Transcutaneous electrical nerve stimulation and conditioned pain modulation influence the perception of pain in humans

BACKGROUND

Research in animal models suggests that transcutaneous electrical nerve stimulation (TENS) and conditioned pain modulation (CPM) produce analgesia via two different supraspinal pathways. No known studies have examined whether TENS and CPM applied simultaneously in human subjects will enhance the analgesic effect of either treatment alone. The purpose of the current study was to investigate whether the simultaneous application of TENS and CPM will enhance the analgesic effect of that produced by either treatment alone.

METHODS

Sixty healthy adults were randomly allocated into two groups: (1) CPM plus active TENS; (2) CPM plus placebo TENS. Pain threshold for heat (HPT) and pressure (PPT) were recorded from subject's left forearm at baseline, during CPM, during active or placebo TENS, and during CPM plus active or placebo TENS. CPM was induced by placing the subjects' contralateral arm in a hot water bath (46.5 °C) for 2 min. TENS (100 μs, 100 Hz) was applied to the forearm for 20 min at a strong but comfortable intensity.

RESULTS

Active TENS alone increased PPT (but not HPT) more than placebo TENS alone (p = 0.011). Combining CPM and active TENS did not significantly increase PPT (p = 0.232) or HPT (p = 0.423) beyond CPM plus placebo TENS. There was a significant positive association between PPT during CPM and during active TENS (r(2)  = 0.46; p = 0.003).

CONCLUSIONS

TENS application increases PPT; however, combining CPM and TENS does not increase the CPM's hypoalgesic response. CPM effect on PPT is associated with the effects of TENS on PPT.

Wrestlers' minimal weight: anthropometry, bioimpedance, and hydrostatic weighing compared

The need for accurate assessment of minimal wrestling weight among interscholastic wrestlers has been well documented. Previous research has demonstrated the validity of anthropometric methods for this purpose, but little research has examined the validity of bioelectrical impedance (BIA) measurements. Comparisons between BIA systems has received limited attention. With these two objectives, we compared the prediction of minimal weight (MW) among 57 interscholastic wrestlers using three anthropometric methods (skinfolds (SF) and two skeletal dimensions equations) and three BIA systems (Berkeley Medical Research (BMR), RJL, and Valhalla (VAL]. All methods showed high correlations (r values greater than 0.92) with hydrostatic weighting (HW) and between methods (r values greater than 0.90). The standard errors of estimate (SEE) were relatively small for all methods, especially for SF and the three BIA systems (SEE less than 0.70 kg). The total errors of prediction (E) for RJL and VAL (E = 4.4 and 3.9 kg) were significantly larger than observed nonsignificant BMR and SF values (E = 2.3 and 1.8 kg, respectively). Significant mean differences were observed between HW, RJL, VAL, and the two skeletal dimensions equations, but nonsignificant differences were observed between HW, BMR, and SF. BMR differed significantly from the RJL and VAL systems. The results suggest that RJL and VAL have potential application for this subpopulation. Prediction equation refinement with the addition of selected anthropometric measurement or moderating variables may enhance their utility. However, within the scope of our study, SF and BMR BIA appear to be the most valid methods for determining MW in interscholastic wrestlers.