| Learning Objective #1: Describe the research hypotheses and rationale for this study | |||
| Learning Objective #2: Discuss the results of this study and the implications for nursing practice |
Recent evidence shows high frequency, high intensity TENS reduces movement-evoked pain by decreasing hyperalgesia. The purpose of this study was to test the effectiveness of intermittent, intense TENS as a supplement to pharmacologic analgesia on pain with movement and pain at rest after abdominal surgery and determine if its use during walking and vital capacity maneuvers enhances these activities. TENS was compared to placebo TENS and pharmacologic analgesia alone (control) using a slit-plot design. Subjects’ self-report of pain intensity was assessed (using a vertical, 21-point NRS), along with walking function (using gait speed, gait distance, and level of assistance) and vital capacity. Repeated measures ANOVA procedures with Tukey follow-up tests revealed significant differences in 33 subjects’ pain intensity scores during gait speed (p<.05) and vital capacity maneuvers (p<.01). TENS resulted in significantly better scores than the control during both activities and significantly less pain than placebo TENS during vital capacity. Significant differences were also found for gait speed (p<.05) and gait distance (p<.01) with TENS resulting in significantly better gait speeds and greater gait distances than the control and significantly greater gait distances than placebo TENS. However, effect sizes were small (.07-.58). Vital capacity and pain intensity at rest were not significantly different. The intensity of the TENS sensation subjects used varied widely but no significant differences were found between subjects who used high and low TENS intensities. These results suggest that TENS reduces pain intensity during walking and deep breathing and increases walking function postoperatively when used as a supplement to pharmacologic analgesia. The small effect sizes suggest selective use is most appropriate. The lack of effect on pain at rest supports the hypothesis that TENS works through reducing hyperalgesia. Further research is needed to investigate the impact of TENS on hyperalgesia around human surgical incisions.
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