About
Scope & Aims
Editorial office
Editorial board
Ethical standards and procedures
Abstracting and indexing
Contact
Articles & Issues
Current issue
Articles in press
Archive
For Authors
General rules
Ethics in publishing
Guide for authors
Templates
Publication charge
For Reviewers
Our reviewers
Ethics in publishing
Guide for reviewers
Books and Events
Books
Events
REVIEW PAPER
Effectiveness of Träbert current in a physiotherapy program for the management of musculoskeletal pain: a systematic review and meta-analysis
1
Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile.
Submission date: 2022-08-23
Acceptance date: 2022-10-06
Publication date: 2024-03-25
Corresponding author
Hernán Andrés de la Barra Ortiz
Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile.
Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile.
Physiother Quart. 2024;32(1):1-14
KEYWORDS
systematic reviewtranscutaneous electrical nerve stimulationelectrical stimulation therapyTräbert currentmusculoskeletal painmusculoskeletal diseases
TOPICS
ABSTRACT
Introduction:
Träbert current (TC) is a physical therapy resource described for the management of musculoskeletal pain (MSP). It combines the effects of galvanism and sensory stimulation, offering various analgesic applications, although it seems that the studies that support its effectiveness are limited. The aim of this study was to evaluate the effectiveness of TC in a physical therapy plan for the management of MSP.
Methods:
Electronic databases reviewed included Medline (via PubMed), Web of Science, Scopus, CINAHL, Science Direct, and PEDro (last updated January 12, 2024). Randomised clinical trials (RCTs) comparing TC with other physical therapy interventions were included. Seven studies met the inclusion criteria and were analysed qualitatively, while five contributed to the meta-analysis. The clinical conditions treated included knee osteoarthritis, low back pain (LBP), and epicondylalgia. The risk of bias and internal validity was evaluated using the Rob2 tool (Cochrane) and the PEDro scale.
Results:
RCTs were rated as having favourable internal validity (PEDro), despite a lack of concealed allocation and blinding, resulting in an unclear risk of bias on D2 and D5 (Rob2). The studies reported a decrease in pain and disability for the experimental groups (p < 0.05), although the meta-analysis revealed a non-significant pooled effect for the standardised mean difference (SMD = 0.2–0.5, p > 0.05) in favour of the controls and with heterogeneity between the studies (I2 = 50–75%).
Conclusions:
TC seems to be effective for the management of MSP, although it is necessary to improve the quality of the clinical trials to conduct a conclusive quantitative analysis. Key words: systematic review, transcutaneous electrical nerve stimulation, electrical stimulation therapy, Träbert current, musculoskeletal pain, musculoskeletal diseases
Träbert current (TC) is a physical therapy resource described for the management of musculoskeletal pain (MSP). It combines the effects of galvanism and sensory stimulation, offering various analgesic applications, although it seems that the studies that support its effectiveness are limited. The aim of this study was to evaluate the effectiveness of TC in a physical therapy plan for the management of MSP.
Methods:
Electronic databases reviewed included Medline (via PubMed), Web of Science, Scopus, CINAHL, Science Direct, and PEDro (last updated January 12, 2024). Randomised clinical trials (RCTs) comparing TC with other physical therapy interventions were included. Seven studies met the inclusion criteria and were analysed qualitatively, while five contributed to the meta-analysis. The clinical conditions treated included knee osteoarthritis, low back pain (LBP), and epicondylalgia. The risk of bias and internal validity was evaluated using the Rob2 tool (Cochrane) and the PEDro scale.
Results:
RCTs were rated as having favourable internal validity (PEDro), despite a lack of concealed allocation and blinding, resulting in an unclear risk of bias on D2 and D5 (Rob2). The studies reported a decrease in pain and disability for the experimental groups (p < 0.05), although the meta-analysis revealed a non-significant pooled effect for the standardised mean difference (SMD = 0.2–0.5, p > 0.05) in favour of the controls and with heterogeneity between the studies (I2 = 50–75%).
Conclusions:
TC seems to be effective for the management of MSP, although it is necessary to improve the quality of the clinical trials to conduct a conclusive quantitative analysis. Key words: systematic review, transcutaneous electrical nerve stimulation, electrical stimulation therapy, Träbert current, musculoskeletal pain, musculoskeletal diseases
REFERENCES (53)
1.
George SZ, Goode AP. Physical therapy and opioid use for musculoskeletal pain management: competitors or companions? Pain Rep. 2020;5(5):e827; doi: 10.1097/PR9.0000000000000827.
2.
Feldman DE, Carlesso LC, Nahin RL. Management of patients with a musculoskeletal pain condition that is likely chronic: results from a national cross sectional survey. J Pain. 2020;21(7–8):869–880; doi: 10.1016/j.jpain.2019.11.01.
3.
Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011;25(2):173–83; http://dx.doi.org/10.1016/j.be....
4.
George SZ, Giczewska A, Alhanti B, Lutz AD, Shanley E, Thigpen CA, et al. Predicting recurrent care seeking of physical therapy for musculoskeletal pain conditions. Pain Med. 2021;22(8):1837–49; doi: 10.1093/pm/pnab154.
5.
Prus V, Kardum Ž. Clinical entities and characteristics of pain in patients with rheumatic diseases [in Croatian]. Reumatizam. 2016;63 Suppl 1:23–26..
6.
Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11): The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160(1):19–27; doi: 10.1097/j.pain.0000000000001384.
7.
El-Tallawy SN, Nalamasu R, Salem GI, LeQuang JAK, Pergolizzi JV, Christo PJ. Management of musculoskeletal pain: An update with emphasis on chronic musculoskeletal pain. Pain Ther. 2021;10(1):181–209; doi: 10.1007/s40122-021-00235-2.
8.
Atchison JW, Herndon CM, Rusie E. NSAIDs for musculoskeletal pain management:current perspectives and novel strategies to improve safety. J Manag Care Pharm. 2013;19(9 Suppl A):3–19.
9.
Derry S, Conaghan P, Da Silva JAP, Wiffen PJ, Moore RA. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2016;4(4):CD007400; doi: 10.1002/14651858.CD007400.pub3.
10.
Babatunde OO, Jordan JL, Van der Windt DA, Hill JC, Foster NE, Protheroe J. Effective treatment options for musculoskeletal pain in primary care: a systematic overview of current evidence. PLoS One. 2017;12(6):e0178621; doi: 10.1371/journal.pone.0178621.
11.
Qaseem A, Wilt TJ, McLean RM, Forciea MA, Clinical Guidelines Committee of the American College of Physicians, Denberg TD, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514–30; doi: 10.7326/M16-2367.
12.
Marris D, Theophanous K, Cabezon P, Dunlap Z, Donaldson M. The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials. Physiother Theory Pract. 2021;37(4):461–472; doi: 10.1080/09593985.2019.1633714.
13.
Hussein HM, Alshammari RS, Al-Barak SS, Alshammari ND, Alajlan SN, Althomali OW. A systematic review and meta-analysis investigating the pain-relieving effect of interferential current on musculoskeletal pain. Am J Phys Med Rehabil. 2021;101(7):624–633; doi: 10.1097/PHM.0000000000001870.
14.
Gladwell PW, Cramp F, Palmer S. Matching the perceived benefits of Transcutaneous Electrical Nerve Stimulation (TENS) for chronic musculoskeletal pain against Patient Reported Outcome Measures using the International Classification of Functioning, Disability and Health (ICF). Physiotherapy. 2020;106:128–135; doi: 10.1016/j.physio.2019.01.017.
15.
Johnson MI, Paley CA, Jones G, Mulvey MR, Wittkopf PG. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain: a systematic review and meta-analysis (meta-TENS). SSRN Electron J. 2020; doi: 10.2139/ssrn.3756796.
16.
Cameron MH. Physical agents in rehabilitation: an evidence-based approach to practice. 6th ed. Philadelphia: Elsevier Health Sciences Division; 2022.
17.
Rodríguez Martin JM. Electroterapia en fisioterapia [in Spanish]. 2nd ed. Editorial Medica Panamericana; 2005.
18.
Ahangari M, Fashkhami AN, Zinalpoor H, Ahangari H, Sajjadi MRM. Ultra-reiz current appears to be more effective modality than interferential for people with knee osteoarthritis: a randomized Block clinical trial. Psych Ther J Indonesia. 2020;1(2):29–34; doi: 10.51559/ptji.v1i2.13.
19.
Chwieśko-Minarowska S, Kuryliszyn-Moskal A, Olędzka A, Moskal-Jasińska D. The effectiveness of short-term massage versus Träbert current therapy in patients with low back pain. Acta Balneol. 2019;61(4/158):247–251; doi: 10.36740/abal201904104.
20.
Ortiz HA, Cancino JO, Goluboff NM, Obando GA, Jara MH, Vera MFG. Effects of ascending and descending direct current on grip strength assessed through dynamometry and myofeedback: a randomized controlled trial. Physiother Quart. 2020;28(2):1–8; doi: 10.5114/pq.2020.92471.
21.
Sluka KA, Walsh D. Transcutaneous electrical nerve stimulation: basic science mechanisms and clinical effectiveness. J Pain. 2003;4(3):109–121; doi: 10.1054/jpai.2003.434.
22.
Liebano RE, Rakel B, Vance CGT, Walsh DM, Sluka KA. An investigation of the development of analgesic tolerance to TENS in humans. Pain. 2011;152(2):335–342; doi: 10.1016/j.pain.2010.10.040.
23.
van Wijk G, Veldhuijzen DS. Perspective on diffuse noxious inhibitory controls as a model of endogenous pain modulation in clinical pain syndromes. J Pain. 2010;11(5):408–419; doi: 10.1016/j.jpain.2009.10.009.
24.
Villanueva L, Le Bars D. The activation of bulbo-spinal controls by peripheral nociceptive inputs: diffuse noxious inhibitory controls. Biol Res. 1995;28(1):113–125.
25.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10(1):89; doi: 10.1186/s13643-021-01626-4.
26.
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan – a web and mobile app for systematic reviews. Syst Rev. 2016;5:210; doi: 10.1186/s13643-016-0384-4.
27.
Macedo LG, Elkins MR, Maher CG, Moseley AM, Herbert RD, Sherrington C. There was evidence of convergent and construct validity of Physiotherapy Evidence Database quality scale for physiotherapy trials. J Clin Epidemiol. 2010;63(8):920–925; doi: 10.1016/j.jclinepi.2009.10.005.
28.
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898; doi: 10.1136/bmj.l4898.
29.
McGuinness LA, Higgins JPT. Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments. Res Synth Methods. 2021;12(1):55–61; doi: 10.1002/jrsm.1411.
30.
Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011;64(4):380–382; doi: 10.1016/j.jclinepi.2010.09.011.
31.
Basu A. How to create a summary of findings table with GRADEPro. Qeios. 2020; doi: 10.32388/p8gac4.
32.
Sen S, Kumar TRN, Rau S. Effects of ultra Reitz current and TENS on pain and functional ability in older patients with osteo arthritis knee. Int J Physiother Res. 2013;1(4):171–176.
33.
Pantoja FI, Pérez TO, Quintana ME,Effectiveness of the segmental treatment with Trabert current in patient with epicondylitis external humeral. MediSan. 2015;19(6):747–755.
34.
Pantoja FI, Pérez TO, Quintana ME, González BR. Effectiveness of the acupunctural treatment in patients with external humeral epicondylitis. MediSan. 2015;19(7):831–838.
35.
Dakowicz A, Milewska A, Gradkowska A, Matys A, Tarkowska K, Białowieżec M. Efficiency of selected physiotherapeutic treatments for low back pain. Prog Health Sci. 2016;6(2):70–76; doi: 10.5604/01.3001.0009.5051.
36.
Nurachma W, Pristianto A, Budi T. Efek Electro Therapy Träbert current and Pulse burst Knee Osteoarthritis pain grade II: Academic Physiotherapy Conference; 2019.
37.
Ruppar T. Meta-analysis: how to quantify and explain heterogeneity? Eur J Cardiovasc Nurs. 2020;19(7):646–652; doi: 10.1177/1474515120944014.
38.
Rodrigues EV, Gomes ARS, Tanhoffer AIP, Leite N. Effects of exercise on pain of musculoskeletal disorders: a systematic review. Acta Ortop Bras. 2014;22(6):334–338; doi: 10.1590/1413-78522014220601004.
39.
Hurley M, Dickson K, Hallett R, Grant R, Hauari H, Walsh N, et al. Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. Cochrane Database Syst Rev. 2018;4:CD010842; doi: 10.1002/14651858.CD010842.pub2.
40.
Gomes-Neto M, Lopes JM, Conceição CS, Araujo A, Brasileiro A, Sousa C, et al. Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: a systematic review and meta-analysis. Phys Ther Sport. 2017;23:136–142;doi: 10.1016/j.ptsp.2016.08.004.
41.
Cantín M. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Reviewing the latest version [in Spain]. Int J Med Surg Sci. 2018;1(4):339–346; doi: 10.32457/ijmss.2014.042.
42.
Chiarotto A, Maxwell LJ, Ostelo RW, Boers M, Tugwell P, Terwee CB. Measurement properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity subscale of the Brief Pain Inventory in patients with low back pain: a systematic review. J Pain. 2019;20(3):245–263; doi: 10.1016/j.jpain.2018.07.009.
43.
Alghadir A, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res. 2018;11:851–856; doi: 10.2147/jpr.s158847.
44.
Salaffi F, Leardini G, Canesi B, Mannoni A, Fioravanti A, Caporali R, et al. Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee. Osteoarthritis Cartilage. 2003;11(8):551–560; doi: 10.1016/s1063-4584(03)00089-x.
45.
Collins NJ, Prinsen CAC, Christensen R, Bartels EM, Terwee CB, Roos EM. Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta-analysis of measurement properties. Osteoarthritis Cartilage. 2016;24(8):1317–1329; doi: 10.1016/j.joca.2016.03.010.
46.
van Wijk G, Veldhuijzen DS. Perspective on diffuse noxious inhibitory controls as a model of endogenous pain modulation in clinical pain syndromes. J Pain. 2010;11(5):408–19; doi: 10.1016/j.jpain.2009.10.009.
47.
Moayedi M, Davis KD. Theories of pain: from specificity to gate control. J Neurophysiol. 2013;109(1):5–12; doi: 10.1152/jn.00457.2012.
48.
Vance CGT, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Manag. 2014;4(3):197–209; doi: 10.2217/pmt.14.13.
49.
Hebb ALO, Poulin J-F, Roach SP, Zacharko RM, Drolet G. Cholecystokinin and endogenous opioid peptides: Interactive influence on pain, cognition, and emotion. Prog Neuro-Psychopharmacol Biol Psychiatry. 2005;29(8):1225–1238; doi: 10.1016/j.pnpbp.2005.08.008.
50.
Van Oosterwijck J, Nijs J, Meeus M, Paul L. Evidence for central sensitization in chronic whiplash: a systematic literature review: systematic review: central sensitization in chronic WAD. Eur J Pain. 2013;17(3):299–312; doi: 10.1002/j.1532-2149.2012.00193.x.
51.
Pereira-Silva R, Costa-Pereira JT, Alonso R, Serrão P, Martins I, Neto FL. Attenuation of the diffuse noxious inhibitory controls in chronic joint inflammatory pain is accompanied by anxiodepressive-like behaviors and impairment of the descending noradrenergic modulation. Int J Mol Sci. 2020;21(8):2973; doi: 10.3390/ijms21082973.
52.
Mibu A, Nishigami T, Tanaka K, Manfuku M, Yono S. Difference in the impact of central sensitization on pain-related symptoms between patients with chronic low back pain and knee osteoarthritis. J Pain Res. 2019;12:1757–1765; doi: 10.2147/JPR.S200723.
53.
Johnson MI, Paley CA, Wittkopf PG, Mulvey MR, Jones G. Characterising the features of 381 clinical studies evaluating transcutaneous electrical nerve stimulation (TENS) for pain relief: a secondary analysis of the meta-TENS study to improve future research. Medicina. 2022;58(6):803; doi: 10.3390/medicina58060803.
Share
RELATED ARTICLE
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
