A Randomized Controlled Trial of Auricular Transcutaneous Electrical Nerve Stimulation for Managing Posthysterectomy Pain

Background. A patient- and assessor-blinded randomized controlled trial was conducted to examine the effectiveness of auricular transcutaneous electrical nerve stimulation (TENS) in relieving posthysterectomy pain. Method. Forty-eight women who had undergone a total abdominal hysterectomy were randomly assigned into three groups (n = 16 each) to receive either (i) auricular TENS to therapeutic points (the true TENS group), (ii) auricular TENS to inappropriate points (the sham TENS group), or (iii) 20 minutes of bed rest with no stimulation (the control group). The intervention was delivered about 24 hours after the operation. A visual analogue scale was used to assess pain while resting (VAS-rest) and upon huffing (VAS-huff) and coughing (VAS-cough), and the peak expiratory flow rate (PEFR) was assessed before and at 0, 15, and 30 minutes after the intervention. Result. As compared to the baseline, only the true TENS group reported a significant reduction in VAS-rest (P = .001), VAS-huff (P = .004), and VAS-cough (P = .001), while no significant reduction in any of the VAS scores was seen in the sham TENS group (all P > .05). In contrast, a small rising trend was observed in the VAS-rest and VAS-huff scores of the control group, while the VAS-cough score remained largely unchanged during the period of the study. A between-group comparison revealed that all three VAS scores of the true TENS group were significantly lower than those of the control group at 15 and 30 minutes after the intervention (all P < .02). No significant between-group difference was observed in PEFR at any point in time. Conclusion. A single session of auricular TENS applied at specific therapeutic points significantly reduced resting (VAS-rest) and movement-evoked pain (VAS-huff, VAS-cough), and the effects lasted for at least 30 minutes after the stimulation. The analgesic effects of auricular TENS appeared to be point specific and could not be attributed to the placebo effect alone. However, auricular TENS did not produce any significant improvement in the performance of PEFR

Effects of pulsed electromagnetic field (PEMF) on the tensile biomechanical properties of diabetic wounds at different phases of healing

<div><p>The present study investigated the effects of pulsed electromagnetic field (PEMF) on the tensile biomechanical properties of diabetic wounds at different phases of healing. Two intensities of PEMF were adopted for comparison.</p><p>We randomly assigned 111 10-week-old male streptozotocin-induced diabetic Sprague-Dawley rats to two PEMF groups and a sham control group. Six-millimetre biopsy punched full thickness wounds were made on the lateral side of their hindlimbs. The PEMF groups received active PEMF delivered at 25 Hz with intensity of either 2 mT or 10 mT daily, while the sham group was handled in a similar way except they were not exposed to PEMF. Wound tissues were harvested for tensile testing on post-wounding days 3, 5, 7, 10, 14 and 21. Maximum load, maximum stress, energy absorption capacity, Young’s modulus and thickness of wound tissue were measured.</p><p>On post-wounding day 5, the PEMF group that received 10-mT intensity had significantly increased energy absorption capacity and showed an apparent increase in the maximum load. However, the 10-mT PEMF group demonstrated a decrease in Young’s modulus on day 14. The 10-mT PEMF groups showed a significant increase in the overall thickness of wound tissue whereas the 2-mT group showed a significant decrease in the overall maximum stress of the wounds tissue.</p><p>The present findings demonstrated that the PEMF delivered at 10 mT can improve energy absorption capacity of diabetic wounds in the early healing phase. However, PEMF (both 2-mT and 10-mT) seemed to impair the material properties (maximum stress and Young’s modulus) in the remodelling phase. PEMF may be a useful treatment for promoting the recovery of structural properties (maximum load and energy absorption capacity), but it might not be applied at the remodelling phase to avoid impairing the recovery of material properties.</p></div

Thermal pain and detection threshold modulation in augmented reality

International audienceAugmented Reality (AR) overlays computer-generated visual, auditory or other sensory information onto the real world. Due to recent technological advancement in the field, it can become increasingly difficult for the user to differentiate between sensory information coming from real and virtual objects, leading to interesting perceptual phenomena. For example, an AR experience in which users can experience their own hands in flames has been shown to elicit heat illusions on the affected hands. In this study, we investigate the potential that AR has for top-down modulation of pain and thermal perception. We assessed thermal pain and detection thresholds on the participant's right hand while covering it with realistic virtual flames. We compared this experience to a baseline condition with no additional stimuli. We also report on a condition in which the hand is covered by a blue fluid not instantly associated with fire. We found that experiencing a virtual burning hand induces analgesic as well hyperalgesic effects as participants begin to feel heat related pain at lower temperatures and cold related pain at higher temperatures. The experience also impacts significantly on the lowest temperature at which participants starts perceiving warmth. The blue fluid do not affect the thresholds corresponding to the baseline condition. Our research thus confirms previous experiments showing that pain and thermal perception can be manipulated by by AR, while providing quantitative results on the magnitude of this effect

Grip force control is dependent on task constraints in children with and without developmental coordination disorder

2010-2011 > Academic research: refereed > Publication in refereed journa

Representative wounds from sham, 2-mT and 10-mT PEMF groups on post-wounding day 0, 3, 5, 7, 10, 14 and 21.

<p>The area of wounds of the 2-mT PEMF group was slightly smaller on day 3. All photographs were taken with a 20 mm × 20 mm scale. Scale bar: 10 mm.</p

Application of Multiscale Entropy in Assessing Plantar Skin Blood Flow Dynamics in Diabetics with Peripheral Neuropathy

Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus, while tissue ischemia caused by impaired vasodilatory response to plantar pressure is thought to be a major factor of the development of DFUs, which has been assessed using various measures of skin blood flow (SBF) in the time or frequency domain. These measures, however, are incapable of characterizing nonlinear dynamics of SBF, which is an indicator of pathologic alterations of microcirculation in the diabetic foot. This study recruited 18 type 2 diabetics with peripheral neuropathy and eight healthy controls. SBF at the first metatarsal head in response to locally applied pressure and heating was measured using laser Doppler flowmetry. A multiscale entropy algorithm was utilized to quantify the regularity degree of the SBF responses. The results showed that during reactive hyperemia and thermally induced biphasic response, the regularity degree of SBF in diabetics underwent only small changes compared to baseline and significantly differed from that in controls at multiple scales (p &lt; 0.05). On the other hand, the transition of regularity degree of SBF in diabetics distinctively differed from that in controls (p &lt; 0.05). These findings indicated that multiscale entropy could provide a more comprehensive assessment of impaired microvascular reactivity in the diabetic foot compared to other entropy measures based on only a single scale, which strengthens the use of plantar SBF dynamics to assess the risk for DFU

Wound area and percentage wound area measured from sham, 2-mT and 10-mT PEMF groups on post-wounding day 0, 3, 5, 7, 10, 14 and 21.

<p>Data are expressed as mean ± s.e.m. The % wound area of the 2-mT PEMF group was significantly smaller than that of the sham PEMF group (p = 0.036). * p < 0.05. The data used to plot this figure can be found in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0191074#pone.0191074.s002" target="_blank">S1 Data</a>.</p