Skin impedance is not a factor in transcutaneous electrical nerve stimulation effectiveness

Carol GT Vance; Barbara A Rakel; Dana L Dailey; Kathleen A Sluka

doi:10.2147/JPR.S86577

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Skin impedance is not a factor in transcutaneous electrical nerve stimulation effectiveness

Journal article

Open access

Peer reviewed

Skin impedance is not a factor in transcutaneous electrical nerve stimulation effectiveness

Carol GT Vance, Barbara A Rakel, Dana L Dailey and Kathleen A Sluka

Journal of pain research, Vol.8, pp.571-580

08/19/2015

DOI: 10.2147/JPR.S86577

PMCID: PMC4547643

PMID: 26316808

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https://doi.org/10.2147/JPR.S86577View

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Abstract

Objective: Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological intervention used to manage pain using skin surface electrodes. Optimal electrode placement is unclear. We hypothesized that better analgesia would occur if electrodes were placed over sites with lower skin impedance. Optimal site selection (OSS) and sham site selection (SSS) electrode sites on the forearm were identified using a standard clinical technique. Methods: Experiment 1 measured skin impedance in the forearm at OSS and SSS. Experiment 2 was a crossover design double-blind randomized controlled trial comparing OSS-TENS, SSS-TENS, and placebo TENS (P-TENS) to confirm differences in skin impedance between OSS and SSS, and measure change in pressure pain threshold (PPT) following a 30-minute TENS treatment. Healthy volunteers were recruited (ten for Experiment 1 [five male, five female] and 24 for Experiment 2 [12 male, 12 female]). TENS was applied for 30 minutes at 100 Hz frequency, 100 µs pulse duration, and "strong but nonpainful" amplitude. Results: Experiment 1 results demonstrate significantly higher impedance at SSS (17.69±1.24 Ω) compared to OSS (13.53±0.57 Ω) (P=0.007). For Experiment 2, electrode site impedance was significantly higher over SSS, with both the impedance meter (P=0.001) and the TENS unit (P=0.012) compared to OSS. PPT change was significantly greater for both OSS-TENS (P=0.024) and SSS-TENS (P=0.025) when compared to P-TENS. PPT did not differ between the two active TENS treatments (P=0.81). Conclusion: Skin impedance is lower at sites characterized as optimal using the described technique of electrode site selection. When TENS is applied at adequate intensities, skin impedance is not a factor in attainment of hypoalgesia of the forearm in healthy subjects. Further investigation should include testing in patients presenting with painful conditions.

Pain

impedance

electrode site selection

Original Research

transcutaneous electrical nerve stimulation

Details

Title: Subtitle: Skin impedance is not a factor in transcutaneous electrical nerve stimulation effectiveness
Creators: Carol GT Vance - Department of Physical Therapy and Rehabilitation Science, University of Iowa Carver College of Medicine, IA, USA
Barbara A Rakel - Department of Physical Therapy and Rehabilitation Science, University of Iowa Carver College of Medicine, IA, USA
Dana L Dailey - Department of Physical Therapy and Rehabilitation Science, University of Iowa Carver College of Medicine, IA, USA
Kathleen A Sluka - Department of Physical Therapy and Rehabilitation Science, University of Iowa Carver College of Medicine, IA, USA
Resource Type: Journal article
Publication Details: Journal of pain research, Vol.8, pp.571-580
DOI: 10.2147/JPR.S86577
PMID: 26316808
PMCID: PMC4547643
NLM abbreviation: J Pain Res
ISSN: 1178-7090
eISSN: 1178-7090
Publisher: Dove Medical Press
Language: English
Date published: 08/19/2015
Academic Unit: Iowa Neuroscience Institute; Nursing; Physical Therapy and Rehabilitation Science; Neuroscience and Pharmacology
Record Identifier: 9984040270502771

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