본 연구에서는 경피신경전기자극(TENS)을 이용하여 다양한 자극 강도에 따른 뇌혈관에 미치는 영향을 확인하고 자 한다. 특히 비지각적 감각의 전기자극을 통해 총경동맥(CCA)에서의 혈류 변화 및 혈관의 구조적인 변화를 확인 해 보고자 한다. 본 연구에는 20대의 건강한 성인 24명이 참여하였다. 자극 강도는 감각 역치 미만, 감각 역치, 그리 고 감각 역치 초과 세 가지를 각각 랜덤 순서로 적용하였다. 측정위치는 CCA 분기점의 1cm 하단에서 측정하였고, 혈류속도는 C-mode 도플러, 혈관의 구조는 B-mode 영상을 통해 측정하였다. 측정은 각각의 자극별로 중재 전, 중재 중, 그리고 중재 후에 수행하였고 각 세션마다 혈압의 변화를 측정하였다. 그 결과 최고 수축기 속도(PSV)는 역치 미만의 비지각적 감각자극에서 중재 후 유의하게 감소함이 확인되었다(p = .008). 역치 미만의 자극 후 PSV는 자극 전보다 평균 3.04% 유의하게 감소한 것으로 나타났다(p = .011). 반면 CCA의 혈관 직경의 변화는 모든 강도에서 자극 전후 유의한 변화가 나타나지 않았다. 본 연구에서 적용한 단시간의 비지각적 전기자극이 혈관의 직경이나 혈 압의 유의한 변화를 주지 않으면서 즉각적인 혈류속도 감소에 효과가 있음을 발견했다. 따라서 본 연구는 경동맥 부위에 환자의 불편함과 부작용이 없는 전기자극을 통해 뇌혈류의 조절이 가능하다는 것을 보여주는 중요한 시도로 평가될 수 있다.

Background: The transcutaneous electrical nerve stimulation (TNES) is the most used non-invasive treatment method in physical therapy. As the mobile TENS (MTENS) has become popular, patients with pain have started using MTENS to reduce pain. Objectives: To evaluate pain, range of motion, and muscle strength before and after using MTNES in patients with wrist pain. Design: Quasi-experimental research. Methods: We conducted an experiment with 80 patients; 15 patients were dropped out, and 35 and 30 patients were evaluated in the experimental group (EG) and control group (CG), respectively. Before and after using MTENS for 4 weeks, patients were evaluated using visual analogue scale (VAS), grip power, range of motion (ROM), and digital infrared thermography imaging (DITI). In the EG, electricity was applied for the MTENS device, while electricity was not applied in the CG. Results: A significant difference in pain reduction was observed between the EG and CG. In the EG, a significant difference in grip strength was also noticed before and after using the MTENS; patients showed significantly increased power grip and tip pinch. A significant difference was observed in pre-rest and post-test wrist ROM and DITI values. Conclusion: MTENS is an appropriate procedure for patients with wrist pain.

Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.

Background: Surgery has been known as an inefficient approach to reduce back pain in patients with lumbar spinal stenosis; therefore, non-surgical treatments are necessary. However, there has been little research to analyze the effect of non-surgical treatments on lumbar spinal stenosis pain. Objective: To identify the effectiveness of 2 physiotherapeutic treatment approaches to relieve pain due to lumbar spinal stenosis. Design: Randomized controlled trial Methods: The participants were 36 lumbar spinal stenosis patients who were randomized in the joint mobilization group (JMG) and transcutaneous electrical nerve stimulation group (TENSG). Joint mobilization (JM) was conducted at the posteroanterior joint in the spinous process of the lumbar spine with stenosis. Transcutaneous electrical nerve stimulation (TENS) was applied on the lumbar spine with stenosis at a high frequency and intensity. Results: Visual analog scale (VAS) pain score significantly decreased in both groups, and the VAS value decreased more after JMG than that after TENSG. The pain thresholds of both groups also significantly increased, and that of JMG increased more compared to TENSG. In both the groups, significant improvements in VAS and pain thresholds were found, and JMG showed better results than TENSG. Conclusions: JM and TENS showed significant relief in both pain threshold and painpain, and JM showed more advanced relief compared to TENS.

The present study purposed to examine the effects of transcutaneous electrical nerve stimulation, self-stretching and functional massage on the recovery of muscle contraction force for muscle fatigue caused by sustained isotonic contraction. The subjects of this study were 45 healthy students. They were divided into transcutaneous electrical nerve stimulation group(n=15), self-stretching group(n=15) and functional massage group(n=15), and using Primus RS. We observed the pattern of changes in maximal voluntary isometric contraction force(MVIC) after causing muscle fatigue in quadriceps femoris muscle through sustained isotonic contraction. Maximal voluntary isometric contraction force(MVIC) were greatly increased after transcutaneous electrical nerve stimulation, self-stretching and functional massage. In the comparison of recovery rate of muscle contraction force for muscle fatigue caused by sustained isotonic contraction among the treatment groups, it did not show any significant differences. However, it showed that each treatment may be effective in recovery of muscle fatigue caused by sustained isotonic contraction.

The purpose of this study was to compare visual analogue scale (VAS), pain threshold (PT), , and EMG gaps before and after applying transcutaneous electrical nerve stimulation (TENS) on the upper trapezius muscle at the patients with myofascial pain syndrome (MPS). The subjects were 4 men and 10 women composed of both the inpatients and outpatients who were diagnosed as MPS at Wonju Medical Center. VAS and PT measurements were performed to assess the subjective pain level. The reference voluntary contraction (RVC) test was performed for 15 seconds for normalization on the bilateral trapezius muscle using surface electromyography (sEMG). After 3-minute resting time, the EMG signal was recorded while performing a typing activity for 2 minutes and then TENS was applicated with a comfortable intensity for 10 minutes. The EMG activity of the upper trapezius muscle was recorded during typing for 2 minutes. The results of study were as follows: 1) VAS score was significantly decreased on the more painful side after treatment, however, it was not significantly different on the less painful side. 2) PT was increased after treatment on both sides, however, it was not significantly different between before and after the TENS application. 3) The EMG activity during typing was significantly decreased after treatment, and 4) The EMG gaps were significantly increased after TENS treatment compared to before it. Consequently, the study showed that TENS was effective in decreasing VAS, , and in increasing EMG gaps. The EMG gap analysis could be a useful method to measure pain in patients with MPS in the upper trapezius.

본 연구에서는 상부 승모근의 근막통증(myofascial pain syndrome; MPS)를 대상으로 이완상태에서 근 활성도를 측정해보고, 통증을 감소시키는 데 주로 이용되는 경피신경자극 치료 후 근 활성도에 어떠한 영향을 미치는지 알아보기 위해 실시하였다. 본 연구의 대상자는 근막 통증으로 진단을 받은 총 10명을 대상으로 실시하였다. 주관적 시각 척도(visual analogue scale; VAS)와 압통 역치 측정계(pressure thresh

Delayed onset muscle soreness (DOMS) is a common problem that can interfere with rehabilitation as well as activities of daily living. The purpose of this study was to determine the effects of both transcutaneous electrical nerve stimulation (TENS) and microcurrent electrical neuromuscular stimulation (MENS) on DOMS, Twenty-seven untrained and male volunteer subjects were randomly assigned to one of three treatment groups: 1) a group that received TENS (7 Hz), 2) MENS (60 , .3 pps) or 3) a control group that received no treatment. Subjects performed repeated eccentric exercise of the non-dominant forearm flexor muscle with submaximal intensity by the simply designed eccentric exercise devices. Treatments were applied after 24 hours and 48 hours. Subjects attended on two consecutive days for treatment and measurement of elbow flexion, extension, resting angle (universal goniometer), and pain (visual analogue scale: VAS) on a daily basis. Measurements were taken after treatment. Analysis of results were as follows; 1) There were no significant differences between TENS and MENS by one-way repeated ANOVA, 2) The t-test for pain, resting, flexion and extension angle revealed significant differences within TENS group, 3) The t-test for resting angle revealed significant differences within MENS group.

The purpose of this study was to determine the effects of transcutaneous electrical nerve stimulation(TENS) on delayed onset muscle soreness(DOMS). Twenty males performed eccentric exercise of the elbow flexor. Subjects were randomly assigned to one of three groups: 1) a group (=7) that received low frequency TENS (7 Hz), 2) a group (=7) that received high frequency TENS (500 Hz), 3) a control group (=6) that received no treatment. DOMS was induced in a standardised fashion in the non-dominant elbow flexor of all subjects by repeated eccentric exercise. Treatments were applied immediately following exercise and again at 24 hours and at 48 hours after. Subjects attended on three consecutive days for treatment and measurement of elbow flexion, extension and resting angle(universal goniometer), and pain(Visual Analogue Scale; VAS) on a daily basis. Measurements were taken after treatment. Analysis of results using repeated measures analysis of variance(ANOVA) and post hoc tests were as follows: 1) there were between groups differences in pain value at 48 hours after (p<0.05), 2) one-way ANOVA with repeated measurement for pain, resting angle, flexion angle and extension angle revealed significant differences within low frequency TENS group, 3) one-way ANOVA with repeated measurement for flexion angle revealed significant difference within high frequency TENS group.

The purposes of this study were 1) to determine the changes between pre-treatment and post-treatment of four groups of 15 persons each and 2) to compare the effect of conventional transcutaneous electrical nerve stimulation(TENS) and laser at auricular acupuncture points on experimental pain threshold measured at the wrist. Sixty healthy adult men and women(M:32, F:28), aged 20 to 28 years, were assigned randomly to one of four groups. Group 1 received TENS to the appropriate auricular point for wrist pain, Group 2 received laser to the appropriate auricular point for wrist pain, Group 3 received placebo TENS to the appropriate auricular point for wrist pain, Group 4 received no treatment and served as controls. Experimental pain threshold at the wrist was determined with a painful electrical stimulus before and 20 minutes after ear stimulation. Group 1 was the only group that showed a stastically significant increase (p<0.05) in pain threshold after treatment whereas the Group 2,3 and 4 did not. These results suggest that TENS has the capability to higher pain threshold but laser does not.

The purpose of this study was to determine the effect of transcutaneous electrical nerve stimulation(TENS) on sympathetic tone in healthy subjects. Stimulation in the conventional and burst modes was applied to the skin of the forearm overlying the median nerve. TENS was applied for 20 minutes at an intensity sufficient to produce a perceptible though not uncomfortable sensation and no muscle contracion of the forearm musculature. The change in sympathetic tone was measured with skin temperature. Skin temperature was measured at the index finger and on the volar surface of the forearm in the stimulated limb. The conventional and burst modes did not change the skin temperature at any of the two measurement sites. We conclude that TENS, as applied in this study, does not influence sympathetic tone. Further research is needed to assess the sympathetic effects of TENS on patient groups, long term treatment and other modalities.

The purpose of this study was to compare acupuncture-like transcutaneous electrical nerve stimulation(ALTENS) with conventional transcutaneous electrical nerve stimulation(C-TENS) for crossover effect in healthy subjects. Forty subjects recieved ALTENS(20 persons), C-TENS(20 persons) to one upper extremity. Each technic was applied to the motor point of the wrist extensor muscle group for twenty-minutes. With the subject placed in supine the technics were applied at 80 Hz, 2-10 mA(ALTENS) and 10 Hz, 4-12 mA(C-TENS). Results revealed: (1) a significant difference between the pretreatment and posttreatment in each group(p<.05) (2) no significant difference between ALTENS and C-TENS(p>.05). In conclusion, there was no difference between ALTENS and C-TENS for crossover effect.

The purpose of this study was to determine a more effective method for shoulder pain reduction. Forty-five normal subjects were randomly assigned to one of 3 groups a control group, an acupuncture-like transcutaneous electrical nerve stimulation(ALTENS) group, and a silver spike point(SSP) group. Each person in the ALTENS and SSP groups was measured for pressure pain threshold before and after a 20 minute treatment. The control group was also checked for pressure pain threshold before and after a 20 minute period but no "treatment" was given. The major findings were as follows ; 1)The ALTENS and SSP groups showed significant differences before and after treatment but the control group showed no significant difference. 2)When the three groups were compared, the only significant difference was between the SSP group and the control group. As mentioned above, it may be concluded that both ALTENS and SSP therapy were effective in reducing shoulder pain when measured directly after treatment. However, SSP did not show any superior effect. Further study should be done to determine the effective the maintained pain reduction with post-treatment time lapse.