cognitive impairment, older adults, pain, pressure injury, skin temperature, TENS, transcutaneous electric nerve stimulation, wound healing



  1. Garcia-Perez, Sara PT
  2. Garcia-Rios, Ma Carmen PhD, PT
  3. Perez-Marmol, Jose Manuel PhD, OT
  4. Tapia-Haro, Rosa Maria OT, PT
  5. Albornoz-Cabello, Manuel PhD, PT
  6. Valenza, Marie Carmen PhD, PT
  7. Aguilar-Ferrandiz, Maria Encarnacion PhD, PT


OBJECTIVE: To evaluate the effectiveness of a transcutaneous electric nerve stimulation (TENS) device typically used for pain suppression (analgesia) during pressure injury (PI) healing, peripheral vascularization, and secondary pain in older adults with chronic PIs and cognitive impairment.


DESIGN AND SETTING: This pilot clinical trial followed patients from 6 nursing homes.


PATIENTS AND INTERVENTION: Twenty-two patients with PIs in the distal third of their lower limbs (7 men, 15 women) were included in this study. The control group completed standard wound care (SWC), whereas the experimental group received SWC and TENS. A total of 20 sessions were conducted for each group over 2 months, 3 times a week.


MAIN OUTCOME MEASURE: PI area, PI healing rate, blood flow, skin temperature, oxygen saturation, and level of pain at baseline and posttreatment.


MAIN RESULTS: Significant improvements were achieved in PI area (mean difference, 0.92; 95% confidence interval [CI], 0.15-1.67; P =.024), healing rate (3; 95% CI, 1-4.99; P =.009), skin temperature (1.82; 95% CI, 0.35-3.28; P =.021), and pain (1.44; 95% CI, 0.49-2.39; P =.008) in the experimental group, whereas none of the variables revealed a significant change in the control group.


CONCLUSIONS: The effect of local and spinal TENS combined with the SWC for PI produced a significant improvement in size, healing, skin temperature, and pain levels.