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Efficacy of transcutaneous electrical nerve stimulation for rotator cuff tendinopathy: a systematic review

  • F. Desmeules
    Correspondence
    Corresponding author. Address: Unité de recherche clinique en orthopédie/Orthopaedic Clinical Research Unit, Centre de recherche de l’Hôpital Maisonneuve-Rosemont, 5415 Blvd L’Assomption, Pav. Rachel Tourigny, Bureau/Office 4163, Montréal, QC H1T 2M4, Canada. Tel.: +1 514 252 3400x5607; fax: +1 514 254 7455.
    Affiliations
    Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada

    School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
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  • J. Boudreault
    Affiliations
    Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada
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  • J-S. Roy
    Affiliations
    Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada

    Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada
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  • C.E. Dionne
    Affiliations
    Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada

    Axe Santé des populations et pratiques optimales en santé, Centre de recherche FRQS du Centre hospitalier universitaire de Québec, Quebec City, Quebec, Canada
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  • P. Frémont
    Affiliations
    Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada

    Laval University Hospital (CHU) Research Center, Quebec City, Quebec, Canada
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  • J.C. MacDermid
    Affiliations
    School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Published:September 07, 2015DOI:https://doi.org/10.1016/j.physio.2015.06.004

      Abstract

      Objective

      To perform a systematic review on the efficacy of transcutaneous electrical nerve stimulation (TENS) for the treatment of rotator cuff tendinopathy in adults.

      Methods

      A literature search was conducted in four databases (CINAHL, Embase, PubMed and PeDRO) for randomised controlled trials published from date of inception until April 2015, comparing the efficacy of TENS for the treatment of rotator cuff tendinopathy with placebo or any other intervention. Risk of bias was evaluated using the Cochrane risk of bias tool. Results were summarised qualitatively.

      Results

      Six studies were included in this review. The mean methodological score was 49% (standard deviation 16%), indicating an overall high risk of bias. One placebo-controlled trial reported that a single TENS session provided immediate pain reduction for patients with rotator cuff tendinopathy, but did not follow the participants in the short, medium or long term. Two trials that compared ultrasound therapy with TENS reported discrepancy and contradictory results in terms of pain reduction and shoulder range of motion. Corticosteroid injections were found to be superior to TENS for pain reduction in the short term, but the differences were not clinically important. Other studies included in this review concluded that TENS was not superior to heat or pulsed radiofrequency.

      Conclusion

      Due to the limited number of studies and the overall high risk of bias of the studies included in this review, no conclusions can be drawn on the efficacy of TENS for the treatment of rotator cuff tendinopathy. More methodologically sound studies are needed to document the efficacy of TENS. Until then, clinicians should prefer other evidence-based rehabilitation interventions proven to be efficacious to treat patients with rotator cuff tendinopathy.

      Keywords

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