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Qual o parâmetro mais recomendado para aplicação de TENS?

Muitos estudos apresentam divergência na escolha dos parâmetros.

Jeffeson Hildo Medeiros de Queiroz

7 months ago

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patrick.debock99
patrick.debock99

Hi Jeffeson,

Conventional and acupuncture-like TENS are two general descriptions for parameter settings. Others like "high-frequency-low-intensity TENS" and "low-frequency-high-intensity TENS" are in use too. They are really not the only ones and like I said, one could debate for hours about what is right or wrong. My suggestion is not to use these general descriptions but to focus on what is the goal of using the TENS current. If the goal were to stimulate muscles, there would again be complete different parameter settings. Next to that I often stumbled upon literature that left some parameters undiscussed, which is why I made parameter lists with 9 items. There is always room for interpretation but if your purpose is to decrease pain you can rely upon these.

Regards, Patrick

Jeffeson Medeiros
Jeffeson Medeiros

Encontrei na literatura este parâmetro: TNS CONVENCIONAL: 90-130 Hz e 20-50 uS durante 30/60 minutos (dores agudas) e TNS ACUPUNTURA: 2-10 Hz e 180-250 uS durante, no máximo, 20 minutos ( para dores crônicas). Isto realmente é o mais indicado?

Prof Richard Liebano
Prof Richard Liebano

Jefferson, a escolha dos parâmetros deve ser feita com base em tentativa e erro. Em dores agudas o uso de alta frequência (80-100 Hz) geralmente é o mais indicado. Por exemplo, em dismeorreia primária já se sabe que somente as frequências altas apresentam evidencias, em contraste com a as baixas frequências (<10 Hz). Já em pacientes com dores crônicas, ambas as modalidades podem ser usadas, lembrando que como a TENS de alta frequência ativa receptores delta opioides, pacientes em uso de drogas opioides ainda poderão ter analgesia. Já a TENS de baixa frequência não promoverá analgesia em paciente com uso de drogas opioides devido à tolerância cruzada, pois ambos agem nos receptores mu-opioides.

Cliff Eaton
Cliff Eaton

Patrick nailed it!

patrick.debock99
patrick.debock99

Hi Jefferson,

Espero que entiendan inglés ya que no confié en Google Translate para poner todo en Español. One could talk for days about the parameter settings and these two sets certainly aren't the only ones but based on literature findings and years of clinical experience apply well for pain decreasing purposes.

  1. Decreasing pain on the basis of gate control: pulse shape: biphasic asymmetric TENS pulse; frequency: between 50 and 100 Hz, see modulation; pulse width: preferably 30 µs but otherwise <50 µs; interruption: do not select the burst option or switch burst to OFF!; modulation: ON! 50 to100 Hz (= frequency min 50 Hz, frequency max 100 Hz) in a 0-2-0-2 seconds spectrum; electrodes: vertebral at innervation level of the pathology and/or local electrode position; treatment time: 20 minutes ON + minimal 40 minutes PAUSE + repeat when pain comes back; intensity: a strong feeling of current above M-threshold but not painful, annoying, irritating or unpleasant; CC vs CV: CC.

  2. Decreasing pain on the basis of endorphin release: pulse shape: biphasic asymmetric TENS pulse; frequency: 4 Hz; pulse width: > 300 µs; interruption: do not select the burst option or switch burst to OFF!; modulation: OFF! = this option is not used, frequency min = frequency max; electrodes: local or vertebral, for humane reasons not related to the pathology; treatment time: 40 minutes ON + 60 to 90 minutes PAUSE + repeat when pain comes back; intensity: just below nocisensory level with well tolerable muscle contractions; CC vs CV: CC.

Patrick De Bock, PT school, university of Antwerp, Belgium

Last updated 7 months ago

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