Systematic review to inform a World Health Organization (WHO) clinical practice guideline: Benefits and harms of transcutaneous electrical nerve stimulation (TENS) for chronic primary low back pain in adults

Verville, L., Hincapié, C. A., Southerst, D., Yu, H., Bussières, A., Gross, D. P., Pereira, P., Mior, S., Tricco, A. C., Cedraschi, C., Brunton, G., Nordin, M., Connell, G., Shearer, H. M., Wong, J. J., Hofstetter, L., Romanelli, A., Guist, B., To, D., Stuber, K., da Silva-Oolup, S., Stupar, M., Myrtos, D., Lee, J. G. B., DeSouza, A., Muñoz Laguna, J., Murnaghan, K. et Cancelliere, C. (2023). Systematic review to inform a World Health Organization (WHO) clinical practice guideline: Benefits and harms of transcutaneous electrical nerve stimulation (TENS) for chronic primary low back pain in adults. Journal of Occupational Rehabilitation . ISSN 1053-0487 1573-3688 DOI 10.1007/s10926-023-10121-7

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Résumé

Abstract

Purpose
To evaluate benefits and harms of transcutaneous electrical nerve stimulation (TENS) for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.

Methods
We searched for randomized controlled trials (RCTs) from various electronic databases from July 1, 2007 to March 9, 2022. Eligible RCTs targeted TENS compared to placebo/sham, usual care, no intervention, or interventions with isolated TENS effects (i.e., combined TENS with treatment B versus treatment B alone) in adults with CPLBP. We extracted outcomes requested by the WHO Guideline Development Group, appraised the risk of bias, conducted meta-analyses where appropriate, and graded the certainty of evidence using GRADE.

Results
Seventeen RCTs (adults, n = 1027; adults ≥ 60 years, n = 28) out of 2010 records and 89 full text RCTs screened were included. The evidence suggested that TENS resulted in a marginal reduction in pain compared to sham (9 RCTs) in the immediate term (2 weeks) (mean difference (MD) = -0.90, 95% confidence interval  -1.54 to -0.26), and a reduction in pain catastrophizing in the short term (3 months) with TENS versus no intervention or interventions with TENS specific effects (1 RCT) (MD = -11.20, 95% CI -17.88 to -3.52). For other outcomes, little or no difference was found between TENS and the comparison interventions. The certainty of the evidence for all outcomes was very low.

Conclusions
Based on very low certainty evidence, TENS resulted in brief and marginal reductions in pain (not deemed clinically important) and a short-term reduction in pain catastrophizing in adults with CPLBP, while little to no differences were found for other outcomes.

Type de document:	Article
Date de dépôt:	23 avr. 2024 18:41
Dernière modification:	23 avr. 2024 18:41
Version du document déposé:	Version officielle de l'éditeur
URI:	https://depot-e.uqtr.ca/id/eprint/11264

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