Laurie's Blogs.

Here’s a relevant research paper for all of us to dissect and digest!

This researchers looked at whether treatment with transcutaneous electrical nerve stimulation will affect gait parameters in dogs with osteoarthritis.  Fifteen dogs with osteoarthritis of various joints were included in the study. TENS treatment of 80 Hz and 100 μs with an individually selected amplitude was conducted for 45-minutes once daily for a treatment period of seven or ten days. They then evaluated stance time, swing time, stride time, stride length, peak vertical force (%BW), vertical impulse (%BW*sec), and symmetry indices were obtained using a pressure-sensitive mat. The comparison was made on data collected before and after the first treatment session and before and after the last day of the whole treatment period for TENS and placebo; hereafter, the terms “single treatment” and “multiple treatments” are used.

The findings?

No significant differences were seen between TENS and placebo for any of the gait parameters. Hence, in this study, TENS did not affect gait parameters, compared to placebo.

Digging into it a little more:

I think it’s important for null research hypotheses to be published, as well as the confirmed hypotheses.  However, when I read a null hypothesis study, I always like to dig into the materials and methods to see if there might have been a methodologic flaw to explain for the finding before accepting it at face value.  Plus, it helps me to put some context around the findings.

So, here are my thoughts (and I will say that the discussion portion of this paper is very well reasoned and addresses some of my thoughts and critiques as well):

1)  Inclusion criterion was an osteoarthritic joint, not an arthritic hip, or stifle, or carpus, but any of those.  Thus the ‘location’ of the osteoarthritis was not consistent.  

2)  The TENS frequency used (i.e. 80Hz) is thought to have more of an impact on immediate & acute pain relief, but less of an impact on long term or chronic pain relief.  (Note: Lower Hz is reported to have more of an effect on the opioid system, and thus has a better effect for chronic pain and longer lasting pain relieving effects).

3)  Using TENS as a stand-alone treatment isn’t something done traditionally in any rehab setting (human or animal), however, the hope in using TENS is that it reduces the pain, thus enabling an exercise session that might improve adjacent muscles that can help to cushion the impact on an arthritic joint.  However, if there is not an immediate improvement in gait parameters, then this study also potentially debunks the combination of TENS and Exercise as well.

4)  There are so many better things you can do and use for osteoarthritis.  Fortunately, this paper frees you up to toss the TENS and use other methods to treat osteoarthritis instead!

That’s it!  I hope you enjoyed this learning instalment!

Until next time… Cheers!

Laurie