MR – ITALIAN JOURNAL OF REHABILITATION MEDICINE VOL. 27 – N. 2
41° SIMFER NATIONAL CONGRESS
UNIVERSITÀ CATTOLICA DEL SACRO CUORE (ROMA)
13-16 October 2013
376
REHABILITATION PROTOCOL WITH “SHORT VOLTAGE IMPULSES” SYSTEM
CONTROLLED BY SOFTWARE “IN LUMBOSCIATALGIA AND CERVICOBRACHIALGIA
ROSA GRAZIA BELLOMO – ALEXANDRA DI STEFANO – FLORENZO CAPOGROSSO – EMILIO
ANCONA – LAURA DI PANCRAZIO – MARCO SUPPLIZI – RAOUL SAGGINI
UNIVERSITÀ DEGLI STUDI “G. D’ANNUNZIO”, CHIETI, ITALY
Introduction. Chronic pain is defined as persistent or recurrent pain, which persists after the
normal healing time, or in any case longer than 3-6 months, affecting the patient’s well-being;
represents one of the most serious health problems in the industrialized world, it affects millions of individuals e
constitutes the most frequent cause of suffering, disability, deterioration of the quality of life; Education
epidemiologicals indicate that 25-30% of the population in the most developed countries is affected by chronic pain, e
of these, from half to 2/3 have a variable degree of disability for periods of days, weeks, months or
permanent with very high social cost in terms of medical assistance, indirect costs and days
lost jobs. The annual incidence of cervical radiculopathy is 83 cases per 100,000 individuals e
about 60-90% of the adult population develops low back pain, which for 10-20% is chronic.
A single pain relief treatment is unable to completely abolish chronic pain and exposes more
easily the patient to the adverse effects related to it; it is therefore appropriate to resort to integration
of multimodal anelgesia with a global rehabilitation project. The most accredited therapies are:
laser therapy, infiltrative therapy, short wave diathermy, electrotherapies, manual therapy, stretching,
proprioception. Literature studies have highlighted the effectiveness of biofeedback systems
“Biological / molecular” with software-controlled short voltage pulse therapy in the treatment of
chronic pain in diseases characterized by abnormalities in motor neuron excitability. Goal of our
study was to evaluate the effectiveness of the treatment of chronic lumbar and cervical pain with
short voltage pulses controlled by software with So.Co.Short system with application mode
innovative electrodes.
Materials and methods. 39 subjects with Lumbosciatica aged between 28 and 80 were evaluated and treated
years (mean age 57; 15M 24F) and 30 subjects with Cervicobrachialgia aged between 31 and 80 years (age
average 53; 11M 19F) who had had chronic symptoms (“pain sickness”) for at least 12 months.
Treatment inclusion criteria were: age over 18, pain present for more than 12 months, level of
pain of at least 3 on the VAS scale, informed consent, Exclusion criteria were: pregnancy,
pacemaker, non self-sufficiency in ADL and IADL, severe cognitive impairment, pathologies with prognosis
bad at 6-12 months. All subjects underwent 10 treatment sessions. In the Lombosciatalgia group
MR – ITALIAN JOURNAL OF REHABILITATION MEDICINE VOL. 27 – No. 2
29 patients underwent therapy every other day, 10 patients underwent the same number of
sessions but on a daily basis. In the Cervicobrachialgia group 20 patients underwent therapy a
alternate days and 10 patients with daily frequency. Each session lasted 31 minutes in
Lumbosciatalgia group and 27 minutes in the Cervicobrachialgia group. In all subjects one was applied
innovative and original topographic distribution modality of the electrodes. All subjects were evaluated
using specific evaluation scales for pathology and myometric measurement of characteristics
rheological muscles at the beginning of T0 and the end of the T1 treatment cycle and subjective measurement of pain
using the VAS scale after each session.
Results. A statistically significant (p <0.05) reduction in level was achieved in all subjects
of pain on a VAS scale after each session. In detail, as regards the subjects affected by
lumbosciatalgia who performed therapy on alternate days, there was an average pain of 7.2 ± 2.3 at T0 and
at 1.9 ± 2.3 at T1; in subjects suffering from lumbosciatalgia who carried out daily therapy it was evident
mean pain equal to 7.6 ± 2.3 at T0 and equal to 2.7 ± 3.1 at T1. In subjects suffering from cervicobrachialgia that
performed therapy on alternate days, mean pain was found on the VAS scale equal to 6.8 ± 2.7 at T0 and 1.9 ± 2.5
at T1; pain was recorded in subjects with cervicobrachialgia who received daily therapy
mean on VAS scale equal to 6.3 ± 1.9 at T0 and 2.8 ± 2.8 at T1. The score obtained in the Oswestry questionnaire
Disability Index in the Lumbosciatalgia group who performed therapy every other day was reduced on average
from 50% to 8% and in the Lombosciatalgia group subjected to daily treatment from 46% to 6%. The
Neck Disability Index score decreased from 54% to 12% in the day therapy group
alternate and 52% to 12% in the daily therapy group; in all subjects it was found
improvement in the state of stiffness, tone and muscle elasticity.
Conclusions. The results described demonstrate the effectiveness of the system used and the overlap of the
two different operative modalities in the reduction of painful symptoms and disability related to
chronic pain in subjects with cervical and lumbar radiculopathy.
Bibliography
- American Society of Anesthesiologists, 2002
- Siddall PJ, Loeser JD. Pain following spinal cord injury. Spinal Cord. 2001 Feb;39(2):63-73.
- Jin F, Chung F. Multimodal analgesia for postoperative pain control. J Clin Anesth. 2001
Nov;13(7):524-39.
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