but comfortable tingling sensat
The intervention is a routine electrical stimulation modality called interferential therapy (IFT) used for the management of musculoskeletal pain in physiotherapy clinics. IFT is used via applying 4 rubber electrodes placed around the painful area and conducting two medium-frequency currents, around 4000Hz, to the painful area with the premise of producing a low-frequency effect deep inside the body with minimum skin irritation. IFT is adjusted to produce a strong but comfortable tingling sensation over 20 minutes which in turn is proposed to reduce subject's pain severity. In present work, two different electrode placement were compared, in relation to the painful spot. The first was the traditional placement of electrodes where the painful spot is located in the crossing pint of the two intersecting currents. The second was external placement where the painful spot was located at 2 centimeters outside the borders of the electrodes. Standardized placements of the painful spot were achieved by using a transparent sheet where the places of the IFT electrodes were determined via making 4 square holes in a quadrant shape. Additionally, two circular holes were made, one in the middle of the four square holes and one at 2 centimeters outside the borders of the squared holes. The IFT electrodes were placed in the squared holes then based on the tested application placement the circular whole was placed on the painful spot so the placement is guided either traditional or external application. A frequency current of 100Hz was used for admitting the IFT for all subject as this frequency is commonly used for pain management in physiotherapy clinics.Additionally, the current intensity was adjusted at the comfort at each subject in a way that strong but comfortable sensation is felt. Current intensity was increased or decreased based on individual sensation so that at all times current is felt as strong and comfortable. This procedure was carried out in a single session for 20 minutes only as this was the aim of the experiment.
Sponsors
Prince Sultan Military College of Health Science
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
The inclusion criteria included that they are in age range of 18 to 70 years with body mass index 18 - 40 kg/m2, have low back pain with or without leg pain and haven’t been treated with IFT before or at least in the last two years.
Exclusion criteria
Subjects were excluded from the study if they have infection, neoplasms, metastasis, osteoporosis, rheumatoid arthritis, fractures, metabolic systemic disorder, heart disease, renal disease, intellectual disability and breaks or irritation of the skin of back.
Outcome results
None listed