Effect of acupuncture-like transcutaneous electrical nerve stimulation versus cryotherapy on pain and chest mobility at the intercostal drainage site in patients with pleural effusion: A comparative study

Abstract: BACKGROUND: Intercostal drain insertion is associated with pleural irritation, causing pain at the intercostal drainage (ICD) site. Pain reflexively leads to muscle guarding, hypoventilation, and restricts mobility and participation in exercises. Hence, pain management is crucial to prevent secondary impairment and improve functional activity following ICD insertion. The study aimed to compare the efficacy of, acupuncture-like transcutaneous electrical nerve stimulation (AL-TENS) and cryotherapy on pain, chest expansion, thoracic spine mobility, and Patient-Specific Functional Scale (PSFS) for functional activities in patients having pleural effusion. MATERIALS AND METHODS: Thirty-two individuals with pleural effusion with an intercostal drain inserted for 24 h. Participants were randomly allocated into two groups, i.e., Group A receiving cryotherapy and Group B receiving AL-TENS. Both groups received interventions for 20 min along with conventional physiotherapy treatment for a week. Participants were assessed for pain on the Visual Analog Scale (VAS) at rest, chest expansion, thoracic spine mobility, and PSFS before and after the intervention period. RESULTS: The AL-TENS group showed significantly greater improvement in pain, chest expansion (R2, R4, R6), thoracic spine mobility (same-side rotation, extension), and PSFS ( P < 0.05). Pre–post P values: VAS < 0.001; chest expansion 0.002, 0.007, 0.016; spine mobility 0.03, 0.04; PSFS 0.007. Both groups improved significantly. CONCLUSION: AL-TENS was superior for reducing pain at the ICD site and improving chest expansion, thoracic spine mobility, and PSFS (functional activity) in patients following ICD placement for pleural effusion.