Background. Somatosensory input may lead to long-lasting cortical plasticity enhanced by motor recovery in patients with neurological impairments. Sensory transcutaneous electrical stimulation (TENS) is a relatively risk-free and easy-to-implement modality for rehabilitation. Objective. The authors systematically examine the effects of sensory TENS on motor recovery after stroke. Methods. Eligible randomized or quasi-randomized trials were identified via searches of computerized databases. Two assessors reviewed independently the eligibility and methodological quality of the retrieved articles. Results. In all, 15 articles satisfied the inclusion criteria. Methodological quality was generally good, with a mean (standard deviation) PEDro score of 6.7/10 (1.2). Although the majority of studies reported significant effects on at least 1 outcome measure, effect sizes were generally small. Meta-analysis could not be performed for the majority of outcome measures because of variability between studies and insufficient data. A moderate effect was determined for force production of the ankle dorsiflexors and for the Timed Up and Go test. Conclusions. Sensory stimulation via TENS may be beneficial to enhance aspects of motor recovery following a stroke, particularly when used in combination with active training. Because of the great variability between studies, particularly in terms of the timing of the intervention after the stroke, the outcome measures used, and the stimulation protocols, insufficient data are available to provide guidelines about strategies and efficacy.

Background: Transcutaneous electrical nerve stimulation (TENS) is a noninvasive modality which may be used to reduce acute postoperative pain. Intense perioperative pain within the first few days after hip fracture surgery is common and is related to negative consequences such as restricted and delayed ambulation. Objective: The objective of the present study was to examine the effect of incorporating TENS treatment on pain intensity, and mobility, with standard rehabilitation care during the acute post-operative phase following Gamma-nail surgical fixation of extracapsular hip fractures. Materials and methods: Forty-one patients were randomly assigned to a supplement of 30 mins of active TENS or sham TENS. The standard rehabilitation care included five daily 30 mins physical therapy treatments beginning 24 hrs after surgery. Outcome measures were: pain intensity at rest, at night and during ambulation (assessed with the Numeric Rating Scale; Functional Ambulation Classification instrument; time to complete five sit-to-stand tests; and two-minute walk test). Data were analyzed with Wilcoxon score rank tests. Significance was set at p≤0.05. Results: Significantly greater pain reduction during walking was noted in the active TENS group compared to sham TENS group (differences between the fifth and the second days: 2.55±1.37 vs 1.06± 1.11, respectively; p=0.0011). Additionally, advantage of active TENS was demonstrated in greater increase in walking distance on the fifth day and higher level of mobility compared to the sham TENS group. No additional effects of active TENS were noted on pain intensity at rest and at night and on five times sit-to-stand performance. Conclusion: Addition of TENS to the standard care of elderly patients in the early days following Gamma nail surgical fixation of extracapsular hip fracture is recommended for pain management while walking and functional gait recovery. The effect of TENS on long-term functional outcomes should be explored in future studies. Trial registration: The trial was registered at the ISRCTN registry: ID ISRCTN32476360.

Reatment algorithm aimed at optimizing and simplifying the clinical application of NMES therapy following knee surgery.➤The suggested algorithm includes a short preoperative phase for patient education (1 visit) and familiarization with NMES, followed by 2 home-based treatment phases (each lasting 3 weeks): (1) a high-intensity, high-volume phase initiated within the first few days following surgery, and (2) a high-intensity, low-volume phase.➤Two evaluation sessions are also incorporated, with the first following 1 week of treatment to assess the responsiveness to NMES and the second after 3 weeks of treatment to assess whether voluntary activation failure has resolved.➤Practical guidelines for maximizing muscle response while minimizing discomfort and fatigue, including optimal pulse characteristics, electrode size and location, knee joint position, and patient instructions, are provided....

Primary dysmenorrhea is a chronic health condition that affects primarily young women. Transcutaneous electrical nerve stimulation (TENS) has been suggested as an effective pain reduction modality in primary dysmenorrhea. TENS is a noninvasive, inexpensive, portable method with minimal risks and a few contraindications. When necessary, it can be self-administered on a daily basis during everyday activities. Several studies have investigated the effectiveness of TENS in reducing pain, decreasing the use of analgesics, and improving the quality of life in primary dysmenorrhea patients. These studies have some limitations in methodological quality and therapeutic validation. However, the overall positive effects of TENS in primary dysmenorrhea encountered in all prior studies indicated its potential value. This review presents the clinical recommendations for TENS parameters for treating primary dysmenorrhea symptoms based on previously published studies.

Background. There is no consensus regarding gender-related differences in pain intensity and functional abilities among patients with knee osteoarthritis (OA). Objective. Determine gender-related differences in pain intensity and functional ability among subjects with knee OA, as assessed by a self-report questionnaire and by performance-based tests. Methods. Sixty-three subjects with symptomatic knee pain due to OA were included in this study. The outcome measures were self-reported knee pain intensity and physical function (WOMAC), as well as three performance-based functional assessments: time up and go test, a 10-meter walk test, and stair negotiation. Independent sample t-tests were performed to determine gender differences. Level of significance was set at . Results. Female subjects reported higher levels of knee pain and lower functional performance. In contrast, no significant gender-related differences were determined in any of the performance-based measures. Conclusion. The results indicate that the two types of functional ability measures may address different constructs of functional ability. Self-reported ability, particularly in the female subjects, may be influenced by psychological aspects associated with chronic pain. Rehabilitation programs should consider the underlying mechanisms of the patients’ performance limitations in order to address the specific needs of each individual patient.

Introduction: Weight stigmatization is reflected in anti-fat attitudes and stereotypical perceptions of people who are overweight; it has been demonstrated to be prevalent in many segments of society across multiple countries. Studies examining the prevalence of weight stigmatization use different research tools, which can hinder inter-study comparisons. There is also evidence indicating weight stigmatization among registered physical therapists, although its magnitude differs between studies. Limited information exists regarding the attitudes and beliefs of physical therapy (PT) students toward individuals with obesity. Examining weight stigmatization among PT students is particularly important for developing appropriate educational interventions that may influence the professional lives of future physical therapists. Objective: This study aims to characterize and compare the stigmatizing attitudes and beliefs of PT students and certified physical therapists regarding people with obesity in Israel. Its secondary objective is to translate three weight stigmatization questionnaires into Hebrew and determine their psychometric properties. Methods: A cross-sectional, anonymous, and computerized self-report survey was completed by 285 certified physical therapists (average age 39.6 ± 10.1 years) and 115 PT students (average age 26.4 ± 4.9 years). The study used three validated weight stigma questionnaires employed in earlier studies to determine different aspects of weight stigmatization: the Fat Phobia Scale (short form; FPS), Anti-Fat Attitudes (AFA) questionnaire, and Beliefs about Obese People (BAOP). These questionnaires were translated into Hebrew and their psychometric properties ascertained. Results: Similar to the original English versions, the translated versions of the three questionnaires demonstrated good internal consistency (Cronbach’s α values of FPS = 0.77; AFA = 0.75; BOAP = 0.59). The three questionnaires showed a low correlation. No significant difference was noted in the FPS and AFA scores between groups, reflecting that both demonstrated average weight stigmatization (FBS in both groups: average score of 3.6 out of 5; AFA therapists: 3.3 ± 1.2, students: 3.0 ± 1.2 out of 9). However, significant between-group differences were observed for BOAP, which examines beliefs regarding individuals’ control over their weight (therapists: 16.4 ± 5.6, students: 18.0 ± 5.7 out of 48; p < 0.01). Conclusion: Student and certified physical therapists demonstrate average levels of weight stigmatization, as reflected in the FPS and AFA scores. Nevertheless, compared to certified physical therapists, physical therapist students believe more strongly that obesity cannot be controlled by the individual. The students’ beliefs could affect their clinical judgment and behavior as health care professionals in the future. Therefore, anti-fat attitudes and stereotypical perceptions should be addressed and remediated early using educational interventions during the study period.