We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Medicine AI
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine

Does the use of interferential current prior to pilates exercises accelerate improvement of chronic nonspecific low back pain?

    Yuri RS Franco

    Master's & Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, São Paulo, SP, Brazil

    ,
    Katherinne FM Franco

    *Author for correspondence: Tel.: +55 11 21781214;

    E-mail Address: katherinneferro@gmail.com

    Master's & Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, São Paulo, SP, Brazil

    ,
    Letícia A Silva

    Physical Therapy Department, Universidade Cidade de São Paulo, São Paulo, SP, Brazil

    ,
    Macilene O Silva

    Physical Therapy Department, Universidade Cidade de São Paulo, São Paulo, SP, Brazil

    ,
    Michele N Rodrigues

    Physical Therapy Department, Universidade Cidade de São Paulo, São Paulo, SP, Brazil

    ,
    Richard E Liebano

    Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil

    &
    Cristina MN Cabral

    Master's & Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, São Paulo, SP, Brazil

    Published Online:https://doi.org/10.2217/pmt-2018-0034

    Aim: To evaluate whether active interferential current (AIC) before pilates exercises improves pain faster than placebo interferential current (PIC) in patients with chronic nonspecific low back pain (CNLBP). Methods: A total of 142 patients with CNLBP were treated with AIC or PIC before pilates exercises. Pain intensity was measured daily before and after treatment by Pain Numerical Rating Scale. Statistical analysis was performed using survival analysis for Kaplan–Meier method. Results: The AIC group presented 30% reduction of pain one session, 50% reduction of pain two sessions and 100% reduction of pain three sessions faster than the PIC group and these improvements were statistically significant (p < 0.05). Conclusion: The AIC before pilates exercises can reduce pain faster than PIC in patients with CNLBP.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1 Hoy D, Bain C, Williams G et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 64(6), 2028–2037 (2012).
    • 2 Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 8(1), 8–20 (2008).
    • 3 Delitto A, George SZ, van Dillen LR et al. Low back pain. J. Orthop. Sports Phys. Ther. 42(4), A1–A57 (2012).
    • 4 Wells C, Kolt GS, Marshall P, Hill B, Bialocerkowski A. The effectiveness of pilates exercise in people with chronic low back pain: a systematic review. PLoS ONE 9(7), e100402 (2014).
    • 5 Yamato TP, Maher CG, Saragiotto BT et al. Pilates for low back pain. Cochrane Database Syst. Rev. 7, CD010265 (2015).
    • 6 Beatti A, Tucker K, Chipchase LS. A double-blind placebo-controlled investigation into the effects of interferential therapy on experimentally induced pain using a cross-over design. Int. Musculoskelet. Med. 34(3), 115–122 (2012).
    • 7 Melzack R, Wall PD. Pain mechanisms: a new theory. Survey Anesthesiol. 11(2), 89–90 (1967).
    • 8 Fuentes JP, Olivo SA, Magee DJ, Gross DP. Effectiveness of interferential current therapy in the management of musculoskeletal pain: a systematic review and meta-analysis. Phys. Ther. 90(9), 1219–1238 (2010).
    • 9 Poitras S, Brosseau L. Evidence-informed management of chronic low back pain with transcutaneous electrical nerve stimulation, interferential current, electrical muscle stimulation, ultrasound, and thermotherapy. Spine J. 8(1), 226–233 (2008).
    • 10 Vance CG, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Manag. 4(3), 197–209 (2014). •• Systematic reviews and meta-analyses are emerging, indicating that both high-frequency and low-frequency transcutaneous electrical nerve stimulation (TENS) provide analgesia, specifically when applied at a strong, but nonpainful intensity.
    • 11 Resende L, Merriwether E, Rampazo EP et al. Meta-analysis of transcutaneous electrical nerve stimulation for relief of spinal pain. Eur. J. Pain 22(4), 663–678 (2018).
    • 12 Werners R, Pynsent PB, Bulstrode CJ. Randomized trial comparing interferential therapy with motorized lumbar traction and massage in the management of low back pain in a primary care setting. Spine 24(15), 1579 (1999).
    • 13 Lara-Palomo IC, Aguilar-Ferrándiz ME, Matarán-Peñarrocha GA et al. Short-term effects of interferential current electro-massage in adults with chronic nonspecific low back pain: a randomized controlled trial. Clin. Rehabil. 27(5), 439–449 (2013).
    • 14 Hurley DA, Mcdonough SM, Dempster M, Moore AP, Baxter GD. A randomized clinical trial of manipulative therapy and interferential therapy for acute low back pain. Spine 29(20), 2207–2216 (2004).
    • 15 Deyo RA, Walsh NE, Martin DC, Schoenfeld LS, Ramamurthy S. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N. Engl. J. Med. 322(23), 1627–1634 (1990).
    • 16 Johnson MI, Tabasam G. An investigation into the analgesic effects of interferential currents and transcutaneous electrical nerve stimulation on experimentally induced ischemic pain in otherwise pain-free volunteers. Phys. Ther. 83(3), 208–223 (2003).
    • 17 Cheing GL, Hui-Chan CW. Analgesic effects of transcutaneous electrical nerve stimulation and interferential currents on heat pain in healthy subjects. J. Rehabil. Med. 35(1), 15–19 (2003).
    • 18 Fuentes CJ, Armijo-Olivo S, Magee DJ, Gross DP. A preliminary investigation into the effects of active interferential current therapy and placebo on pressure pain sensitivity: a random crossover placebo controlled study. Physiotherapy 97(4), 291–301 (2011).
    • 19 Fuentes J, Armijo-Olivo S, Funabashi M et al. Enhanced therapeutic alliance modulates pain intensity and muscle pain sensitivity in patients with chronic low back pain: an experimental controlled study. Phys. Ther. 94(4), 477–489 (2014). • Therapeutic alliance combined with active interferential current appears to lead to clinically meaningful improvements in outcomes of patients with chronic low back pain.
    • 20 Franco KM, Franco YD, Oliveira NB et al. Is interferential current before pilates exercises more effective than Placebo in patients with chronic nonspecific low back pain?: a randomized controlled trial. Arch. Phys. Med. Rehabil. 98(2), 320–328 (2017). • Active interferential current before pilates exercises is not more effective than placebo interferential current for clinical outcomes of patients with chronic nonspecific low back pain at short and medium terms.
    • 21 Franco YR, Liebano RE, Moura KF et al. Efficacy of the addition of interferential current to pilates method in patients with low back pain: a protocol of a randomized controlled trial. BMC Musculoskelet. Disord. 15(1), 420–427 (2014).
    • 22 Pantaleao MA, Laurino MF, Gallego NL et al. Adjusting pulse amplitude during transcutaneous electrical nerve stimulation (TENS) application produces greater hypoalgesia. J. Pain 12(5), 581–590 (2011).
    • 23 Ostelo RW, De Vet HC. Clinically important outcomes in low back pain. Best Pract. Res. Clin. Rheumatol. 19(4), 593–607 (2005).
    • 24 Carvalho TD, Nóbrega AD, Lazzoli JK et al. Posição oficial da Sociedade Brasileira de Medicina do Esporte: atividade física e saúde. Rev. Bras. Med. Esporte 2(4), 79–81 (1996).
    • 25 Costa LO, Maher CG, Latimer J et al. Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best? Spine 33(22), 2459–2463 (2008).
    • 26 Ostelo RW, Deyo RA, Stratford P et al. Interpreting change scores for pain and functional status in low back pain: toward international consensus regarding minimal important change. Spine 33(1), 90–94 (2008).
    • 27 Williamson OD, Schroer M, Ruff DD et al. Onset of response with duloxetine treatment in patients with osteoarthritis knee pain and chronic low back pain: a posthoc analysis of placebo-controlled trials. Clin. Ther. 36(4), 544–551 (2014).
    • 28 Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J. Am. Stat. Assoc. 53(282), 457–481 (1958).
    • 29 Klein JP, Moeschberger ML. Survival Analysis: Techniques for Censored and Truncated Data (2nd Edition). Springer Science & Business Media, NY, USA (2003).
    • 30 Sluka KA, Bjordal JM, Marchand S, Rakel BA. What makes transcutaneous electrical nerve stimulation work?: making sense of the mixed results in the clinical literature. Phys. Ther. 93(10), 1397–1402 (2013). •• A number of variables related to TENS application are not being considered in the systematic reviews that show that TENS is inconclusive or ineffective to treat low back pain.
    • 31 Vong SK, Cheing GL, Chan F, So EM, Chan CC. Motivational enhancement therapy in addition to physical therapy improves motivational factors and treatment outcomes in people with low back pain: a randomized controlled trial. Arch. Phys. Med. Rehabil. 92(2), 176–183 (2011).
    • 32 Correa JB, Costa LO, Oliveira NT, Lima WP, Sluka KA, Liebano RE. Effects of the carrier frequency of interferential current on pain modulation and central hypersensitivity in people with chronic nonspecific low back pain: a randomized placebo-controlled trial. Eur. J. Pain 20(10), 1653–1666 (2016). • The interferential current has changed some physiological mechanisms of pain and showed a decrease in the use of pain medication, but there was no change in the pain intensity at short and medium terms.
    • 33 Facci LM, Nowotny JP, Tormem F, Trevisani VF. Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial. Sao Paulo Med. J. 129(4), 206–216 (2011). • There is no difference in pain reduction between TENS and IFC in patients with nonspecific chronic low back pain, but both currents were significantly better than the control group.
    • 34 Meeus M, Nijs J. Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. Clin. Rheumatol. 26(4), 465–473 (2007).
    • 35 Goubert D, Danneels L, Graven-Nielsen T, Descheemaeker F, Coppieters I, Meeus M. Differences in pain processing between patients with chronic low back pain, recurrent low back pain and fibromyalgia. Pain Physician 20(4), 307–318 (2017).