Article

Transcutaneous electrical nerve stimulation (TENS) could offer a
non-drug form of pain relief, but there is no consensus regarding its
effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent
review of previous trial methods identified significant problems with low
treatment fidelity. There is little information available to inform the
development of a pragmatic implementation design for a TENS evaluation.
OBJECTIVES: The aim of this study was to explore the experiences of patients who
were receiving secondary care in a pain clinic and who had expertise in using
TENS to manage chronic musculoskeletal pain. These key informants were selected
because they had the potential to generate knowledge that could inform research
design and clinical practice. DESIGN: A qualitative method using individual
semistructured interviews with open questions was selected for its capacity to
generate rich data. METHODS: Semistructured interviews were conducted with 9
patients (6 women, 3 men). Thematic analysis was used as the primary data
analysis method, and this analysis was enhanced by a case-level analysis of the
context and processes of TENS use of each individual. RESULTS: Data analysis
indicated that patients learned to address a range of problems in order to
optimize TENS use. Patients may need to personalize the positioning of electrodes
and the TENS settings and to readjust them over time. Patients learned to use
TENS in a strategic manner, and the outcomes of each strategy varied.
CONCLUSIONS: The findings indicated that a pragmatic TENS evaluation may need to
incorporate a learning phase to allow patients to optimize this complex pattern
of TENS usage, and evaluation may need to be sensitive to the outcomes of
strategic use. These findings also have implications for clinical practice.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS