Effects of Dysesthesia-Matched Transcutaneous Electrical Nerve Stimulation Combined With Exercise Therapy on Tingling and Postural Stability in Cervical Spondylotic Myelopathy: A Case Report

To investigate the effects of an intervention combining transcutaneous electrical nerve stimulation (TENS), with parameters adjusted to match the patient's dysesthesia characteristics, and exercise therapy in a patient with cervical spondylotic myelopathy (CSM) who exhibited marked tingling of the lower limbs and impaired standing balance. A 41-year-old woman diagnosed with CSM associated with spinal canal stenosis and disc herniation at the C5-C6 level underwent an intervention using a two-phase AB design consisting of an exercise therapy-only phase (Phase A) and a DM-TENS plus exercise therapy phase (Phase B). Phase A lasted seven days, and Phase B lasted eight days. On the first day of Phase B, the tingling and standing balance were evaluated as immediate changes in effect at three time points: before, immediately after, and 180 min post-intervention. Tingling and electric-shock pain were assessed daily using an 11-point numerical rating scale (NRS). Superficial plantar sensation and standing balance were assessed on the final day of each phase. The intervention consisted of a 60-min program combining TENS and exercise therapy. The effectiveness of TENS was analyzed using Tau-U statistics. Immediate improvements in tingling, electric-shock pain, superficial plantar sensation, and standing balance were observed following TENS; however, these symptoms worsened over time. After the intervention, improvements in tingling and electric-shock pain were observed as extended carry-over effects, along with maintained gains in superficial plantar sensation and standing balance. TENS, with stimulation parameters tailored to the characteristics of tingling, when combined with exercise therapy, may contribute not only to the relief of tingling and electric-shock pain but also to the improvement of motor performance.