TENS a Better Alternative to Winks Greene Transeva

The Winks Greene Transeva has allegedly shown the following effects upon application of the device. These have all been listed on the manufacturer’s website, with unknown sources of evidence (Winks Greene Transeva, 2002):

• Muscle tone returned to normal
• Increase in blood flow to the treated tissues
• Movement in lymph and waste products
• Increase in oxygen and nutrients
• Increase in absorption of fluid
• Dangers of adhesions are minimised
• Increase in elasticity of connective tissue
• Adhesions are gently and gradually torn apart by causing increasingly powerful contractions to the muscles
• Muscles are prevented from wasting
• Control of inflammation process (Winks Greene Transeva, 2002)

Transcutaneous electrical nerve stimulation (TENS) has been proven to have the following physiological effects upon application:

• Pain control

o   Gate Control Theory (Melzack & Wall, 1965)

o   Opiate-mediated control theory: promotion of endorphin release (McMahon & Koltzenburg, 2005)

o   Increase in local vasodilation in ischaemic tissue (Figure 4) (Leandri, Brunetti & Parodi, 1986)

o   Stimulation of acupuncture points causes a sensory analgesic effect (Melzack & Wall, 1965)

• Reduce nausea with the application of acupuncture TENS to PC06 (median nerve at the wrist level) (Dundee, Yang, & McMillan, 1991)
• Reduce spasticity by reducing or inhibiting excessive alpha-motor neuron activity (Goulet, Arsenault, Bourbonnais, Laramee & Lepage, 1996)
• Increase in local cutaneous blood flow (low frequency TENS above the motor threshold) (Sherry, Oehrlein, Hegge & Morgan, 2001)
  
  

  

  Figure 4: An example of TENS application

It can be seen from the above information that TENS and the Winks Greene Transeva have similar physiological effects. However, the information regarding the Winks Greene Transeva has no supporting research whereas TENS has a large evidence base to justify these effects. Currently the Winks Greene Transeva is not being used in Australia. Since TENS has evidence-based research available with the evidence becoming stronger as time continues and the transeva with currently no research base, there is reason behind why TENS is a popular choice in Australian physiotherapy practice.

A disadvantage of the transeva is the unknown contraindications and precautions. TENS, however, has an extensive list of contraindications ensuring those that can be harmed from the machine are prevented from using it (Belanger, 2010). Quite often, for physiotherapists to use a form of electrical stimulation, they want to be reassured that the patient is safe during and after its application.

In modern society Australia, there is an expectation of clinical research needed to be performed before clinicians and patients will use any technique or application of a machine. Without this research, the Winks Greene Transeva will not be TGA approved and therefore not implemented into clinical practice in Australia (Commonwealth Department of Health and Ageing, 2011). This is based on the lack of research supporting the transeva compared to the alternative in the TENS machine, performing similar tasks at a lower risk to the patient.

References

Belanger, A. (2010). Therapeutic Electrophysical Agents: Evidence Behind Practice (2nd ed.). Baltimore, USA: Lippincott Williams & Wilkins.

Commonwealth Department of Health and Ageing. (2011). Australian Regulatory Guidelines for Medical Devices (ARGMD). Canberra, Australian: Author. Retrieved from http://www.tga.gov.au/industry/devices-argmd.htm   

Dundee, J., Yang, J. & McMillan, C. (1991). Non-invasive Stimulation of the P6 (Neiguan) Antiemetic Acupuncture Point in Cancer Chemotherapy. The Journal of the Royal Society of Medicine, 84(4), 210-212.

Goulet C., Arsenault A., Bourbonnais D., Laramee M. & Lepage Y. (1996). Effects of Transcutaneous Electrical Nerve Stimulation on H-reflex and Spinal Spasticity. Scandinavian Journal of Rehabilitation Medicine, 28(3), 169-176.

Leandri, M., Brunetti, O. & Parodi, C. (1986). Telethermographic findings after Transcutaneous Electrical Nerve Stimulation. Physical Therapy, 66(2), 210-213.

McMahon S., & Koltzenburg M. (2005). Wall and Melzack’s Textbook of Pain. London, UK: Churchill Livingstone.

Melzack, R. & Wall P. (1965). Pain Mechanisms: A New Theory. Science, 150(3699), 971-979.

Sherry, J., Oehrlein, K., Hegge, K. & Morgan, B. (2001). Effect of Burst-Mode Transcutaneous Electrical Nerve Stimulation on Peripheral Vascular Resistance. Journal of the American Physical Therapy Association, 81(6), 1183-1191.

Winks Greene Transeva. (2002). Retrieved March 28, 2012, from http://www.winksgreenetranseva.com