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Article ; Online: Effect of Transcutaneous Electrical Nerve Stimulation on Pain-related Quantitative Sensory Tests in Chronic Musculoskeletal Pain and Acute Experimental Pain: Systematic Review and Meta-analysis.

DeJesus, Beatriz M / Rodrigues, Ingrid Kyelli L / Azevedo-Santos, Isabela F / DeSantana, Josimari M

2023 Volume 24, Issue 8, Page(s) 1337–1382

Abstract: This report provides a systematic review of the literature to analyze the effects of transcutaneous electrical nerve stimulation (TENS) on analgesia on sensitization measures, in studies with chronic musculoskeletal pain and in studies with acute ... ...

Abstract	This report provides a systematic review of the literature to analyze the effects of transcutaneous electrical nerve stimulation (TENS) on analgesia on sensitization measures, in studies with chronic musculoskeletal pain and in studies with acute experimental pain. The protocol was registered at PROSPERO (CRD42020213473). The authors searched Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Latin American and Caribbean Health Sciences Literature via Biblioteca Virtual de Saúde, Physiotherapy Evidence Database, PubMed, ScienceDirect, Web of Science, Google Scholar, and hand-searched reference lists were also conducted. Among 22,252 manuscripts found, 58 studies were included in the systematic review and 35 in the meta-analysis. Thirty-four studies assessed pain intensity; 24 studies investigated hyperalgesia; temporal summation was only evaluated in 2 studies; and conditioned pain modulation was not observed in the included studies. Meta-analyses favored TENS, despite its limitations and heterogeneity. Primary hyperalgesia in studies with musculoskeletal pain presented a high level of evidence, while other outcomes presented moderate evidence in the studies that were included. It is not possible to infer results about both temporal summation and conditioned pain modulation. Moderate evidence suggests that TENS promotes analgesia by reducing both central and peripheral sensitization, as shown by the reduction in primary and secondary hyperalgesia, pain intensity at rest, and during movement in experimental acute pain and chronic musculoskeletal pain. Overall, both types of studies analyzed in this review presented meta-analyses favorable to the use of TENS (compared to placebo TENS), showing reductions in both primary and secondary hyperalgesia, as well as decreases in pain intensity at rest and in motion. PERSPECTIVE: This article presents data from the literature on the effect of TENS through sensitization assessments in individuals with chronic musculoskeletal pain, or acute experimental pain. These data contribute to knowledge about pain neuroscience research, using TENS technology.
MeSH term(s)	Humans ; Transcutaneous Electric Nerve Stimulation/methods ; Acute Pain/therapy ; Hyperalgesia ; Musculoskeletal Pain/therapy ; Chronic Pain/therapy
Language	English
Publishing date	2023-04-07
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2018789-0
ISSN	1528-8447 ; 1526-5900
ISSN (online)	1528-8447
ISSN	1526-5900
DOI	10.1016/j.jpain.2023.03.014
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Article: Effect of dance on lower-limb range of motion in young people with cerebral palsy: a blinded randomized controlled clinical trial.

Teixeira-Machado, Lavinia / DeSantana, Josimari M

Adolescent health, medicine and therapeutics

2019 Volume 10, Page(s) 21–28

Abstract: Purpose: One of the most limiting conditions in cerebral palsy (CP) is the impairment in musculoskeletal mobility. CP may impair the ability to perform efficient movements. The aim of this trial was to investigate the effect of dance on the range of ... ...

Abstract	Purpose: One of the most limiting conditions in cerebral palsy (CP) is the impairment in musculoskeletal mobility. CP may impair the ability to perform efficient movements. The aim of this trial was to investigate the effect of dance on the range of motion (ROM) of lower limbs in young people with CP. Patients and methods: the randomized clinical trial consisted of two groups: dance group (DG) and control group (CG). Both of them underwent a 1-hour treatment, twice a week, for 2 months. Sanny Results: In DG, the sampling variances showed improvements in all lower limb joints and axes of movements ( Conclusion: Physical intervention is imperative to improve ROM. It seems dance practice can contribute to CP corporal mobility in a positive way. Clinical trial number: Nº CAAE-06154012.4.0000.0058-12, number 98.993.
Language	English
Publishing date	2019-03-27
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2587456-1
ISSN	1179-318X
ISSN	1179-318X
DOI	10.2147/AHMT.S177867
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Article ; Online: Influence of Neonatal Pain in Motor Development During Childhood.

Azevedo-Santos, Isabela F / Lima, Lucas V / DeSantana, Josimari M

Pain medicine (Malden, Mass.)

2016 Volume 17, Issue 6, Page(s) 1204–1206

Language	English
Publishing date	2016-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2015903-1
ISSN	1526-4637 ; 1526-2375
ISSN (online)	1526-4637
ISSN	1526-2375
DOI	10.1093/pm/pnv059
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Zs.A 6119: Show issues

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Article ; Online: Correlations between brain changes and pain management after cognitive and meditative therapies: A systematic review of neuroimaging studies.

Nascimento, Simone S / Oliveira, Larissa R / DeSantana, Josimari M

Complementary therapies in medicine

2018 Volume 39, Page(s) 137–145

Abstract: Background: There are different ways of dealing with pain and cognitive and meditative therapies (CMT) are alternative ways to regulate the emotions associated with pain. Current studies apply neuroimaging techniques trying to elucidate the neural ... ...

Abstract	Background: There are different ways of dealing with pain and cognitive and meditative therapies (CMT) are alternative ways to regulate the emotions associated with pain. Current studies apply neuroimaging techniques trying to elucidate the neural mechanisms of cognitive strategies for pain. This systematic review aimed to summarize the evidence on brain activity changes after CMT, which include cognitive behavioral therapy, mindfulness and/or meditation, for pain management as well as to evaluate clinical pain outcomes. Methods: Electronic databases - Pubmed, EMBASE, PsycINFO, Science Direct, Scopus - were searched to find randomized controlled trials (RCTs) examining neuroimaging data of CMT for chronic pain patients or healthy individuals with experimental pain. Two reviewers independently selected the relevant trials, rated for quality assessment and extracted all data using a standardized form. Primary outcome was brain activity changes (activation, deactivation or functional connectivity). Secondary outcomes were pain intensity, self-management, pain coping, quality of life, anxiety and depression. Results: Nine RCTs were included involving 280 adults (18-59 years), 139 chronic pain patients vs. 148 healthy subjects. Three main kinds of intervention were identified: cognitive-behavioral therapy (n = 4), mindfulness meditation (n = 4) and transcendental meditation technique (n = 1). Neuroimaging results revealed distinct patterns of activity, but the main findings were related to increased activation of prefrontal cortex (PFC), specially dorsolateral prefrontal cortex (dlPFC) and ventrolateral prefrontal cortex (vlPFC), orbitofrontal cortex (OBF), somatosensory cortices (SSC) and limbic system in chronic pain population; and increased activation of anterior cingulate cortex (ACC), anterior insular cortex (AI) and decreased activation of thalamus in healthy individuals following CMT. Conclusion: This result means that regulation of pain by CMT can alter functioning of brain regions in an extensive network including non-nociceptive regions. CMT reduced the affective experience of pain, while reductions of pain intensity ratings were less consistent. Brain changes have been demonstrated as a result of the application of psychological measures and may represent the clinical implications of changes in brain activity or morphology.
MeSH term(s)	Adult ; Brain/diagnostic imaging ; Chronic Pain/epidemiology ; Chronic Pain/therapy ; Cognitive Therapy ; Female ; Humans ; Male ; Meditation ; Middle Aged ; Mindfulness ; Neuroimaging ; Pain Management/methods ; Pain Management/statistics & numerical data ; Young Adult
Language	English
Publishing date	2018-06-19
Publishing country	Scotland
Document type	Journal Article ; Review
ZDB-ID	1155895-7
ISSN	1873-6963 ; 0965-2299
ISSN (online)	1873-6963
ISSN	0965-2299
DOI	10.1016/j.ctim.2018.06.006
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Zs.A 3726: Show issues

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Article ; Online: Transcutaneous Electric Nerve Stimulation in Animal Model Studies: From Neural Mechanisms to Biological Effects for Analgesia.

Tavares Oliveira, Mayara / Maciel Santos, Mateus / Lucas Mayara da Cruz Reis, Kamilla / Resende Oliveira, Larissa / DeSantana, Josimari Melo

Neuromodulation : journal of the International Neuromodulation Society

2023 Volume 27, Issue 1, Page(s) 13–21

Abstract: Objective: This systematic and meta-analysis review evaluated the transcutaneous electrical nerve stimulation (TENS)-induced action mechanisms for animal analgesia.: Materials and methods: Two independent investigators identified relevant articles ... ...

Abstract	Objective: This systematic and meta-analysis review evaluated the transcutaneous electrical nerve stimulation (TENS)-induced action mechanisms for animal analgesia. Materials and methods: Two independent investigators identified relevant articles published until February 2021 through a literature review, and a random-effects meta-analysis was performed to synthesize the results. Results: Of the 6984 studies found in the data base search, 53 full-text articles were selected and used in the systematic review. Most studies used Sprague Dawley rats (66.03%). High-frequency TENS was applied to at least one group in 47 studies, and most applications were performed for 20 minutes (64.15%). Mechanical hyperalgesia was analyzed as the primary outcome in 52.83% of the studies and thermal hyperalgesia in 23.07% of studies using a heated surface. More than 50% of the studies showed a low risk of bias on allocation concealment, random housing, selective outcome reporting, and acclimatization before the behavioral tests. Blinding was not performed in only one study and random outcome assessment in another study; acclimatization before the behavioral tests was not performed in just one study. Many studies had an uncertain risk of bias. Meta-analyses indicated no difference between low-frequency and high-frequency TENS with variations among the pain models. Conclusions: This systematic review and meta-analysis suggests that TENS has presented a substantial scientific foundation for its hypoalgesic effect in preclinical studies for analgesia.
MeSH term(s)	Rats ; Animals ; Transcutaneous Electric Nerve Stimulation/methods ; Rats, Sprague-Dawley ; Pain ; Pain Management ; Hyperalgesia ; Models, Animal
Language	English
Publishing date	2023-04-27
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	1500372-3
ISSN	1525-1403 ; 1094-7159
ISSN (online)	1525-1403
ISSN	1094-7159
DOI	10.1016/j.neurom.2023.02.085
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Zs.A 5912: Show issues

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Article ; Online: Short-duration physical activity prevents the development of activity-induced hyperalgesia through opioid and serotoninergic mechanisms.

Lima, Lucas V / DeSantana, Josimari M / Rasmussen, Lynn A / Sluka, Kathleen A

Pain

2017 Volume 158, Issue 9, Page(s) 1697–1710

Abstract: Regular physical activity prevents the development of chronic muscle pain through the modulation of central mechanisms that involve rostral ventromedial medulla (RVM). We tested if pharmacological blockade or genetic deletion of mu-opioid receptors in ... ...

Abstract	Regular physical activity prevents the development of chronic muscle pain through the modulation of central mechanisms that involve rostral ventromedial medulla (RVM). We tested if pharmacological blockade or genetic deletion of mu-opioid receptors in physically active mice modulates excitatory and inhibitory systems in the RVM in an activity-induced hyperalgesia model. We examined response frequency to mechanical stimulation of the paw, muscle withdrawal thresholds, and expression of phosphorylation of the NR1 subunit of the N-methyl-D-aspartate receptor (p-NR1) and serotonin transporter (SERT) in the RVM. Mice that had performed 5 days of voluntary wheel running prior to the induction of the model were compared with sedentary mice. Sedentary mice showed significant increases in mechanical paw withdrawal frequency and a reduction in muscle withdrawal threshold; wheel running prevented the increase in paw withdrawal frequency. Naloxone-treated and MOR mice had increases in withdrawal frequency that were significantly greater than that in physically active control mice and similar to sedentary mice. Immunohistochemistry in the RVM showed increases in p-NR1 and SERT expression in sedentary mice 24 hours after the induction of the model. Wheel running prevented the increase in SERT, but not p-NR1. Physically active, naloxone-treated, and MOR mice showed significant increases in SERT immunoreactivity when compared with wild-type physically active control mice. Blockade of SERT in the RVM in sedentary mice reversed the activity-induced hyperalgesia of the paw and muscle. These results suggest that analgesia induced by 5 days of wheel running is mediated by mu-opioid receptors through the modulation of SERT, but not p-NR1, in RVM.
MeSH term(s)	Animals ; Disease Models, Animal ; Female ; Gene Expression Regulation/physiology ; Hyperalgesia/etiology ; Hyperalgesia/prevention & control ; Male ; Medulla Oblongata/metabolism ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Nerve Tissue Proteins/metabolism ; Pain Measurement ; Pain Threshold/physiology ; Physical Conditioning, Animal/methods ; Physical Stimulation/adverse effects ; Receptors, N-Methyl-D-Aspartate/metabolism ; Receptors, Opioid, mu/genetics ; Receptors, Opioid, mu/metabolism ; Serotonin Plasma Membrane Transport Proteins/metabolism ; Statistics, Nonparametric ; Time Factors
Chemical Substances	Gprin1 protein, mouse ; Nerve Tissue Proteins ; Receptors, N-Methyl-D-Aspartate ; Receptors, Opioid, mu ; Serotonin Plasma Membrane Transport Proteins ; Slc6a4 protein, mouse
Language	English
Publishing date	2017-04-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	193153-2
ISSN	1872-6623 ; 0304-3959
ISSN (online)	1872-6623
ISSN	0304-3959
DOI	10.1097/j.pain.0000000000000967
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Article ; Online: Animal models of fibromyalgia.

DeSantana, Josimari M / da Cruz, Kamilla M L / Sluka, Kathleen A

Arthritis research & therapy

2013 Volume 15, Issue 6, Page(s) 222

Abstract: Animal models of disease states are valuable tools for developing new treatments and investigating underlying mechanisms. They should mimic the symptoms and pathology of the disease and importantly be predictive of effective treatments. Fibromyalgia is ... ...

Abstract	Animal models of disease states are valuable tools for developing new treatments and investigating underlying mechanisms. They should mimic the symptoms and pathology of the disease and importantly be predictive of effective treatments. Fibromyalgia is characterized by chronic widespread pain with associated co-morbid symptoms that include fatigue, depression, anxiety and sleep dysfunction. In this review, we present different animal models that mimic the signs and symptoms of fibromyalgia. These models are induced by a wide variety of methods that include repeated muscle insults, depletion of biogenic amines, and stress. All potential models produce widespread and long-lasting hyperalgesia without overt peripheral tissue damage and thus mimic the clinical presentation of fibromyalgia. We describe the methods for induction of the model, pathophysiological mechanisms for each model, and treatment profiles.
MeSH term(s)	Animals ; Disease Models, Animal ; Fibromyalgia
Language	English
Publishing date	2013-12-08
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2107602-9
ISSN	1478-6362 ; 1478-6354
ISSN (online)	1478-6362
ISSN	1478-6354
DOI	10.1186/ar4402
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Zs.A 5490: Show issues

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Article ; Online: Does electrode placement influence tens-induced antihyperalgesia in experimental inflammatory pain model?

Neto, Maurício L Poderoso / Maciel, Leonardo Y S / Cruz, Kamilla M L / Filho, Valter J Santana / Bonjardim, Leonardo R / DeSantana, Josimari M

Brazilian journal of physical therapy

2017 Volume 21, Issue 2, Page(s) 92–99

Abstract: Background: Transcutaneous electrical nerve stimulation (TENS) is a treatment commonly used for managing pain; however, the ideal placement of the electrodes is not fully understood.: Objective: To investigate the best way to apply TENS electrodes in ...

Abstract	Background: Transcutaneous electrical nerve stimulation (TENS) is a treatment commonly used for managing pain; however, the ideal placement of the electrodes is not fully understood. Objective: To investigate the best way to apply TENS electrodes in an experimental inflammatory pain model. Method: Knee joint inflammation was induced in rats, followed by administration of low-frequency TENS (4Hz) under anesthesia for five days. Animals were randomly allocated to five groups according to electrode placement (n=6, each): dermatome, contralateral, paraspinal, acupoint, and control. Interventions: Low-frequency TENS at sensory intensity and 100μs pulse duration. Withdrawal thresholds to mechanical (von Frey) and thermal stimuli and joint edema were assessed before induction of inflammation and immediately before and after application of TENS. Results: Reduced paw withdrawal threshold and thermal latency that occur 24h after the induction of inflammation were significantly reversed by the administration of TENS in all groups when compared with sham treatment or with the condition before TENS treatment. No difference was observed in the edema measurement. Conclusion: These results offer more options for practitioners to choose the area of the body most commodious for electrode placement, depending on the clinical condition of the patient, because the effect was similar at all sites. In addition, there was a loss of the effectiveness of TENS in reversing mechanical and thermal hyperalgesia on the fifth day, suggesting the development of the tolerance phenomenon.
MeSH term(s)	Animals ; Drug Tolerance/physiology ; Electrodes ; Humans ; Hyperalgesia/physiopathology ; Inflammation/physiopathology ; Knee Joint/physiopathology ; Pain Management ; Rats ; Transcutaneous Electric Nerve Stimulation/methods
Language	English
Publishing date	2017-03
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2252917-2
ISSN	1809-9246 ; 1413-3555
ISSN (online)	1809-9246
ISSN	1413-3555
DOI	10.1016/j.bjpt.2017.03.003
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Article ; Online: Comparison between functional and traditional training exercises on joint mobility, determinants of walking and muscle strength in older women.

de Resende-Neto, Antônio G / do Nascimento, Matheus A / de Sá, Clodoaldo A / Ribeiro, Alex S / Desantana, Josimari M / da Silva-Grigoletto, Marzo E

The Journal of sports medicine and physical fitness

2019 Volume 59, Issue 10, Page(s) 1659–1668

Abstract: Background: Currently, several strength training protocols have been verified aiming improvements on functionality in older population. For this purpose, integrated exercises aimed at improving essential movements may be an interesting strategy in ... ...

Abstract	Background: Currently, several strength training protocols have been verified aiming improvements on functionality in older population. For this purpose, integrated exercises aimed at improving essential movements may be an interesting strategy in improving performance for daily activities. This randomized trial compared the effects of eight and twelve weeks of functional and traditional training (TT) on joint mobility, gait determinants and muscle strength, and verified the maintenance of the effects after eight weeks of detraining in the older women. Methods: Fifty-two older women were randomized into three groups: Functional Training (FT: N.=19), TT (TT: N.=16) and Stretching Group (SG: N.=17). The data were analyzed by ANOVA with Bonferroni post-hoc test. Results: The FT and TT groups obtained significant improvements in the tests of muscle strength and muscle power both after twelve weeks of intervention, as well as with SG. Only the FT presented statistically significant improvements in dynamic agility/balance (32%, P=0.000), and cardiorespiratory condition (8.71%, P=0.020) in relation to SG. Conclusions: The experimental protocols are equally effective in improving joint mobility and strength components in active older women. However, FT seems to be more effective than TT in the improvement of the determinants of gait ability.
MeSH term(s)	Aged ; Aging/physiology ; Exercise/physiology ; Exercise Therapy/methods ; Female ; Gait/physiology ; Humans ; Middle Aged ; Muscle Strength/physiology ; Range of Motion, Articular/physiology ; Resistance Training/methods
Language	English
Publishing date	2019-06-19
Publishing country	Italy
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	410823-1
ISSN	1827-1928 ; 0022-4707
ISSN (online)	1827-1928
ISSN	0022-4707
DOI	10.23736/S0022-4707.19.09751-2
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Article ; Online: Influence of Therapeutic Approach in the TENS-induced Hypoalgesia.

Agripino, Mayara E D J / Lima, Lucas V / Freitas, Ingrid F / Souto, Natália B R / Carvalho, Taís C S / DeSantana, Josimari M

The Clinical journal of pain

2016 Volume 32, Issue 7, Page(s) 594–601

Abstract: Introduction: The present study aimed to determine how the therapist's approach about intervention may influence transcutaneous electrical nerve stimulation (TENS)-induced hypoalgesia.: Methods: One hundred and sixty-one pain-free individuals agreed ... ...

Abstract	Introduction: The present study aimed to determine how the therapist's approach about intervention may influence transcutaneous electrical nerve stimulation (TENS)-induced hypoalgesia. Methods: One hundred and sixty-one pain-free individuals agreed to participate in this study and had their demographics, perceived pain intensity, pressure pain threshold, anxiety level, and the state of anxiety inventory score measured. Subsequently, participants were randomly assigned into 6 study groups, 3 active and 3 placebo TENS associated with positive, negative, or neutral approaches about electrical stimulation, as given by the investigator. After the treatment, all parameters were reassessed. Results: Active TENS-treated participants receiving either positive or neutral expectations about intervention showed a significant increase in pressure pain threshold (P<0.02) compared with pretreatment; however, this was not observed in the active TENS group when associated with negative expectations. The intensity of perceived pain was significantly reduced (P<0.02) only in the active TENS groups in association with either positive or neutral expectations. There was no significant difference in any of the variables assessed in the groups receiving placebo TENS intervention. Discussion: The negative expectations induced prior to the proposed intervention promoted unfavorable outcomes with respect to the analgesic properties of TENS, suggesting that the approach taken by the physical therapist should be used to convey positive expectations and avoid those negatives, to promote more efficacious treatment.
MeSH term(s)	Adolescent ; Adult ; Anticipation, Psychological ; Anxiety ; Double-Blind Method ; Humans ; Pain Management/methods ; Pain Perception ; Pain Threshold ; Personality Tests ; Transcutaneous Electric Nerve Stimulation/methods ; Young Adult
Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	632582-8
ISSN	1536-5409 ; 0749-8047
ISSN (online)	1536-5409
ISSN	0749-8047
DOI	10.1097/AJP.0000000000000243
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