HI-TENS BY R-SHOCK, CLINICAL APPROACH
Discover how to integrate the Hi-Tens by R-SHOCK device into your daily practice through resources such as a case study, a thesis and filmed protocols.
CLINICAL APPROACH
Fractures are among the most common cases treated by physiotherapists. Their complications can be complex but can be limited with the use of Hi-TENS which combines the strengths of two technologies generating transcutaneous electrical nerve stimulation (TENS) in high frequency pulses (PHF).
CONTEXT
The patient fractured his wrist in February 2022.
Operated with pins, complications with compartment syndrome occurred with a large scar on the forearm.
PROTOCOL AT M+2
The patient had pain on mobilisation rated at 6/10 with a limitation of range of motion.
The protocol for this session is very simple:
| MODE | METHOD | TIME |
|---|---|---|
 33% MIX Hi-RET | Target 3' on each side of the wrist | 6 mn |
 2Hz Hi-TENS |
After 6 minutes of treatment with HiTENS and without any other mobilization or technology used:
- Pain was then assessed at 3.
- ROM increased from +27° to +42° (+15°).
abstract
Matthieu Morissau’s 2021 Master’s thesis in Physiotherapy and Rehabilitation in France – Read the full thesis in french
OBJECTIVE
The aim of this study was to evaluate the value of HI-TENS by R-SHOCK in the acute management of patients with rotator cuff tendinopathy.
Material and Methods:
Ten individuals, 5 women and 5 men, received a single treatment of Hi-TENS by R-SHOCK. They underwent assessment of their global pain, following a Jobe test and a Gerber test, and completed the DASH questionnaire. These assessments were carried out before and after treatment with Hi-TENS by R-SHOCK.
RESULTS
The use of Hi-TENS by R-SHOCK in the acute management of patients with of patients with rotator cuff tendinopathy had a significant benefit on pain improvement in pain and functionality in the upper limb, over a 24-hour period.
After 24 hours:
- Global VAS & Jobe VAS test: 70% of patients improved their VAS score following a Jobe test.
- Gerber VAS: 90% of subjects experienced a reduction in pain the day after TECAR treatment.
- DASH score: 100% of participants in this study saw their DASH score improve after a TECAR session.
method
The experiments took place over two consecutive days, with one session per day (< 20 min), separated by 24 hours. Participants were then treated with Hi-TENS by R-SHOCK.
The parameters assessed were as follows:
- Global VAS
- VAS during a Jobe test
- VAS in Gerber test
- DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire
These parameters were collected before the first session and 24 hours afterwards.
PROTOCOL
| MODE | METHOD | TIME |
|---|---|---|
| MIX | Target the various triggers. Release muscular tension by sweeping the muscles. Return electrode on same side. | 3 mn |
| SHOCK | Electrodes on either side of the tendon opposite the the fibrosed area. Alternate with manual defibrosing. | 2 mn |
| MIX | When hyperthermia is reached. Electrodes are placed on either side of the tendon, opposite the fibrosed area. Alternate with manual defibrosing. The aim of this treatment is to eliminate pain, restore collagen architecture, work on trigger points and break tendon adhesions. | 3 mn |
evaluation
GLOBAL VAS
For 7 subjects out of 10, a reduction in overall VAS was observed after treatment with Hi-TENS. 2 subjects maintained the same score before and after experimentation. Finally, one one participant saw his overall VAS increase by one point.
JOBE VAS
This specific manipulation is designed to assess the supraspinatus muscle (Cotter et al., 2018). The patient was standing against a wall with his arms in the frontal plane of the scapula (approximately 30° forward) at 90° abduction, thumbs down and elbows straight.
Downward pressure was applied, and he was asked to resist it. Once the test had been performed, the pain felt by the patient during this exercise was measured using a visual analog scale rated from 0 to 10. The instructions given was as follows: “Try to resist the pressure exerted on your arms”; the exercise had been shown and explained to the patient beforehand.
7 patients out of 10 saw their VAS score improve following a Jobe test. For 2 of them, there was an increase, of one point for one and two points for the other. One person’s score remained the same as before treatment.
GERBER VAS
This specific test is focused on evaluating the subscapularis muscle (Yoon, 2013). The patient stood with his hand behind his back at the level of the lumbar girdle, closed his fist, unclenched it from his back and held the position (figure 8). The pain felt by the patient during this maneuver was measured on the visual was measured on a visual analog scale from 0 to 10. The instructions given to the patient were “Place your hand behind your back with a closed fist and lift it up. Try to hold this position”. The exercise had, of course, been explained and demonstrated before the patient performed it.
For VAS after the Gerber test, 9 participants out of 10 had a reduction in pain the day after Hi-TENS by R-SHOCK treatment. One person experienced slightly more pain pain (increase of one point on the VAS).
DASH SCORE
This is a subjective self-assessment questionnaire for global upper limb capacity. It can be completed by the patient him/herself in just a few minutes. It consists of 30 mandatory and 4 optional questions (not taken into account here). 21 assess the difficulty of performing specific activities of daily living. Of the remaining 9 questions, 3 concern social relationships and 6 focus on specific symptoms such as pain, strength, mobility and sleep.
All the participants in this study have improved their DASH scores after a session of Hi-TENS by R-SHOCK.
Video protocols
MORE RESOURCES ON HI-TENS BY R-SHOCK
Getting started with my Hi-TENS by R-SHOCK
Hi-TENS by R-SHOCK for treating tendinopathies
