Dados do Trabalho

Título

EFFECTS OF TRANSCUTANEOUS ELECTRICAL STIMULATION ON PERIPHERAL NERVE REGENERATION AFTER DIGITAL NERVE NEURORRHAPHY: A RANDOMIZED CLINICAL TRIAL.

Introdução e Objetivo

Background: The human hand can suffer significant disability from upper extremity nerve injuries. Strategies like neurotrophic factors, stem cells, and electrical stimulation aim to enhance peripheral nerve regeneration. The surface electrical stimulation has been studied on recovery post nerve repair. This study aims to investigate the impact of low-frequency electrical stimulation on sensitivity outcomes in patients with digital nerve injuries.

Material e Método

Methods: A double-blinded, randomized controlled trial was conducted with 32 patients divided into two groups: one received surgery followed by real electrical stimulation, while the other received surgery and sham stimulation. The stimulation parameters included a square-pulsed, biphasic current at 20 Hz for 1 hour postoperatively. Assessment tools such as Semmes-Weinstein monofilaments, two-point discrimination tests, cold sensitivity and pain disability questionnaires were utilized preoperatively and at three measurements moments to evaluate the effect of PES on nerve regeneration.

Resultados

The results show that patients from both groups recovered gradually their sensitivity as measured by MSW and s2PD tests, up to almost normal at the last measurement. However, no significant effect was found to the PES group at the end of the three measurements moments after the operation. Sensitivity to cold and pain disability were measured only in the last stage and presented high variability, thus it is hard to conclude strongly that the treatment did not affect this aspect.

Discussão

Transcutaneous electrical stimulation holds promise in nerve regeneration, offering a non-invasive approach with potential practical benefits. Previous results demonstrated that subjects who received stimulation exhibited earlier and better outcomes around 3 months post-surgery.However, no significant effect was found to the treatment at the end of the three measurements moments after the operation in our sample. In face of this scenario, the efficacy of applied fields in enhancing peripheral nerve regeneration in vivo appears to be uncertain.

Conclusão

In this study, the use of surface electrical stimulation after neurorrhaphy of digital nerves of the hand did not improve postoperative sensitivity measured by MSW and s2PD tests and was not associated with better results in terms of sensitivity to cold and pain involving the outcomes studied