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Efficacy of home-based transcutaneous electrical stimulation rehabilitation for ankylosing spondylitis

Summaries 2 min 10

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Created On: 27/02/2025

Managing ankylosing spondylitis is challenging, particularly in maintaining function and flexibility.

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Key take away

In-home TENS therapy boosts patient adherence, offers effective remote rehabilitation, and allows easy treatment progress tracking, improving ankylosing spondylitis management.

Background

Managing ankylosing spondylitis is challenging, particularly in maintaining function and flexibility. While manual therapy and transcutaneous electrical nerve stimulation (TENS) show promise, home-based options are limited. This crossover trial assessed the usefulness of home TENS system with a novel treatment program for people with ankylosing spondylitis.

Method

The home-based TENS treatment for ankylosing spondylitis patients was administered using the modified WeHeal TENS and galvanic skin response technique. Participants (aged between 20 and 70 years) were assigned to 1-month or 2-month treatment courses, followed by a washout period.

Afterwards, they could decide to resume with a second course. Efficacy was assessed using measures like Bath Indices (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Bath Ankylosing Spondylitis Functional Index [BASFI]), Schober diagnostic test, finger-to-floor test, score of tendon attachment sites, and levels of cytokines and inflammatory markers.

Result

Nine patients completed the first treatment plan (5 in the 2-month group; 4 in the 1-month group), and five completed the subsequent path (4 in the 2-month group and 1 in the 1-month group). After the treatment, the weighted results indicated an improvement in the BASFI score (mean difference –0.9, standard deviation 1.7; P=.03). Analysis of the score trajectories revealed a reduction in scores of the Bath indices during treatment, which increased during the washout phase.

Trends showed improvement in the Schober test (P=.11) and finger-to-floor flexion test (P=.79), though neither result was statistically noteworthy. Fluctuations in cytokines, chemokines, inflammatory markers, and immunoglobulins prior to and following the treatment did not display a consistent trend, with all results lacking statistical significance (all P>.05).

Conclusion

The home TENS device shows promise in managing ankylosing spondylitis by improving accessibility and adherence, with remote monitoring for clinicians. Future research should compare home versus clinic-based electrotherapy and explore combining TENS with exercise to enhance physical function and spinal range of motion.