NCT04683042

Brief Summary

The purpose of this study is to determine if addition of Transcutaneous Electrical Nerve Stimulation (TENS) to routine physical therapy improves movement-evoked pain in patients with fibromyalgia (FM). The study will also determine if addition of TENS to routine physical therapy (PT) improves disease activity and symptoms, increases adherence to physical therapy, increases the likelihood of meeting patient specific functional goals, and reduces medication use.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
459

participants targeted

Target at P50-P75 for phase_3

Timeline
Completed

Started Jan 2021

Typical duration for phase_3

Geographic Reach
1 country

6 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 22, 2020

Completed
2 days until next milestone

First Posted

Study publicly available on registry

December 24, 2020

Completed
29 days until next milestone

Study Start

First participant enrolled

January 22, 2021

Completed
4.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 11, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 11, 2025

Completed
Last Updated

October 29, 2025

Status Verified

October 1, 2025

Enrollment Period

4.1 years

First QC Date

December 22, 2020

Last Update Submit

October 27, 2025

Conditions

Keywords

Transcutaneous Electrical Nerve Stimulation (TENS)chronic painfibromyalgiamovement pain

Outcome Measures

Primary Outcomes (1)

  • Reduction of movement-evoked pain (0-10 Low to High scale) during the Sit and Stand Test

    Numeric rating scale of 0-10 for reduction of movement-evoked pain measured by 11-point NRS from baseline to 60 days.

    Research Homework before PT Visit 3 (Day 1), Day 60 +/- 5 days Home

Secondary Outcomes (8)

  • Change in the resting pain score (0 - 10 Low to High scale)

    Research Homework before PT Visit 3 (Day 1), Day 60 +/- 5 days Home

  • Pain interference (BPI) (0-10 Low to High Scale)

    Research Homework before PT Visit 3 (Day 1), Day 60 +/- 5 days Home

  • FM Disease activity (FIQR) (0-10 Low to High Scale)

    Research Homework before PT Visit 3 (Day 1), Day 60 +/- 5 days Home

  • Resting fatigue (NRS) (0-10 Low to High Scale)

    Research Homework before PT Visit 3 (Day 1), Day 60 +/- 5 days Home

  • Movement-evoked fatigue (NRS) (0-10 Low to High Scale)

    Research Homework before PT Visit 3 (Day 1), Day 60 +/- 5 days Home

  • +3 more secondary outcomes

Study Arms (2)

TENS with PT

ACTIVE COMPARATOR

TENS with PT group: The TENS with PT group will receive usual PT care and following enrollment, during the second PT visit, participants will receive TENS units and instruction on use of the TENS units. TENS will be applied to the upper and lower back with butterfly electrodes using the following parameters: mixed frequency (2-125Hz), strong but comfortable intensity, variable pulse duration from 100-250 microseconds. TENS to be applied when the patient is active and doing exercises at home and during PT sessions for 30 minutes at least 2 hours per day. The TENS with PT group will complete TENS use to the end of the study at 6 months.

Device: Transcutaneous Electrical Nerve Stimulation (TENS) with PT

No TENS with PT

OTHER

The No TENS group will receive usual PT care until the primary endpoint timeframe of 60 days. After completion of the research homework at 60 days, TENS units will be mailed to the participants and a study team member will complete virtual TENS instruction. The no TENS group will complete TENS to the end of the study at 6 months.

Other: PT only

Interventions

Use of TENS units along with routine PT therapy

TENS with PT
PT onlyOTHER

Routine PT therapy only

No TENS with PT

Eligibility Criteria

Age18 Years - 99 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18 until 99.
  • Clinician diagnosis of FM
  • Referred for land-based PT
  • Referred for treatment for FM or chronic pain (pain lasting more than 3 months)
  • Able to provide informed consent.
  • Fluent in reading English
  • Willing to use TENS

You may not qualify if:

  • Contraindications to TENS use including:
  • Pacemaker, defibrillator, implanted neurostimulator or implanted device
  • Epilepsy
  • Currently pregnant or plan to become pregnant in the next 6 months
  • Allergic reaction to patches with gel
  • Current treatment for cancer
  • Currently enrolled in another pain control study
  • Use of TENS within the last 30 days
  • Clinically unstable medical or psychiatric issues

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (6)

University of Illinois at Chicago

Chicago, Illinois, 60607, United States

Location

Rock Valley Physical Therapy

Moline, Illinois, 61265, United States

Location

Kepros Physical Therapy and Performance

Cedar Rapids, Iowa, 52404, United States

Location

Genesis Physical Therapy

Davenport, Iowa, 52807, United States

Location

Big Stone Therapies (BST)

Big Stone City, South Dakota, 57216, United States

Location

Advanced Physical Therapy Sport Medicine

Appleton, Wisconsin, 54913, United States

Location

Related Publications (1)

  • Post AA, Dailey DL, Bayman EO, Chimenti RL, Costigan M, Franck C, Huff T, Johnson E, Koepp M, Lafontant DE, McCabe ME, Neill-Hudson T, Vance CGT, Van Gorp B, Zimmerman BM, Ecklund D, Crofford LJ, Sluka KA. The Fibromyalgia Transcutaneous Electrical Nerve Stimulation in Physical Therapy Study Protocol: A Multisite Embedded Pragmatic Trial. Phys Ther. 2022 Nov 6;102(11):pzac116. doi: 10.1093/ptj/pzac116.

MeSH Terms

Conditions

FibromyalgiaChronic Pain

Interventions

Transcutaneous Electric Nerve Stimulation

Condition Hierarchy (Ancestors)

Muscular DiseasesMusculoskeletal DiseasesRheumatic DiseasesNeuromuscular DiseasesNervous System DiseasesPainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Electric Stimulation TherapyTherapeuticsPhysical Therapy ModalitiesRehabilitationAnalgesiaAnesthesia and Analgesia

Study Officials

  • Kathleen Sluka, PhD, PT

    University of Iowa

    PRINCIPAL INVESTIGATOR
  • Leslie Crofford, MD

    Vanderbilt University

    PRINCIPAL INVESTIGATOR
  • Dana Dailey, PhD, PT

    University of Iowa

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: This study is a pragmatic clinical trial in outpatient PT practices utilizing cluster randomization by facility and facility size. Sites will be randomized to enroll all eligible and consented participants with FM to TENS with PT, or PT only (no TENS). We have identified 25-35 clinics across 6 healthcare systems in both rural and urban settings.
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Kathleen A. Sluka, PhD, PT, FAPTA

Study Record Dates

First Submitted

December 22, 2020

First Posted

December 24, 2020

Study Start

January 22, 2021

Primary Completion

March 11, 2025

Study Completion

March 11, 2025

Last Updated

October 29, 2025

Record last verified: 2025-10

Data Sharing

IPD Sharing
Will share

The current study is expected to generate patient-reported outcomes for individuals with fibromyalgia across a broad spectrum of domains, pain, fatigue, function, psychological factors, and quality of life. We will also collect some data from the electronic health record about number of physical therapy visits, Current Protocol Terminology (CPT) codes for treatments, and the patient-specific functional scale. In addition, we will have TENS usage data downloaded from the TENS devices that will show the number of minutes of TENS use and the number of 30 minute sessions completed. Data will be collected prior to the intervention (baseline data) and 30, 60, 90 and 180 days after enrollment.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR
Time Frame
Analysis datasets will be made available at the time of publication of the primary manuscript. Complete datasets and accompanying resources will be deposited to the designated NIH Helping to End Addiction Long-term initiative (HEAL) data repository after the completion of the primary aim manuscript.
Access Criteria
In accordance with NIH Collaboratory policies, we will prepare the primary analysis datasets (at a minimum) for submission to the Collaboratory Coordinating Center. In accordance with International Committee of Medical Journal Editors (ICMJE) policies, we will prepare the primary analysis datasets for review and reproducibility by peer-reviewed journals. We will prepare the final datasets and accompanying resource documents for final deposit to the designated NIH HEAL data repository. Publications will be made available to the public using open access publishing, so they become available immediately to the public. All publications will be accessible through PubMED, google scholar, and available to the public through open access.

Locations