Effectiveness of Sympathetic Ganglion Modulation by TENS on Claudication Distance and Haematological and Doppler Ultrasound Parameters in Men with Peripheral Arterial Disease: A Randomized Controlled Trial

Abstract Objective This study aims to investigate the effect of sympathetic ganglion electrical modulation in peripheral arterial disease (PAD) patients and the resultant changes in claudication distance, haematological parameters, and Doppler ultrasound parameters. Methods Forty male PAD patients were randomly divided into two groups: (i) transcutaneous electrical nerve stimulation (TENS) group ( n = 20, mean age 55.55 ± 2.16 years), which received TENS at T12, L1, and L2 (4 Hz frequency, 200 µs pulse duration), and (ii) control group ( n = 20, mean age 54.6 ± 2.56 years), which received sham therapy. Both interventions lasted 45 min per session, three times per week for 12 weeks. Outcomes included claudication distance [initial (ICD) and absolute (ACD)], Doppler parameters [ankle peak systolic velocity (APSV) and arterial diameter (AD)], and haematological markers [mean platelet volume (MPV) and red cell distribution width (RDW)]. Results The TENS group demonstrated significant improvements compared to the control group across all measured outcomes ( p < 0.001). Notable enhancements were observed in absolute and initial claudication distances (mean differences: 150.5 m and 71.9 m, respectively), arterial diameter (+ 0.21 mm), and ankle peak systolic velocity (+ 10.39 cm/s). Additionally, mean platelet volume and red cell distribution width decreased significantly in the TENS group, indicating favourable haematological changes. Conclusions Sympathetic ganglion modulation by TENS is an effective non-invasive intervention that significantly enhances walking capacity, vascular function, and haematological markers in patients with PAD. These results support its potential as a therapeutic adjunct to traditional PAD management strategies.