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Peripheral Artery Disease III: Interprofessional Care01:27

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Transcutaneous Electrical Nerve Stimulation Improves Walking Performance in Patients With Intermittent Claudication.

Chris Seenan1, Steve McSwiggan, Patricia A Roche

  • 1Chris Seenan, PhD Lecturer in Physiotherapy, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.Steve McSwiggan, PhD Senior Clinical Trials Manager, Division of Cardiovascular and Diabetes Medicine, University of Dundee, Dundee, United Kingdom.Patricia A. Roche, PhD Honorary Lecturer, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom.Chee-Wee Tan, PhD Lecturer in Physiotherapy, School of Health, Queen Margaret University, Edinburgh, United Kingdom.Tom Mercer, PhD Professor of Exercise Physiology and Rehabilitation, School of Health, Queen Margaret University, Edinburgh, United Kingdom.Jill J. F. Belch, PhD Dean of Research and NHS Tayside R&D Director, Division of Cardiovascular and Diabetes Medicine, University of Dundee, Dundee, United Kingdom.

The Journal of Cardiovascular Nursing
|June 15, 2016
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Summary

Transcutaneous electrical nerve stimulation (TENS) improved walking distance in patients with peripheral arterial disease (PAD) and intermittent claudication (IC). However, TENS did not significantly reduce pain levels in this study group.

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Rehabilitation Medicine

Background:

  • Peripheral arterial disease (PAD) with intermittent claudication (IC) significantly impairs quality of life and mobility.
  • Current treatments for IC have limitations, necessitating exploration of novel therapeutic strategies.
  • Transcutaneous electrical nerve stimulation (TENS) is a non-invasive modality with potential applications in pain management and functional improvement.

Purpose of the Study:

  • To evaluate the efficacy of two TENS frequencies (high and low) on walking distance and pain in patients with PAD and IC.
  • To compare the effects of active TENS versus placebo TENS on functional and absolute claudication distances.
  • To assess the impact of TENS on pain perception using the McGill Pain Questionnaire (MPQ).

Main Methods:

  • A phase 2a study involving 40 participants diagnosed with PAD and IC.
  • Participants underwent graded treadmill tests on two occasions, receiving either active TENS or placebo TENS.
  • Two groups received either high-frequency or low-frequency TENS, with walking distances and MPQ scores recorded.

Main Results:

  • High-frequency TENS significantly increased all measures of walking distance compared to placebo (P < .05).
  • Low-frequency TENS showed a significant increase in absolute claudication distance (P = .043).
  • No significant difference in pain scores (MPQ-Pain Rating Index) was observed between active TENS and placebo TENS (P = .41).

Conclusions:

  • TENS applied to the lower limb can enhance walking performance in patients with PAD and IC.
  • While TENS may improve functional capacity, it did not demonstrate a significant analgesic effect in this study.
  • TENS presents a potential adjunctive therapy for improving walking ability in individuals suffering from IC.