Immediate analgesic effect of 2KHz interferential current in chronic low back pain: randomized clinical trial

Almeida, Nicole; Paladini, Luis Henrique; Pivovarski, Madeline; Gaideski, Fernanda; Korelo, Raciele Ivandra Guarda; Macedo, Ana Carolina Brandt de

doi:10.5935/2595-0118.20190006

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ORIGINAL ARTICLE • BrJP 2 (1) • Jan-Mar 2019 • https://doi.org/10.5935/2595-0118.20190006 copy

Immediate analgesic effect of 2KHz interferential current in chronic low back pain: randomized clinical trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Interferential current is widely used in clinical practice for the treatment of low back pain, but there is no literature consensus regarding its parameters. The objective of this study was to analyze the immediate effect of the 2KHz interferential current in chronic low back pain.

METHODS:

This randomized controlled clinical trial was previously approved by the Research Ethics Committee of the Federal University of Paraná, with the participation of 105 individuals with chronic low back pain (>12 weeks) of both genders. Participants were randomized in 3 groups: placebo group (PG, n=35), electrical stimulus off; interferential current1 (IG1, n=35), carrier frequency 2KHz, AMF of 2Hz, motor intensity level and IG2, n=35, carrier frequency 2KHz, AMF of 100Hz, sensory intensity level. All groups were subjected to a single application for 30 minutes with 4 electrodes in a crossed-shape position in the lumbar region.

RESULTS:

The visual analog scale, McGill pain scale, Oswestry Low Back disability questionnaire, Roland Morris disability questionnaire and Algometria of pressure were used for evaluation and revaluation.

CONCLUSION:

It may be noticed that by the visual analog scale and questionnaires, the interferential current provided an immediate analgesic effect in chronic lumbar pain regardless of the mode of stimulation.

Keywords:
Analgesia; Chronic pain; Electric stimulation therapy; Low back pain

Variables	IG1 (n=35)	IG2 (n=35)	PG (n=35)
Age (mean±SD) (years)	43.3 ± 15.3	42.2 ± 14.3	32.9 ± 15.6
Gender (n, %)
Female	23 (65.7)	23 (65.7)	21 (60)
Male	12 (34.3)	12 (34.3)	14 (40)
Education (n, %)
Incomplete elementary school	1 (2.9)	0 (0)	1 (2.9)
Complete elementary school	0 (0)	2 (5.7)	1 (2.9)
Incomplete secondary school	7 (20)	6 (17.1)	3 (8.6)
Complete secondary school	9 (25.7)	7 (20)	3 (8.6)
Incomplete higher education	11 (31.4)	10 (28.6)	20 (57.1)
Complete higher education	7 (20)	10 (28.6)	7 (20)
Lifestyle habits
Smoker (n, %)	2 (5.7)	4 (11.4)	2 (5.7)
Alcohol consumption (n, %)	7 (20)	1 (2.9)	4 (11.4)
Sedentary (n, %)	17 (48.6)	14 (40)	17 (48.6)
Time of pain (years) (mean, min, max, median)	5.81; 3; 34; 3	6.54; 3; 31; 3	4.46; 3; 17; 3
Location of pain (n, %)
Centralized	12 (34.3)	8 (22.9)	10 (28.6)
On the right	7 (20)	9 (25.7)	5 (14.3)
On the left	1 (2.9)	1 (2.9)	4 (11.4)
Bilateral	15 (42.9)	17 (48.6)	16 (45.7)
Period of the day when pain worsens (n, %)
Morning	14 (40)	12 (34.3)	8 (22.9)
Afternoon	6 (17.1)	7 (10)	7 (10)
Night	15 (42.9)	16 (45.7)	20 (57.1)
Activities that exacerbate pain (n, %)
Walking	9 (25.7)	14 (40)	12 (34.3)
Sitting	13 (37.1)	17 (48.6)	11 (31.4)
Getting down	9 (25.7)	19 (54.3)	15 (42.9)
Standing up	8 (22.9)	11 (31.4)	10 (28.6)
Climbing stairs	5 (14.3)	12 (34.3)	11 (31.4)
Effort/lifting object	31 (88.6)	28 (80)	31 (88.6)

	IG1 (n=35)		IG2 (n=35)		PG (n=35)
VAS (mean ± SD)	Before	After	Before	After	Before	After
VAS (mean ± SD)	5.3 ± 2.1	2.0 ± 1.9^* * p<0.05 - intragroup (paired t test). ^# # p<0.05 comparing with PG.	4.7 ± 1.8	1.0 ± 1.4^* * p<0.05 - intragroup (paired t test). ^# # p<0.05 comparing with PG.	4.9 ± 2.3	3.0 ± 2.0^* * p<0.05 - intragroup (paired t test).

PPT (mean ± SD)	IG1 (n=35)		IG2 (n=35)		PG (n=35)
	Before	After	Before	After	Before	After
ATL	4.6 ± 2.7	4.5 ± 2.6	5.5 ± 1.8	5.3 ± 1.6	5.6 ± 1.9	5.1 ± 2.1
ATR	4.7 ± 2.4	4.5 ± 2.4	5.9 ± 1.8	5.6 ± 1.6	4.4 ± 1.7	5.3 ± 1.9
L3L	4.6 ± 2.8	4.9 ± 2.9	4.8 ± 1.4	5.3 ± 1.7^* * p<0.05.	4.4 ± 1.7	4.5 ± 1.8
L3R	4.8 ± 2.9	4.8 ± 2.9	4.6 ± 1.4	5.1 ± 1.4^* * p<0.05.	4.4 ± 1.8	4.7 ± 1.8
L5L	4.6 ± 2.6	4.9 ± 3.0	4.7 ± 1.5	5.1 ± 1.6	4.5 ± 1.8	4.6 ± 1.8
L5R	4.7 ± 2.9	5.1 ± 2.7	4.7 ± 1.8	5.1 ± 1.4	4.9 ± 2.4	4.9 ± 2.3

	IG1 (n=35)		IG2 (n=35)		PG (n=35)
	Before	After	Before	After	Before	After
MPQ (mean±SD)
Sensory	7.7 ± 2.6	4.0 ± 3.3^* * p<0.05 - intragroup (paired t test).	8.5 ± 2.2	4.0 ± 3.3^* * p<0.05 - intragroup (paired t test).	8.3 ± 3.3	5.4 ± 2.7^* * p<0.05 - intragroup (paired t test).
Affective	3.0 ± 1.8	0.7 ± 1.3^* * p<0.05 - intragroup (paired t test).	3.8 ± 1.7	0.9 ± 2.1^* * p<0.05 - intragroup (paired t test).	3.5 ± 1.9	1.8 ± 1.5
Evaluative	1.4 ± 0.7	0.4 ± 0.7	1.1 ± 0.3	0.4 ± 0.6^* * p<0.05 - intragroup (paired t test).	1.2 ± 1.3	0.9 ± 1.4
Miscellaneous	3.0 ± 1.7	1.4 ± 1.3^* * p<0.05 - intragroup (paired t test).	3.5 ± 1.6	1.1 ± 1.5^* * p<0.05 - intragroup (paired t test).	3.2 ± 1.1	2.0 ± 1.4^* * p<0.05 - intragroup (paired t test).
Total	15.2 ± 4.9	6.6 ± 6.0^* * p<0.05 - intragroup (paired t test).	17 ± 4.7	6.4 ± 6.8^* * p<0.05 - intragroup (paired t test).	16.2 ± 6.1	10.2 ± 4.9^* * p<0.05 - intragroup (paired t test).
OLBPQ	Before	After	Before	After	Before	After
Total	11.4 ± 4.4	5.2 ± 3.9^* * p<0.05 - intragroup (paired t test). ^# # p<0.05 - comparing with PG.	13.7 ± 6.0	5.6 ± 5.7^* * p<0.05 - intragroup (paired t test). ^# # p<0.05 - comparing with PG.	11.1 ± 5.7	7.0 ± 4.5^* * p<0.05 - intragroup (paired t test).
Dysfunction level n (%)
No dysfunction	0 (0)	3 (8.6)	0 (0)	5 (14.3)	0 (0)	2 (5.7)
Minimal dysfunction	17 (48.6)	28 (80)	12 (34.3)	24 (68.6)	17 (48.6)	28 (80)
Moderate dysfunction	17 (48.6)	4 (11.4)	17 (48.6)	4 (11.4)	16 (45.7)	4 (11.4)
Severe dysfunction	1 (2.9)	0 (0)	6 (17.1)	2 (5.7)	2 (5.7)	1 (2.9)
RMDQ	Before	After	Before	After	Before	After
Total	9 ± 4.2	5.1 ± 3^* * p<0.05 - intragroup (paired t test). #	11.2 ± 5.3	4.6 ± 4.4^* * p<0.05 - intragroup (paired t test). ^# # p<0.05 - comparing with PG.	9.9 ± 6.0	6.9 ± 5.1^* * p<0.05 - intragroup (paired t test).
FD (n, %)
Yes	4 (11.4)	0 (0)	9 (25.7)	1 (2.9)	10 (28.6)	3 (8.6)

Outcomes	Differences between interventions with a 95% confidence interval
Outcomes	IG1 versus PG	p-value	IG2 versus PG	p-value	IG1 versus IG2	p-value
VAS (0-10)	1.4 (0.5 to 2.3)	0.02^* * Significant difference (p<0.05). MPQ = McGill Pain Questionnaire; OLBPQ = Oswestry Low Back Pain Questionnaire; RMDQ = Roland Morris Disability Questionnaire.	1.7 (0.8 to 2.6)	0.00^* * Significant difference (p<0.05). MPQ = McGill Pain Questionnaire; OLBPQ = Oswestry Low Back Pain Questionnaire; RMDQ = Roland Morris Disability Questionnaire.	-0.3 (-1.2 to 0.5)	0.40
MPQ
Sensory (0-10)	-1.0 (-2.1 to 0.1)	0.56	-0.6 (-1.7 to 0.5)	0.56	-0.4 (-1.5 to 0.7)	0.56
Affective (0-5)	-0.7 (-1.5 to -0.0)	0.04^* * Significant difference (p<0.05). MPQ = McGill Pain Questionnaire; OLBPQ = Oswestry Low Back Pain Questionnaire; RMDQ = Roland Morris Disability Questionnaire.	-0.3 (-1.0 to 0.4)	0.44	-0.4 (-1.2 to 0.2)	0.20
Evaluative (0-1)	-0.1 (-0.4 to 0.1)	0.27	-0.3 (-0.6 to -0.0)	0.01	0.2 (-0.0 to 0.4)	0.15
Miscellaneous (0-4)	-0.4 (-1.0 to 0.2)	0.17	-0.3 (-0.9 to 0.3)	0.32	-0.1 (-0.72 to 0.5)	0.32
Total (0-20)	-2.3 (-4.6 to 0.0)	0.05	-1.5 (-3.8 to 0.8)	0.20	-0.8 (-3.1 to 1.5)	0.50
OLBPQ (0-50)	-2.1 (0.2 to 4.0)	0.03^* * Significant difference (p<0.05). MPQ = McGill Pain Questionnaire; OLBPQ = Oswestry Low Back Pain Questionnaire; RMDQ = Roland Morris Disability Questionnaire.	4.0 (2.2 to 5.9)	0.00^* * Significant difference (p<0.05). MPQ = McGill Pain Questionnaire; OLBPQ = Oswestry Low Back Pain Questionnaire; RMDQ = Roland Morris Disability Questionnaire.	1.9 (-0.0 to 3.83)	0.06
RMDQ (-24)	2.9 (1.0 to 4.8)	0.02^* * Significant difference (p<0.05). MPQ = McGill Pain Questionnaire; OLBPQ = Oswestry Low Back Pain Questionnaire; RMDQ = Roland Morris Disability Questionnaire.	3.4 (1.5 to 5.3)	0.00^* * Significant difference (p<0.05). MPQ = McGill Pain Questionnaire; OLBPQ = Oswestry Low Back Pain Questionnaire; RMDQ = Roland Morris Disability Questionnaire.	0.5 (-1.3 to 2.3)	0.59
Algometry
ATR	0.86 (-0.5 to 0.6)	0.77	0.6 (-0.5 to 0.6)	0.82	0.0 (-0.5 to 0.6)	0.94
ATL	0.8 (-0.5 to 0.6)	0.77	0.1 (-0.4 to 0.7)	0.70	-0.0 (-6.6 to 0.5)	0.92
L3R	-0.3 (-0.8 to 0.2)	0.29	-0.2 (-0.7 to 0.3)	0.40	-0.5 (-1.0 to 0.0)	0.06
L3L	0.2 (-0.3 to 0.7)	0.45	0.3 (-0.1 to 0.9)	0.17	-0.1 (-0.7 to 0.3)	0.54
L5R	-0.1 (-0.7 to 0.5)	0.74	-0.04 (-0.7 to 0.6)	0.88	-0.7 (-0.7 to 0.5)	0.82
L5L	0.1 (-0.4 to 0.7)	0.61	0.14 (-0.4 to 0.7)	0.61	-0.0 (-0.6 to 0.5)	0.99

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[1] Correspondence to: Ana Carolina Brandt de Macedo, Rua Aristides Pereira da Cruz, 21 casa 57 - Portão, 80330-290 Curitiba, PR, Brasil. E-mail: acbrandtmacedo@gmail.com