My definition of a competent doctor would have already created a protocol on this and installed it in their hospital. September 22, 2024 publication. Do you have a functioning stroke doctor, or not? Have you fired the incompetent ones yet?
Scrambler Therapy, A Pain Treatment, May Benefit Patients With Poststroke Pain
Long-term treatment with scrambler vs sham therapy resulted
in improvements in patient-reported pain in 80% vs 40% of participants,
respectively.
Scrambler therapy — a noninvasive electroanalgesia device — effectively reduces poststroke pain and may be beneficial in the long-term treatment of pain in peripheral neuropathy, according to the findings of a small study published in Annals of Clinical and Translational Neurology.
Scrambler therapy has been approved by the US Food and Drug Administration (FDA) for the treatment of acute, chronic, and postoperative pain. However, there is limited information on the effectiveness of scrambler therapy for central nervous system (CNS)-related pain.
Researchers of a randomized, single-blind, sham-controlled trial assessed the efficacy of scrambler therapy vs sham in reducing poststroke pain.
Eligible participants were aged at least 18 years, had a prior ischemic or hemorrhagic stroke, and had pain at the area affected by the stroke.
The researchers collected pain scores from all participants, using the Numerical Rating Scale, before neurostimulation. Electrodes were placed on the area of pain.
Participants were randomly assigned to receive scrambler therapy or sham placebo. Those in the treatment group received 40 minutes of treatment during each session at a consistent current intensity, and those in the sham group had an initial increase in channel intensity, but the channels were turned off during the session. All participants received a total of 5 daily treatments or until pain levels of 0 were reached at 2 consecutive assessments.
Of the 20 participants in the study, 10 (mean age, 60 years; women, 30%) received scrambler therapy and the remaining 10 (mean age, 56.9 years; women, 70%) received sham therapy. Mean time from stroke was 35 and 29.5 months, respectively.
Mean pain scores were lower in those who received scrambler vs sham therapy (5.73 vs 6.68), with scores improving over time in the scrambler therapy group and remaining constant in the sham group.
At the completion of the sessions, mean change in pain scores in the scrambler vs sham therapy group was -3.73 vs -0.94 (56% vs 16% reduction in pain), respectively. A large percentage of participants (90%) who received scrambler therapy observed improvements in pain scores during the treatment period, while these improvements were observed in 70% who received sham therapy (P =.264). In addition, 70% vs 10% of the participants in the groups, respectively, reported a decrease in more than 50% of pain (P =.006). Results of the paired t-test were also consistent with these findings, with patients who received scrambler vs sham therapy having significant changes in pain scores from baseline (P =.003 and P =.057, respectively).
At the 4-week follow-up, participants in the scrambler vs sham therapy group continued to have pain relief, reporting mean changes in pain scores of -2.57 and -0.25, a 38% and 4% reduction in pain, respectively. Paired t-test showed significant changes in pain scores for the scrambler therapy group (P =.004).
Long-term treatment with scrambler vs sham therapy resulted in improvements in patient-reported pain (P =.068) in 80% vs 40% of participants, respectively, with more than a 50% reduction in pain in 30% vs 10% of the groups, respectively (P =.264).
Study limitations included the small sample size and that the study was conducted at a single center. The long-term benefits of scrambler therapy also warrant further investigation.
“Overall, results suggest that [scrambler therapy] may be an effective acute and potentially longer-term treatment of poststroke pain and may be a suitable alternative to pharmacologic treatment,” the researchers noted.
They added, “The ability of [scrambler therapy] to reduce pain to a greater extent than previously studied medication regimens, without significant toxicity or side effects, could improve care by reducing burden of disease and enhancing quality of life for stroke survivors.”
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