Hello
I am conducting an umbrella review on transcutaneous tibial nerve stimulation (TENS). I noticed that some of my included systematic reviews, which expressly and exclusively mentioned TENS as their target intervention, had included original studies using percutaneous electrical nerve stimulation (PENS).
As far as I know, there are technical differences between the two methods.
In addition, one study mentioned using PENS with surface electrodes with no further explanation.
Is there a way that PENS can be considered and categorized as TENS?
Hello, you've asked a good question.
As far as I know, Transcutaneous Electrical Nerve Stimulation (TENS) and Percutaneous Electrical Nerve Stimulation (PENS) possess notable technical distinctions; TENS employs surface electrodes for nerve stimulation, while PENS uses needle electrodes penetrating the skin. Despite these differences, systematic reviews or meta-analyses occasionally integrate both interventions for broader evidence synthesis, potentially introducing methodological inconsistencies. Any representation of PENS using surface electrodes prompts a methodological conflict, necessitating clarification. In my opinion, upholding methodological transparency and rigor in delineating the variations and possible inconsistencies between TENS and PENS is imperative to preserve the reliability and comprehensibility of the umbrella review. Balancing the fine nuances and clarifying the operational definitions and application modalities of each technique will ensure the validity and interpretative relevance of the synthesised findings within the review
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