The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    TENS for people with osteoporosis

    Quadriceps activation deficits (delayed muscle activation, see photo) are common in people with tibiofemoral (knee) osteoarthritis.

    Researchers at the University of Toledo, in Ohio, studied transcutaneous electrical nerve stimulation (TENS) set to a sensory level and therapeutic exercise to increase quadriceps activation in people with tibiofemoral osteoarthritis.

    First, the details.

    • 36 people with radiographically assessed tibiofemoral osteoarthritis were randomly assigned to a treatment group for 4 weeks of supervised lower extremity exercise.
      • TENS + exercise
      • Placebo TENS + exercise
      • Exercise only
    • TENS and placebo TENS were worn during the exercise sessions and daily activities.
    • Quadriceps central activation ratio (a measure of muscular activation) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were evaluated at 2 and 4 weeks of the treatment.

    And, the results.

    • Quadriceps activation was significantly higher in the TENS + exercise group vs exercise only at 2 weeks.
    • Quadriceps activation was significantly higher in the TENS + exercise group vs placebo + exercise group at 4 weeks.
    • WOMAC scores improved in all 3 groups over time, with no significant differences among groups.

    The bottom line?

    The authors concluded, ‚ÄúThis study provides evidence that TENS applied in conjunction with therapeutic exercise and daily activities increases quadriceps activation in patients with tibiofemoral osteoarthritis and, while function improved for all participants, effects were greatest in the group treated with a combination of TENS and therapeutic exercises.”

    OK, but consider this. The WOMAC index is used to assess patients with osteoarthritis of the hip or knee using 24 parameters. It can be used to monitor the course of the disease or to determine the effectiveness of anti-rheumatic medications.

    It seems there were changes in a physiological test, but no significant improvement in WOMAC, a clinical assessment of disease, compared to exercise only.

    3/10/11 20:54 JR

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