Effect of high transcutaneous electrical nerve stimulation on pain and chest expansion in subjects with intercostal drain tube: A quasi-experimental study
Aishwarya Pore, Aakanksha Joshi
Background: Conventional TENS that is high frequency low intensity generate nerve impulse in large diameter non-noxious afferents (A-ß) arising from mechanoreceptors. This study aimed to find the effect of high transcutaneous electrical nerve stimulation on pain and chest expansion in subjects with intercostal drainage tube. Thoracotomy can be one of the most painful types of incision that patient can experience. Pain may inhibit effective coughing, deep breathingand upper limb mobilization of affected side . Intercostal Chest drains (ICD) are painful as the parietal pleura are very sensitive to pain. Hypoventilation occurs because of pain and muscle guarding at ICD site. Therefore, it is important to emphasize on pain relief and expansion. The Numeric Pain Rating Scale (NPRS) that is a one-dimensional measure of pain intensity in adults. The NPRS is a valid and reliable scale to measure pain intensity (r= 0.95 & 0.96). Chest expansion is measured using measuring inch tape. Measuring the circumference of chest at axillary, nipple, and xiphoid level. Chest expansion at axillary, nipple and xiphoid level [intra-rater upper chest icc value = 0.90-0.93 for lower chest 0.85-0.86 (very good agreement) inter-rater value for upper chest 0.73-0.83 for lower chest 0.82-83 (good to very good)]Material and methodology: Subjects with intercostal drain tube (n=22) were selected in this study. Total 22 subjects were selected with age group 40-60 years based on inclusion and exclusion criteria with their consent were selected in this study. TENS was applied for 7 days, and NPRS score was used to assess pain and chest expansion was assessed pre and post treatment intervention.Result: TENS showed significant effect in reducing pain and improving chest expansion assessed using NPRS and chest expansion respectively. The p value for NPRS pre and post intervention is 0.01, and chest expansion at nipple and xiphoid level pre and post intervention is 0.01.Conclusion: According to the result, our study proves the alternate hypothesis. TENS is effective in reducing the acute pain after insertion of ICDT and hence improving chest expansion. Therefore TENS can be helpful clinically to alleviate post ICDT insertion pain.
Aishwarya Pore, Aakanksha Joshi. Effect of high transcutaneous electrical nerve stimulation on pain and chest expansion in subjects with intercostal drain tube: A quasi-experimental study. International Journal of Yoga, Physiotherapy and Physical Education, Volume 6, Issue 3, 2021, Pages 124-125