اثر فركانس پايين و بالا تحريكات الكتريكي روي عصب از طريق پوست بر آستانه و شدت درد در هنگام كشش عضلات همسترينگ

Effects of low and high frequency transcutaneous electrical nerve stimulation on the intensitynerve stimulation on the intensity and threshold of pain during the stretching of hamstring muscle

ﺳﺎﺑﻘﻪ و ﻫﺪف: اﺳﺘﻔﺎده از ﺗﺤﺮﯾﮑﺎت اﻟﮑﺘﺮﯾﮑـﯽ ﻋﺼـﺒﯽ از راه ﭘﻮﺳـﺖ ﯾـﺎ Transcutaneous Electrical )) (Nerve Stimulation (TENS ﮐﺎرﺑﺮد ﺑﺴﯿﺎري در ﮐﻨﺘﺮل دردﻫﺎي ﻣﺨﺘﻠﻒ از ﺟﻤﻠﻪ دردﻫﺎي ﻣﺘﻌﺎﻗﺐ ﺗﻤﺮﯾﻨﺎت ﮐﺸﺶ ﻋﻀـﻼني دارد. در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﺎ اﺛﺮ ﻓﺮﮐﺎﻧﺲ ﻫﺎي ﺑﺎﻻ و ﭘﺎﺋﯿﻦ TENS را ﺑﺮ آﺳﺘﺎﻧﻪ درد ﻧﺎﺷﯽ از ﮐﺸﺶ ﻋﻀﻼﻧﯽ ﺑﺮرﺳﯽ ﮐﺮدﯾﻢ. ﻣﻮاد و روش ﻫﺎ: 60 داﻧﺸﺠﻮي ﭘﺴﺮ ﻣﺒﺘﻼ ﺑﻪ ﮐﻮﺗﺎﻫﯽ ﻫﻤﺴﺘﺮﯾﻨﮓ ﺑﻪ ﻃﻮر ﺗﺼـﺎدﻓﯽ در ﯾﮑـﯽ از 3 ﮔـﺮوه آزﻣﺎﯾﺸـﯽ 1) Low-TENS (2 ،High-TENS و 3( ﮐﻨﺘﺮل (ﻫﺮ ﮔﺮوه 20 ﻧﻔﺮ) ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﻫﺮ ﺳﻪ ﮔﺮوه در ﺟﻠﺴـﻪ اول ﺗﺤـﺖ ﺑﺮﻧﺎﻣـﻪ ﮐﺸﺶ اﯾﺴﺘﺎي ﻋﻀﻠﻪ ﻫﻤﺴﺘﺮﯾﻨﮓ ﻗﺮار ﮔﺮﻓﺘﻨﺪ، در ﺣﺎﻟﯽ ﮐﻪ در ﺟﻠﺴﻪ دوم (ﯾﮏ ﻫﻔﺘﻪ ﺑﻌﺪ) از ﮐﺸﺶ اﯾﺴـﺘﺎ ﺑـﻪ ﻫـﻢ راه ﺟﺮﯾﺎن ﻫﺎي اﻟﮑﺘﺮﯾﮑﯽ در ﮔﺮوه ﻫﺎي آزﻣﺎﯾﺸﯽ اﺳﺘﻔﺎده ﺷﺪ و ﮔﺮوه ﮐﻨﺘﺮل ﺗﺤﺖ ﮐﺸﺶ اﯾﺴﺘﺎ ﻗﺮار ﮔﺮﻓﺖ. ﺷـﺪت درد ﺑـﺎ اﺳﺘﻔﺎده از ﻣﻘﯿﺎس ﭼﺸﻤﯽ درد و زاوﯾﻪ آﺳﺘﺎﻧﻪ ﺷﺮوع درد زاﻧﻮ ﺑﺎ اﺳﺘﻔﺎده از ﮔﻮﻧﯿﺎﻣﺘﺮ، در ﻫـﺮ دو ﺟﻠﺴـﻪ اﻧـﺪازه ﮔﯿـﺮي ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: آﺳﺘﺎﻧﻪ درد ﺑﻪ ﻃﻮر ﻣﻌﻨﺎداري در ﮔﺮوه TENS ﻓﺮﮐﺎﻧﺲ ﭘﺎﯾﯿﻦ اﻓﺰاﯾﺶ ﯾﺎﻓﺖ (0/001=p)، در ﺣـﺎﻟﯽ ﮐـﻪ ﻫـﯿﭻ اﻓﺰاﯾﺶ ﻣﻌﻨﺎداري در ﮔﺮوه TENS ﻓﺮﮐﺎﻧﺲ ﺑﺎﻻ و ﮐﻨﺘﺮل ﻣﺸﺎﻫﺪه ﻧﺸﺪ. ﺗﻐﯿﯿﺮ ﻣﻌﻨﺎداري در ﺷﺪت درد ﮔـﺰارش ﺷـﺪه در ﻫﯿﭻ ﮐﺪام از ﮔﺮوه ﻫﺎي آزﻣﺎﯾﺸﯽ ﻣﺸﺎﻫﺪه ﻧﮕﺮدﯾﺪ. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﻧﺘﺎﯾﺞ اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد ﮐﻪ ﺟﺮﯾﺎن اﻟﮑﺘﺮﯾﮑﯽ TENS ﺑﺎ ﻓﺮﮐﺎﻧﺲ ﭘﺎﯾﯿﻦ ﻣـﯽﺗﻮاﻧـﺪ ﻣﻮﺟـﺐ اﻓـﺰ اﯾﺶ آﺳﺘﺎﻧﻪ درد ﻧﺎﺷﯽ از ﺗﮑﻨﯿﮏ ﮐﺸﺶ ﻋﻀﻼﻧﯽ اﯾﺴﺘﺎي ﻋﻀﻼت ﻫﻤﺴﺘﺮﯾﻨﮓ ﺷﻮد. اﯾﻦ ﻧﺘﺎﯾﺞ ﻧﺸﺎن دﻫﻨﺪه ارزش كلينيك اﯾﻦ ﺟﺮﯾﺎن ﺑﺮاي اﻧﺠﺎم ﺗﻤﺮﯾﻨﺎت ﮐﺸﺶ اﯾﺴﺘﺎي ﻋﻀﻼت ﻫﻤﺴﺘﺮﯾﻨﮓ ﮐﻮﺗﺎه ﺷﺪه ﻣﯽ ﺑﺎﺷﺪ.

Introduction: Transcutaneous electrical nerve stimulation (TENS) has been very useful in controlling various pains such of muscle stretching pain. In this study, we investigated the effects of high and low frequency TENS on pain reduction during muscle stretching. Materials and Methods: 60 male students with tight hamstrings were assessed and randomly assigned into one of the three experimental groups (n = 20 in each group): 1) high TENS, 2) low TENS, 3) and control. In the first session all groups received static hamstring stretching exercise technique, while both experimental groups received combined stretching exercises and TENS in the second session (one week later). The control group received only stretching exercises. During both sessions, pain was measured by VAS and pain threshold was evaluated by goniometer. Results: Pain threshold increased significantly (P=0.001) in low TENS group, whereas the high TENS and control groups showed no significant increase. All experimental groups failed to show any significant changes in pain intensity. Conclusion: The results of this study showed that low-frequency TENS may increase the pain threshold during static stretching of the hamstring muscle. These findings may indicate the clinical value of low-TENS to perform static stretching techniques on hamstring muscles tightness.