Preview

Rheumatology Science and Practice

Advanced search

EFFICIENCY OF DYNAMIC ELECTRONEUROSTIMULATION IN KNEE OSTEOARTHRITIS: RESULTS OF A MULTICENTER RANDOMIZED STUDY

https://doi.org/10.14412/1995-4484-2015-281-288

Abstract

Dynamic electroneurostimulation (DENS) is a type of percutaneous electroneurostimulation with a differentiation approach to choosing exposure areas and to optimizing electrocutaneous therapeutic action on the reflexogenic areas and acupuncture points for analgesia and for the treatment of functional disorders.

Objective: to study the clinical efficiency and safety of therapy using a DiaDENS-PC apparatus in the treatment of knee osteoarthritis (OA).

Subjects and methods. A multicenter randomized double-blind placebo-controlled study was conducted in 132 knee OA patients with pain value above 40 mm on visual analogue scale (VAS) and Lequesne’s index of 4–12. In a study group (n = 66), DENS was carried outwith a DiaDENS-PC apparatus using a trailing electrode applicator to the knee target in a Therapy stimulation mode at a frequency 77 Hz, a power of 15 units. In the placebo group, the similar procedure was performed with a switched-on placebo apparatus that did not differ in appearance from the working apparatus; but produced no electrical pulses. The treatment cycle consisted of 10 sessions lasting 30 min. Changes in Lequesne’s algofunctional index were primary end point. The results of the Get-Up to Go test (in seconds) and changes pain on VAS and WOMAC were used as secondary end points.

Results and discussion. Both groups showed a statistically significant reduction of painand improvement of Get-Up and to Go test results by the end of the treatment course (p < 0.0001). Therewas a statistically significant difference in pain in the compared groups after a treatment session during the first (p = 0.037) and second (p = 0.010) visits. The analgesic effect of therapy was observed to persist in the DENS group 2 weeks (p = 0.006) and 1 month (p = 0.070) after treatment termination. After 10 sessions, there was a statistically significant difference between the groups in the Get-Up and Go test (p = 0.033) and Lequesne’s index (p = 0.022). Both groups exhibited a significant decrease in the total WOMAC scores. In the DENS group, positive changes in all subscales were statistically significant starting from the second visit whereas in the control group, the total WOMAC scores improved

only at the expense of the pain subscale.

About the Authors

O. M. Lesnyak
Ural State Medical University, Ministry of Health of Russia, Yekaterinburg, Russia 3, Repin St., Yekaterinburg 620028 I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia 41, Kirochnaya St., Saint Petersburg, Russia
Russian Federation


E. Yu. Kadochnikova
Ural State Medical University, Ministry of Health of Russia, Yekaterinburg, Russia 3, Repin St., Yekaterinburg 620028
Russian Federation


L. I. Alekseeva
V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522
Russian Federation


I. G. Dydykina
Yaroslavl State Medical University, Ministry of Health of Russia, Yaroslavl, Russia
Russian Federation


O. B. Ershova
Yaroslavl State Medical University, Ministry of Health of Russia, Yaroslavl, Russia 5, Revolutsionnaya St., Yaroslavl 150000
Russian Federation


E. M. Zaitseva
V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522
Russian Federation


T. A. Korotkova
V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522
Russian Federation


T. A. Popova
City Rheumatology Center, City Clinical Hospital Forty, Yekaterinburg, Russia 189, Volgogradskaya St., Yekaterinburg 620102
Russian Federation


M. L. Sukhareva
V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522
Russian Federation


E. A. Taskina
V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522
Russian Federation


V. N. Khodyrev
Ural State Medical University, Ministry of Health of Russia, Yekaterinburg, Russia 3, Repin St., Yekaterinburg 620028
Russian Federation


E. P. Sharapova
V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522
Russian Federation


A. G. Solodovnikov
Ural State Medical University, Ministry of Health of Russia, Yekaterinburg, Russia 3, Repin St., Yekaterinburg 620028
Russian Federation


A. A. Vlasov
DENAS MS Corporation, Yekaterinburg, Russia 15, Academician Postovsky St., Yekaterinburg 620146
Russian Federation


References

1. Насонова ВА, Фоломеева ВА, Эрдес Ш. Ревматические болезни в России в начале XXI века. Научно-практическая

2. ревматология.2003;(1):6–10 [Nasonova VA, Folomeeva VA, Erdes Sh. Rheumatic diseases in Russia in the beginning of the XXI century. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practiсе. 2012;(1):6–10 (In Russ.)].

3. Галушко ЕА, Большакова ТЮ, Виноградова ИБ и др. Структура ревматических заболеваний среди взрослого населения России по данным эпидемиологического исследования (предварительные результаты). Научно- практическая ревматология. 2009;(1):11–7 [Galushko EA, Bolshakova TY, Vinogradova IB, et al. Structure of rheumatic diseases among the adult population of Russia according to epidemiological studies (preliminary results). Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practiсе. 2009;(1):11–7 (In Russ.)].

4. Лесняк ОМ. Остеоартрит. Диагностика и ведение больных остеоартритом коленных и тазобедренных суставов. Клинические рекомендации. Москва: ГЭОТАР-Медиа; 2006. С. 19, 68 [Lesnyak OM. Osteoartrit. Diagnostika i vedenie ol'nykh osteoartritom kolennykh i tazobedrennykh sustavov. Klinicheskie rekomendatsii [Osteoarthritis. Diagnosis and management of patients with osteoarthritis of the knee and hip joints. Clinical recommendations]. Moscow: GEOTAR-Media; 2006. P. 19, 68].

5. Разумов АН, Василенко АМ, Боборовницкий ИП и др. Динамическая электронейростимуляция. Учебное пособие. Екатеринбург; 2008. 138 с. [Razumov EN, Vasilenko AM, Bobrowniki FE, et al. Dinamicheskaya elektroneirostimulyatsiya. Uchebnoe posobie [Dynamic electroneurostimulation. The tutorial]. Ekaterinburg; 2008. 138 p.].

6. Мейзеров ЕЕ, Ардашинская ГА, Чернышов ВВ. ДЭНС при болевых синдромах. Рефлексотерапия. 2005;(1):32–4 [Meizerov EE, Ardashinskaya GA, Chernyshov VV. DENS in pain syndromes. Refleksoterapiya. 2005;(1):32–4 (In Russ.)].

7. Osiri M, Welch V, Brosseau L, et al. Transcutaneous electrical nerve stimulation for knee osteoarthritis (Review). A reprint of a Cochrane review. The Cochrane Library. 2007. Availadle from: http://www.thecochranelibrary.com

8. Vance CGT, Rakel BA, Blodgett NP. Effects of transcutaneous electrical nerve stimulation on pain, pain sensitivity, and function in people with knee osteoarthritis: a randomized controlled trial. Physical Therapy. 2012;92(7):898–910. doi: 10.2522/ptj.20110183

9. Корышев ВИ, Хан МА, Черемхин КЮ и др. Применение динамической электронейростимуляции при остеоартрозе коленных суставов, VII Московская ассамблея «Здоровье столицы»: Тезисы докладов. Москва; 2008. P. 173 [Koryshev VI, Khan MA, Cheremin KY, et al. Primenenie dinamicheskoi elektroneirostimulyatsii pri osteoartroze kolennykh sustavov, VII Moskovskaya assambleya «Zdorov'e stolitsy»: Tezisy dokladov [Use dynamic electroneurostimulation in osteoarthritis of the knee, VII Moscow Assembly «Health capital»: The abstracts]. Moscow; 2008. P. 173].

10. Власов АА, Кадочникова ЕЮ, Лесняк ОМ. ДиаДЭНС-ПК при остеоартрозе коленных суставов. Уральский медицинский журнал. 2009;2(56):27–31. [Vlasov AA, Kadochnikova EY, Lesnyak OM. DiaDENS-PC in osteoarthritis of the knee. Ural Medical Journal. 2009;2(56):27–31 (In Russ.)].

11. Lesnyak O, Kadochnikova E, Vlasov A. Randomized placebo-controlled trial on efficacy of dynamic electroneurostimulation in knee osteoarthritis. In: Proceedings of the 16th Congress of Physical and Rehabilitation Medicine (Belgium, Brugge, 3–6 June, 2008), pp.23–25.

12. Brooks P, Hochberg M. Outcome measures and classification criteria for the rheumatic diseases. A compilation of data from OMERACT (Outcome Measures for Arthritis Clinical Trials), ILAR regional leagues and other groups. Rheumatology (Oxford). 2001;40:896–906. doi: 10.1093/rheumatology/40.8.896

13. Tugwell P, Boers M, Brooks P, et al. OMERACT: an international initiative to improve outcome measurement in rheumatology. Trials. 2007 Nov 26;8:38. doi: 10.1186/1745-6215-8-38

14. Zhang W, Doherty M, Peat G, et al. EULAR evidence based recоmmendations for the diagnosis of knee ostheoarthritis. Ann Rheum Dis. 2010;69(3):483–9. doi: 10.1136/ard.2009.113100

15. Lequesne M, Mery C, Samson M. Indexes of severity for osteoarthritis of the hip and knee. Validation-value in comparison with other assessment tests. Scand J Rheumatol. 1987;65:85–9. doi: 3109/03009748709102182

16. Leung MC, Poon NMM. The effects of electro-acupuncture and transcutaneuos electrical nerve stimulation on patients with painful osteoarthritic knees: a randomized, controlled trial with follow-up evaluation. J Altern Complement Med. 2003;9(5):641–9. doi: 10.1089/107555303322524490

17. Itoh K, Itoh S, Katsumi Y. A pilot study on using acupuncture and transcutaneous electrical nerve stimulation to treat chronic nonspecific low back pain. Chin Med. 2008 Feb 29;3:2. doi: 10.1186/1749-8546-3-2

18. Pearl PW, Law P, Gladys L, et al. Optimal stimulation frequency of transcutaneus electrical nerve stimulation on people with knee osteoarthritis. J Rehabil Med. 2004;36:220–5. doi: 10.1080/16501970410029834


Review

For citations:


Lesnyak O.M., Kadochnikova E.Yu., Alekseeva L.I., Dydykina I.G., Ershova O.B., Zaitseva E.M., Korotkova T.A., Popova T.A., Sukhareva M.L., Taskina E.A., Khodyrev V.N., Sharapova E.P., Solodovnikov A.G., Vlasov A.A. EFFICIENCY OF DYNAMIC ELECTRONEUROSTIMULATION IN KNEE OSTEOARTHRITIS: RESULTS OF A MULTICENTER RANDOMIZED STUDY. Rheumatology Science and Practice. 2015;53(3):281-288. (In Russ.) https://doi.org/10.14412/1995-4484-2015-281-288

Views: 2659


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)