{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:30:35Z","timestamp":1792593035802,"version":"4.5.0"},"reference-count":58,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T00:00:00Z","timestamp":1584489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR000445"],"award-info":[{"award-number":["UL1TR000445"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1 AR063381"],"award-info":[{"award-number":["UM1 AR063381"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1 AR063381\u2010S1"],"award-info":[{"award-number":["UM1 AR063381\u2010S1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2020,5]]},"abstract":"\n Objective<\/jats:title>\n \n Fibromyalgia (\n FM<\/jats:styled-content>\n ) is characterized by pain and fatigue, particularly during physical activity. Transcutaneous electrical nerve stimulation (\n TENS<\/jats:styled-content>\n ) activates endogenous pain inhibitory mechanisms. This study was undertaken to investigate if using\n TENS<\/jats:styled-content>\n during activity would improve movement\u2010evoked pain and other patient\u2010reported outcomes in women with\n FM<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Participants were randomly assigned to receive active\n TENS<\/jats:styled-content>\n (n = 103), placebo\n TENS<\/jats:styled-content>\n (n = 99), or no\n TENS<\/jats:styled-content>\n (n = 99) and instructed to use it at home during activity 2 hours each day for 4 weeks.\n TENS<\/jats:styled-content>\n was applied to the lumbar and cervicothoracic regions using a modulated frequency (2\u2013125 Hz) at the highest tolerable intensity. Participants rated movement\u2010evoked pain (primary outcome measure) and fatigue on an 11\u2010point scale before and during application of\n TENS<\/jats:styled-content>\n . The primary outcome measure and secondary patient\u2010reported outcomes were assessed at baseline (time of randomization) and at 4 weeks.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After 4 weeks, a greater reduction in movement\u2010evoked pain was reported in the active\n TENS<\/jats:styled-content>\n group versus the placebo\n TENS<\/jats:styled-content>\n group (group mean difference \u20131.0 [95% confidence interval \u20131.8, \u20130.2];\n P<\/jats:italic>\n = 0.008) and versus the no\n TENS<\/jats:styled-content>\n group (group mean difference \u20131.8 [95% confidence interval \u20132.6, \u20131.0];\n P<\/jats:italic>\n < 0.0001). A reduction in movement\u2010evoked fatigue was also reported in the active\n TENS<\/jats:styled-content>\n group versus the placebo\n TENS<\/jats:styled-content>\n group (group mean difference \u20131.4 [95% confidence interval \u20132.4, \u20130.4];\n P<\/jats:italic>\n = 0.001) and versus the no\n TENS<\/jats:styled-content>\n group (group mean difference \u20131.9 [95% confidence interval \u20132.9, \u20130.9];\n P<\/jats:italic>\n = <0.0001). A greater percentage of the patients in the active\n TENS<\/jats:styled-content>\n group reported improvement on the global impression of change compared to the placebo\n TENS<\/jats:styled-content>\n group (70% versus 31%;\n P<\/jats:italic>\n < 0.0001) and the no\n TENS<\/jats:styled-content>\n group (9%;\n P<\/jats:italic>\n < 0.0001). There were no\n TENS<\/jats:styled-content>\n \u2010related serious adverse events, and <5% of participants experienced minor adverse events from\n TENS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Among women who had\n FM<\/jats:styled-content>\n and were on a stable medication regimen, 4 weeks of active\n TENS<\/jats:styled-content>\n use compared to placebo\n TENS<\/jats:styled-content>\n or no\n TENS<\/jats:styled-content>\n resulted in a significant improvement in movement\u2010evoked pain and other clinical outcomes. Further research is needed to examine effectiveness in a real\u2010world setting to establish the clinical importance of these findings.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/art.41170","type":"journal-article","created":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T08:28:30Z","timestamp":1574065710000},"page":"824-836","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":103,"title":["Transcutaneous Electrical Nerve Stimulation Reduces Movement\u2010Evoked Pain and Fatigue: A Randomized, Controlled Trial"],"prefix":"10.1002","volume":"72","author":[{"given":"Dana L.","family":"Dailey","sequence":"first","affiliation":[{"name":"University of Iowa, Iowa City, and St. Ambrose University Davenport Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol G. T.","family":"Vance","sequence":"additional","affiliation":[{"name":"University of Iowa Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A.","family":"Rakel","sequence":"additional","affiliation":[{"name":"University of Iowa Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Bridget","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"University of Iowa Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennie","family":"Embree","sequence":"additional","affiliation":[{"name":"University of Iowa Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2507-6058","authenticated-orcid":false,"given":"Ericka N.","family":"Merriwether","sequence":"additional","affiliation":[{"name":"New York University New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine M.","family":"Geasland","sequence":"additional","affiliation":[{"name":"University of Iowa Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0514-739X","authenticated-orcid":false,"given":"Ruth","family":"Chimenti","sequence":"additional","affiliation":[{"name":"University of Iowa Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon M.","family":"Williams","sequence":"additional","affiliation":[{"name":"Vanderbilt University Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meenakshi","family":"Golchha","sequence":"additional","affiliation":[{"name":"Vanderbilt University Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie J.","family":"Crofford","sequence":"additional","affiliation":[{"name":"Vanderbilt University Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0207-8728","authenticated-orcid":false,"given":"Kathleen A.","family":"Sluka","sequence":"additional","affiliation":[{"name":"University of Iowa Iowa 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