Effects of visual illusion and transcutaneous electrical nerve stimulation on neuropathic pain in patients with spinal cord injury: A randomised controlled cross-over trial
Affiliations: [a] Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey | [b] Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey | [c] Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
Correspondence:
[*]
Corresponding author: Muhammed Kılınç, Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Samanpazari, Ankara, Turkey. Tel.: +312 3052525/143; Fax: +312 305 20 12; E-mail:muhammedkilinc@yahoo.com
Abstract:
BACKGROUND: Chronic pain is a common consequence of spinal cord
injury (SCI). No therapeutic drugs or drug groups are proven to be superior
for neuropathic pain and treatments only aim to convert pain from dull to
tolerable levels and not to remove it. OBJECTIVE: This study was planned to compare the effect of visual
illusion (VI) and transcutaneous electrical nerve stimulation (TENS) on pain
intensity, pain quality and functional capacity in SCI patients with
neuropathic pain. METHODS: Twenty-four patients were included and randomly
categorized into two groups. In the first group (n= 12), visual illusion was
applied for first two weeks, 1 week wash out period and then TENS was
applied for 2 weeks. In second group (n= 12), TENS was applied firstly, 1 week
wash out and then %visual illusion
VI
were applied. Pain severity, pain quality,
and functional capacity were assessed with the visual analog scale (VAS),
the neuropathic pain scale (NPS), and the brief pain inventory (BPI),
respectively. A pre-post-treatment and cross over design was used. RESULTS: Wilcoxon signed-rank tests were used for within group
analyses. Mann-Whitney U tests were used for analyses that compared
different groups. It was observed that pain intensity decrease immediately
after both applications (VI: p= 0.07, TENS: p= 0.08). After TENS application
for 2 weeks, it was observed that significant decrease in most (p= 0.04) and
less (p= 0.02) pain intensity; while there was no significant decrease in
pain intensity after 2 weeks for VI (p> 0.05). When findings of NPS were
analyzed, hot (p= 0.047), sharp (p= 0.02), unpleasant (p= 0.03) and deep items
(p= 0.047) decreased after VI application. When the results of BPI were
detected, they were observed that the negative effect of pain on moving
ability (p= 0.04) after visual illusion application and the negative effect
of pain on mood (p= 0.03), relationships with others (p= 0.04) and sleep
(p= 0.04) after TENS application decreased significantly. CONCLUSION: TENS and VI therapies can be successfully used in
clinical practice as an alternative treatment or as a supportive method
separetely or together.
