Systematic review to inform a World Health Organization (WHO) clinical practice guideline: Benefits and harms of transcutaneous electrical nerve stimulation (TENS) for chronic primary low back pain in adults

Abstract Purpose To evaluate benefits and harms of transcutaneous electrical nerve stimulation (TENS) for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. Methods We searched for randomized controlled trials (RCTs) from various electronic databases from July 1, 2007 to March 9, 2022. Eligible RCTs targeted TENS compared to placebo/sham, usual care, no intervention, or interventions with isolated TENS effects (i.e., combined TENS with treatment B versus treatment B alone) in adults with CPLBP. We extracted outcomes requested by the WHO Guideline Development Group, appraised the risk of bias, conducted meta-analyses where appropriate, and graded the certainty of evidence using GRADE. Results Seventeen RCTs (adults, n = 1027; adults ≥ 60 years, n = 28) out of 2010 records and 89 full text RCTs screened were included. The evidence suggested that TENS resulted in a marginal reduction in pain compared to sham (9 RCTs) in the immediate term (2 weeks) (mean difference (MD) = -0.90, 95% confidence interval  -1.54 to -0.26), and a reduction in pain catastrophizing in the short term (3 months) with TENS versus no intervention or interventions with TENS specific effects (1 RCT) (MD = -11.20, 95% CI -17.88 to -3.52). For other outcomes, little or no difference was found between TENS and the comparison interventions. The certainty of the evidence for all outcomes was very low. Conclusions Based on very low certainty evidence, TENS resulted in brief and marginal reductions in pain (not deemed clinically important) and a short-term reduction in pain catastrophizing in adults with CPLBP, while little to no differences were found for other outcomes

DAMM: Daten- und Multimedia Uebertragung ueber DAB Abschlussbericht

The document covers the development and research work of the 'Institut fuer Rundfunktechnik IRT' carried out in the project 'Data and Multimedia Services via DAB'. After a short comparison of DAB with other transmission media for radio broadcasting in respect to data transmission capabilities, those data and multimedia services are described, which can be transferred by DAB. The transfer protocol which has been developed and standardised during the project ensures that the objects, i.e. files that consitute a multi media service, can be restored by the receiver in spite of bit errors in hostile reception areas. IRT has worked on the infrastructure required at the broadcasters for producing data services at low expenses. IRT especially developed a set of data inserters for multiplexing data services into the different types of DAB data channels. (orig.)SIGLEAvailable from TIB Hannover: F99B619+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman