To address the high prevalence of c...

To address the high prevalence of chronic depressed back pain in community-dwelling older adults, Weiner and colleagues performed a randomized controll trial evaluating the efficacy of percutaneous electrical resolution stimulation (PENS) combined with physical therapy in patients older than 65 years. According to a well-designed subject of attention acupuncture has not proved beneficial in the treatment of chronic grave back pain. PENS is based forward anatomic and physiologic principles, whose extremity point is stimulation of endogenous opioids to create an analgesic effect.

bring under rules were randomized to a treatment or mastery group after exclusion for neurologic disorders, known spinal pathology, prominent radicular pain, and other conditions. Pain intensity and pain-related disability, physical performance, psychosocial factors, cognitive function, and medications were assessed in addition to demographic data. through six weeks, the treatment form into groups received PENS treatment and physical therapy, while the restrain group received sham PENS treatment and physical therapy.

The treatment cluster achieved significant pain reduction (P <001) which was maintained to the three-month follow-up further the control group did not (P = 94) The treatment cluster also had significant reductions in pain-related disability (P = 002) while the manage group did not (P = 81) Significant differences of secondary issues included reductions in chair-rise performance times in the treatment collection and an increased number of dynamic lifts. There were no differences between clumps in the functional reach task and static lifting solidity Both groups improved gait speed

The authors construct that PENS plus physical therapy produc sustained reductions in pain intensity and disability and improved chair-rise times and lifting endurance. The authors note that physical therapy alone (when given with sham PENS) had no therapeutic benefit, possibly because the succes of physical therapy be pendents on a minimum threshold at which patients are able to cooperate.

The authors cite a number of limitations in this trial, including the difficulty of creating a convincing analog for the repress group (the control group did not receive electrical stimulation, sole placement of acupuncture needles). The importance of this trial is that it shows the first comprehensive attempt to apply a complementary intervention modality to older adults with chronic subdued back pain.

Weiner DK et al. Efficacy of percutaneous electrical energize stimulation for the treatment of chronic grave back pain in older adults. J Am Geriatr Soc May 2003;51:599-608

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