Os efeitos imediatos da aplicação de Kinesiotape no complexo articular do ombro no desempenho do nadador de competição

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia

Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss

We investigated the effect of different exercise modalities on high sensitivity-C reactive protein (hs-CRP) and other inflammatory markers in patients with type 2 diabetes and the metabolic syndrome. Eighty-two patients were randomized into 4 groups: sedentary control (A); receiving counseling to perform low-intensity physical activity (B); performing prescribed and supervised high-intensity aerobic (C) or aerobic + resistance (D) exercise (with the same caloric expenditure) for 12 months. Evaluation of leisure-time physical activity and assessment of physical fitness, cardiovascular risk factors and inflammatory biomarkers was performed at baseline and every 3 months. Volume of physical activity increased and HbA1c decreased in Groups B–D. VO2max, HOMA-IR index, HDL-cholesterol, waist circumference and albuminuria improved in Groups C and D, whereas strength and flexibility improved only in Group D. Levels of hs-CRP decreased in all three exercising groups, but the reduction was significant only in Groups C and D, and particularly in Group D. Changes in VO2max and the exercise modalities were strong predictors of hs-CRP reduction, independent of body weight. Leptin, resistin and interleukin-6 decreased, whereas adiponectin increased in Groups C and D. Interleukin-1β, tumor necrosis factor-α and interferon-γ decreased, whereas anti-inflammatory interleukin-4 and 10 increased only in Group D. In conclusion, physical exercise in type 2 diabetic patients with the metabolic syndrome is associated with a significant reduction of hs-CRP and other inflammatory and insulin resistance biomarkers, independent of weight loss. Long-term high-intensity (preferably mixed) training, in addition to daytime physical activity, is required to obtain a significant anti-inflammatory effect.

Flujo sanguíneo cerebral durante el ejercicio de esprint

Se desconocen los efectos del entrenamiento interválico de alta intesidad (HIIT) sobre el flujo sanguíneo cerebral (FSC) y la oxigenación cerebral. Por ello reclutamos a 20 voluntarios que realizaron una sesión de HIIT (4 test de Wingate con recuperaciones de 4 minutos). Se midió la oxigenación del lóbulo frontal (OLF) y el Vastus lateralis (VL) a través de espectrofotometría cercana a los infrarrojos (NIRS). También se registró la velocidad de la sangre en las arterias cerebrales medias (vACM) mediante Doppler. La vACM disminuyó entre un 5 y 10 % en el primer esprint. En los siguientes esprints se redujo aún más. La vACM descendió en cada esprint coincidiendo con la disminución de la presión tele-espiratoria de dióxido de carbono (PETCO2) y con valores superiores de ventilación pulmonar (VE). Al interrumpirse el pedaleo se redujo bruscamente la vACM. Sin embargo, la OLF se mantuvo estable en el primer esprint sólo reduciéndose ligeramente durante el segundo y tercer Wingate (el cuarto fue similar al tercero). Este estudio muestra que la vACM disminuye durante los ejercicios de esprint, posiblemente debido a la hipocapnia. La reducción de la vACM no ejerce efectos funcionales ni relevantes sobre la oxigenación cerebral, gracias al ajuste de la conductancia vascular a través de los mecanismos de autoregulación, sin que parezca afectar negativamente al rendimiento.

L’analyse biomécanique du sprint sur ergomètre non-motorisé : interaction entre les asymétries cinétiques et cinématiques lors d’un sprint de 40 verges

Au sprint 100 mètres et dans de nombreux sport de puissance, la phase d’accélération est un déterminant majeure de la performance. Toutefois, les asymétries cinétiques et cinématiques peuvent avoir une incidence sur la performance. L’objectif de cette étude était d’identifier la présence d’interaction entre différentes variables cinétiques et cinématiques angulaires aux membres inférieures (MI) d’un sprint de haute intensité sur un ergomètre non-motorisé avec résistance (NMR). Suite à une rencontre de familiarisation, 11 sujets ont exécuté des sprints de 40 verges. Les données cinétiques ont été obtenues par l’entremise de plateformes de force intégrées aux appuis de l’ergomètre NMR à 10 Hz et les données cinématiques ont été amassées à l’aide du système Optitrack et du logiciel Motive Tracker à 120Hz. Nous avons effectué un test de corrélation linéaire (Corrélation linéaire de Pearson) pour déterminer la relation entre les données cinétiques et cinématiques (p < 0,05). L’analyse des données a révélée (1) une corrélation positive entre la moyenne d’amplitude articulaire à la cheville et la moyenne des pics de puissance développés (W/kg) lors de la phase de maintien (r = 0,62), (2) une corrélation négative entre l’extension maximale moyenne (calculé à partir de l’angle de flexion le plus petit) à la hanche et la moyenne de pics de puissance développées en fin de poussée lors de la totalité et de la phase de maintien (r = -0,63 et r = -0,69 respectivement), et finalement (3) une corrélation négative entre la différence de dorsiflexion maximale à la cheville et la différence des pics de puissance développés aux MI lors du contact du pied au sol en phase de maintien ( r = -0,62). Les résultats obtenus dans cette étude permettront d’améliorer l’intervention des préparateurs physiques et la pratique des athlètes de sport de puissance en plus d’aider au développant de nouvelles technologies et outils d’entrainement complémentaire au sprint et particulièrement à la phase d’accélération.

Assessments of training load in elite youth soccer

One of the most popular sports globally, soccer has seen a rise in the demands of the game over recent years. An increase in intensity and playing demands, coupled with growing social and economic pressures on soccer players means that optimal preparation is of paramount importance. Recent research has found the modern game, depending on positional role, to consist of approximately 60% more sprint distance in the English Premier League, which was also found to be the case for frequency and success of discrete technical actions (Bush et al., 2015). As a result, the focus on soccer training and player preparedness is becoming more prevalent in scientific research. By designing the appropriate training load, and thus periodization strategies, the aim is to achieve peak fitness in the most efficient way, whilst minimising the risk of injury and illness. Traditionally, training intensity has been based on heart rate responses, however, the emergence of tracking microtechnology such as global positioning system (GPS) and inertial sensors are now able to further quantify biomechanical load as well as physiological stress. Detailed pictures of internal and external loading indices such as these then combine to produce a more holistic view of training load experience by the player during typical drills and phases of training in soccer. The premise of this research is to gain greater understanding of the physical demands of common training methodologies in elite soccer to support optimal match performance. The coaching process may then benefit from being able to prescribe the most effective training to support these. The first experimental chapter in this thesis began by quantify gross training loads of the pre-season and in-season phases in soccer. A broader picture of the training loads inherent in these distinct phases brought more detail as to the type and extent of external loading experienced by soccer players at these times, and how the inclusion of match play influences weekly training rhythms. Training volume (total distance) was found to be high at the start compared to the end of pre-season (37 kilometres and 28 kilometres), where high cardiovascular loads were attained as part of the conditioning focus. This progressed transiently, however, to involve higher-speed, acceleration and change-of-direction stimuli at the end of pre-season compared to the start and to that in-season (1.18 kilometres, 0.70 kilometres and 0.42 kilometres high-intensity running; with 37, 25 and 23 accelerations >3m/s2 respectively) . The decrease in volume and increase in maximal anaerobic activity was evident in the training focus as friendly matches were introduced before the competitive season. The influence of match-play as being a large physical dose in the training week may then determine the change in weekly periodisation and how resulting training loads applied and tapered, if necessary. The focus of research was then directed more specifically to the most common mode of training in soccer, that also featured regularly in the pre-season period in the present study, small-sided games (SSG). The subsequent studies examined numerous manipulations of this specific form of soccer conditioning, such as player numbers as well as absolute and relative playing space available. In contrast to some previous literature, changing the number of players did not seem to influence training responses significantly, although playing format in the possession style brought about larger effects for heart rate (89.9%HRmax) and average velocity (7.6km/h-1). However, the following studies (Chapters 5, 6 and 7) revealed a greater influence of relative playing space available to players in SSG. The larger area at their disposal brought about greater aerobic responses (~90%HRmax), by allowing higher average and peak velocities (>25km/h-1), as well as greater distance acceleration behaviour at greater thresholds (>2.8m/s2). Furthermore, the data points towards space as being a large determinant in strategy of the player in small-sided games (SSG), subsequently shaping their movement behaviour and resulting physical responses. For example, higher average velocities in a possession format (8km/h-1) reflects higher work rate and heart rate load but makes achieving significant neuromuscular accelerations at a high level difficult given higher starting velocities prior to the most intense accelerations (4.2km/h-1). By altering space available and even through intentional numerical imbalances in team numbers, it may be easier for coaches to achieve the desired stimulus for the session or individual player, whether that is for aerobic and neuromuscular conditioning. Large effects were found for heart rate being higher in the underloaded team (85-90%HRmax) compared to the team with more players (80-85%HRmax) as well as for RPE (5AU versus 7AU). This was also apparent for meterage and therefore average velocity. It would also seem neuromuscular load through high acceleration and deceleration efforts were more pronounced with less numbers (given the need to press and close down opponents, and in a larger area relative to the number of players on the underloaded team. The peak accelerations and deceleration achieved was also higher when playing with less players (3-6.2m/s2 and 3-6.1m/s2) Having detailed ways in which to reach desired physical loading responses in common small training formats, Chapter 8 compared SSG to larger 9v9 formats with full-size 11v11 friendly matches. This enabled absolute and relative comparisons to be made and to understand the extent to which smaller training formats are able to replicate the required movements to be successful in competition. In relative terms, it was revealed that relative acceleration distance and Player Load were higher in smaller 4v4 games than match-play (1.1m.min-1 and 0.3m.min-1 >3m/s2; 16.9AU versus 12AU). Although the smallest format did not replicate the high-velocity demands of matches, the results confirmed their efficacy in providing significant neuromuscular load during the training week, which may then be supplemented by high-intensity interval running in order to gain exposure to more maximal speed work. In summary, the data presented provide valuable information from GPS and inertial sensor microtechnology which may then be used to understand training better to manipulate types of load according to physical conditioning objectives. For example, a library of resources to direct planning of drills of varying cardiovascular, neuromuscular and perceptual load can be created to give more confidence in session outcomes. Combining external and internal load data of common soccer training drills, and their application across different phases and training objectives may give coaches a powerful tool to plan and periodize training.

Propiedades psicométricas de los instrumentos para la medición de la actividad física en adultos con discapacidad física relacionada con lesión de médula espinal: una revisión sistemática

Objetivo: Evaluar las propiedades psicométricas de los instrumentos para la medición de la actividad física en adultos de 18-65 años con discapacidad física por lesión de médula espinal. Materiales y métodos: Revisión sistemática. Las bases de datos de Medline, Scopus, Web of Science y 19 revistas especializadas fueron consultadas durante once días entre abril de 2015 y febrero de 2016 para identificar estudios originales de validación, sin límite de tiempo y que estuvieran publicados en español, francés y/o inglés. La calidad metodológica de los instrumentos de medición se evaluó usando las diferentes cajas de propiedades de la lista COSMIN. Resultados: Se identificaron 9229 referencias, de las cuales sólo 12 cumplieron los criterios de inclusión, dando como resultado 13 instrumentos de medición. Se evaluaron seis propiedades psicométricas. La propiedad más común fue la confiabilidad, además se observó que la calidad metodológica de los estudios incluidos no representa los resultados de las propiedades psicométricas de los instrumentos de medición. La calidad metodológica de los instrumentos para la evaluación de la actividad física en población con lesión medular espinal es “baja” para propiedades como consistencia interna, error de medición, sensibilidad, validez de criterio (con excepción del WISCI II que tiene buena validez) y excelente para validez de contenido y fiabilidad. Conclusión: Se ha encontrado que instrumentos empleados hasta el presente en la medición de la actividad física en población con discapacidad física relacionada con lesión de médula espinal han sido creados para otros tipos de discapacidad y otros instrumentos deben ser validados en futuros estudios.

Study of the Electromagnetic Interference Generated by Wireless Power Transfer Systems

This paper presents a study related with measuring of radio frequency emissions. The purpose is to determine the level of interference generated by wireless power transfer equipment in a specific frequency range, and to compare those levels to the existing standards. The technology of wireless power transfer, especially for electric vehicles batteries charging, is rapidly developing in the recent years. An increasing use of this technology in industrial and consumer electronic products has raised concerns about the possible unfavorable health-effects onto the human being. Another concern is raised from the high intensity fields produced by wireless power transfer systems which will generate highly undesired influence on other electrical and electronic equipment. As a protection against the potential health effects, the governments imposed limits on the occupational and general public exposure to the radio frequencies. These limitations are set out in national and international safety guidelines, standards and regulations. The measurement and evaluation of the human exposure to electromagnetic fields are essential to guarantee occupational and general public safety.

AVALANCHAS EN LA SIERRA VOLCANICA CENTRAL. EL CASO DE RIO CIRUELAS

El dia 20 de julio de 1988, en la tarde, se produjo una avalancha considerable en el rio Ciruelas, localizado en la ladera suroeste del volcán Barva, Heredia, Costa Rica, causando daños enormes en la población de San Bosco de Santa Bárbara.  El área afectada se dividió en tres grandes sectores, descritos a continuación: I.        SECTOR SUPERIOR (DESLIZAMIENTOS)Comprendido entre las cotas de 2.600m y 2.800 m, o sea cerca de la cima del Barva, caracterizado por desprendimientos de materiales poco consolidados (cenizas gruesas) con un ancho de aproximadamente 30m-40m y una profundidad de aproximadamente 4m-5m en casi todos los afluentes del rio Ciruelas. II.      SECTOR INTERMEDIO (TRANSITO)Comprendido entre las cotas de 2.600m y 1.600m, caracterizado por profundización erosiva del cauce en areas de materiales poco resistentes y por la ocurrencia de pequeños deslizamientos secundarios causados por la profundización del cauce. III.    SECTOR BAJO ( SEDIMENTACION)De 1.600m hasta 950m, caracterizado por la sedimentación en los primeros kilómetros de material grueso(bloques mayores de 2m). El pueblo de San Bosco esta situado sobre un abanico aluvial de materiales de eventos similares. En lo9s siguientes kilómetros se presenta la sedimentación de materiales mas finos.  La causa de esta desastre es únicamente la presencia de lluvias de alta intensidad provocadas por un frente de brisa, que en este dia ocurrieron en el sector I, provocando los deslizamientos y por ende las avalanchas de rocas y lodo que llegaron a los lugares mas bajos. Por estar el sector superior totalmente y el sector intermedio parcialmente en la selva virgen del Parque Nacional Braulio Carrillo se puede excluir definitivamente algún impacto humano que haya causado la desestabilización de las laderas. Por los vestigios de eventos antiguos de este tipo( acumulaciones cerca de San Bosco) se puede derivar que estos fenómenos también ocurrieron en tiempos pasados , sin embargo, se estima la probabilidad de una repetición pronta como muy baja. SUMMARYA big avalanche  that occurred the 20 th of july in the afternoon in the (rio ciruelas) watershed situated on the sowthwestern slope of the Volcano Barva, Costa Rica, caused big losses in the village of San Bosco de Santa Barbarbara. Based on field observations we distinguished three sectors analysed below: I.                    SUPERIOR SECTOR (LAND SLIDES)Localed in altitude between 2.600m and 2.800m near the peak of the volcano, characterized by landslides of poorly consolidated ashes, with a  width of between 30m-40m and a depth of about 4m to 5m, found in nearly and all of the affluents of the (Rio Ciruelas). II.                  MEDIUM SECTOR (TRANSIT)Between 2.600m and 1.600m, characterized by deep erosion in area of materials of low resistivity and by secondary(small) landslides provoked by the destruction of the support. III.                LOWER SECTOR ( SEDIMENTATION)Between 1.600m and 950m, characterized by sedimentation, in the first kilometers of coarse material (sometimes<2m).The village of San Bosco was constructed exactly above the detrictic cone of anterior events. In the subsequent kilometers we found the sedimentation of fine materials. As the cause of this desastre we analysed high intensity rainfalls provoked by a local front in the zone of the firt sector, causing landslides and then avalanches in the lower part of the primary forest of the national park <<Braulio Carrillo>>.The sediments of older events(the San Bosco cone) prove that avalanches ocurr in this area with a certain frecuency, but with relatively long recurrence intervals.   

Exploiting the environment for structural health monitoring: Strategies, algorithms, and technologies

A densely built environment is a complex system of infrastructure, nature, and people closely interconnected and interacting. Vehicles, public transport, weather action, and sports activities constitute a manifold set of excitation and degradation sources for civil structures. In this context, operators should consider different factors in a holistic approach for assessing the structural health state. Vibration-based structural health monitoring (SHM) has demonstrated great potential as a decision-supporting tool to schedule maintenance interventions. However, most excitation sources are considered an issue for practical SHM applications since traditional methods are typically based on strict assumptions on input stationarity. Last-generation low-cost sensors present limitations related to a modest sensitivity and high noise floor compared to traditional instrumentation. If these devices are used for SHM in urban scenarios, short vibration recordings collected during high-intensity events and vehicle passage may be the only available datasets with a sufficient signal-to-noise ratio. While researchers have spent efforts to mitigate the effects of short-term phenomena in vibration-based SHM, the ultimate goal of this thesis is to exploit them and obtain valuable information on the structural health state. First, this thesis proposes strategies and algorithms for smart sensors operating individually or in a distributed computing framework to identify damage-sensitive features based on instantaneous modal parameters and influence lines. Ordinary traffic and people activities become essential sources of excitation, while human-powered vehicles, instrumented with smartphones, take the role of roving sensors in crowdsourced monitoring strategies. The technical and computational apparatus is optimized using in-memory computing technologies. Moreover, identifying additional local features can be particularly useful to support the damage assessment of complex structures. Thereby, smart coatings are studied to enable the self-sensing properties of ordinary structural elements. In this context, a machine-learning-aided tomography method is proposed to interpret the data provided by a nanocomposite paint interrogated electrically.

Analysis of earthquakes predictability

Earthquake prediction is a complex task for scientists due to the rare occurrence of high-intensity earthquakes and their inaccessible depths. Despite this challenge, it is a priority to protect infrastructure, and populations living in areas of high seismic risk. Reliable forecasting requires comprehensive knowledge of seismic phenomena. In this thesis, the development, application, and comparison of both deterministic and probabilistic forecasting methods is shown. Regarding the deterministic approach, the implementation of an alarm-based method using the occurrence of strong (fore)shocks, widely felt by the population, as a precursor signal is described. This model is then applied for retrospective prediction of Italian earthquakes of magnitude M≥5.0,5.5,6.0, occurred in Italy from 1960 to 2020. Retrospective performance testing is carried out using tests and statistics specific to deterministic alarm-based models. Regarding probabilistic models, this thesis focuses mainly on the EEPAS and ETAS models. Although the EEPAS model has been previously applied and tested in some regions of the world, it has never been used for forecasting Italian earthquakes. In the thesis, the EEPAS model is used to retrospectively forecast Italian shallow earthquakes with a magnitude of M≥5.0 using new MATLAB software. The forecasting performance of the probabilistic models was compared to other models using CSEP binary tests. The EEPAS and ETAS models showed different characteristics for forecasting Italian earthquakes, with EEPAS performing better in the long-term and ETAS performing better in the short-term. The FORE model based on strong precursor quakes is compared to EEPAS and ETAS using an alarm-based deterministic approach. All models perform better than a random forecasting model, with ETAS and FORE models showing better performance. However, to fully evaluate forecasting performance, prospective tests should be conducted. The lack of objective tests for evaluating deterministic models and comparing them with probabilistic ones was a challenge faced during the study.

The highest intensity and the shortest duration permitting attainment of maximal oxygen uptake during cycling: effects of different methods and aerobic fitness level

The aims of this study were: (1) to verify the validity of previous proposed models to estimate the lowest exercise duration (T (LOW)) and the highest intensity (I (HIGH)) at which VO(2)max is reached (2) to test the hypothesis that parameters involved in these models, and hence the validity of these models are affected by aerobic training status. Thirteen cyclists (EC), eleven runners (ER) and ten untrained (U) subjects performed several cycle-ergometer exercise tests to fatigue in order to determine and estimate T (LOW) (ET (LOW)) and I (HIGH) (EI (HIGH)). The relationship between the time to achieved VO(2)max and time to exhaustion (T (lim)) was used to estimate ET (LOW). EI (HIGH) was estimated using the critical power model. I (HIGH) was assumed as the highest intensity at which VO2 was equal or higher than the average of VO(2)max values minus one typical error. T (LOW) was considered T (lim) associated with I (HIGH). No differences were found in T (LOW) between ER (170 +/- 31 s) and U (209 +/- 29 s), however, both showed higher values than EC (117 +/- 29 s). I (HIGH) was similar between U (269 +/- 73 W) and ER (319 +/- 50 W), and both were lower than EC (451 +/- 33 W). EI (HIGH) was similar and significantly correlated with I-HIGH only in U (r = 0.87) and ER (r = 0.62). ET (LOW) and T (LOW) were different only for U and not significantly correlated in all groups. These data suggest that the aerobic training status affects the validity of the proposed models for estimating I (HIGH).

Exercise intensity optimization for men with high cardiorespiratory fitness

Exercise intensity is a key parameter for exercise prescription but the optimal range for individuals with high cardiorespiratory fitness is unknown. The aims of this study were (1) to determine optimal heart rate ranges for men with high cardiorespiratory fitness based on percentages of maximal oxygen consumption (%VO(2max)) and reserve oxygen consumption (%VO(2reserve)) corresponding to the ventilatory threshold and respiratory compensation point, and ( 2) to verify the effect of advancing age on the exercise intensities. Maximal cardiorespiratory testing was performed on 210 trained men. Linear regression equations were calculated using paired data points between percentage of maximal heart rate (%HR(max)) and %VO(2max) and between percentage of heart rate reserve (%HRR) and %VO(2reserve) attained at each minute during the test. Values of %VO(2max) and %VO(2reserve) at the ventilatory threshold and respiratory compensation point were used to calculate the corresponding values of %HRmax and %HRR, respectively. The ranges of exercise intensity in relation to the ventilatory threshold and respiratory compensation point were achieved at 78-93% of HR(max) and 70-93% of HRR, respectively. Although absolute heart rate decreased with advancing age, there were no age-related differences in %HR(max) and %HRR at the ventilatory thresholds. Thus, in men with high cardiorespiratory fitness, the ranges of exercise intensity based on %HR(max) and %HRR regarding ventilatory threshold were 78-93% and 70-93% respectively, and were not influenced by advancing age.

Noninvasive Brain Stimulation With High-Frequency and Low-Intensity Repetitive Transcranial Magnetic Stimulation Treatment for Posttraumatic Stress Disorder

Objective: We aimed to investigate the efficacy of 20 Hz repetitive transcranial magnetic stimulation (rTMS) of either right or left dorsolateral prefrontal cortex (DLPFC) as compared to sham rTMS for the relief of posttraumatic stress disorder (PTSD)-associated symptoms. Method: In this double-blind, placebo-controlled phase II trial conducted between October 2005 and July 2008, 30 patients with DSM-IV-diagnosed PTSD were randomly assigned to receive 1 of the following treatments: active 20 Hz rTMS of the right DLPFC, active 20 Hz rTMS of the left DLPFC, or sham rTMS. Treatments were administered in 10 daily sessions over 2 weeks. A blinded rater assessed severity of core PTSD symptoms, depression, and anxiety before, during, and after completion of the treatment protocol. In addition, a battery of neuropsychological tests was measured before and after treatment. Results: Results show that both active conditions-20 Hz rTMS of left and right DLPFC induced a significant decrease in PTSD symptoms as indexed by the PTSD Checklist and Treatment Outcome PTSD Scale; however, right rTMS induced a larger effect as compared to left rTMS. In addition, there was a significant improvement of mood after left rTMS and a significant reduction of anxiety following right rTMS. Improvements in PTSD symptoms were long lasting; effects were still significant at the 3-month follow-up. Finally, neuropsychological evaluation showed that active 20 Hz rTMS is not associated with cognitive worsening and is safe for use in patients with PTSD. Conclusions: These results support the notion that modulation of prefrontal cortex can alleviate the core symptoms of PTSD and suggest that high-frequency rTMS of right DLPFC might be the optimal treatment strategy. J an Psychiatry 2010;71(8):992-999 (C) Copyright 2009 Physicians Postgraduate Press, Inc.

High and Low Frequency TENS Reduce Postoperative Pain Intensity After Laparoscopic Tubal Ligation A Randomized Controlled Trial

Background: Transcutaneous electrical nerve stimulation (TENS) is an effective adjunctive therapy for postoperative pain; however, effects of different frequencies Of stimulation have not been systematically investigated. Laparoscopic sterilization (LS) causes significant pain in the early postoperative period and requires substantial postoperative medication. Therefore, we studied the effects of TENS on postoperative pain after LS through placement of Yoon fallopian rings in a prospective, randomized, double-blinded, and placebo-controlled study. Methods: Sixty-four patients undergoing LS for uterine tube ligation were randomly allocated to receive either active TENS or placebo TENS. Postoperative pain was evaluated using a standard I I-point numeric rating scale and the McGill Pain Questionnaire (MPQ)-pain rating index and number of words chosen. Both high frequency (100 Hz) and low frequency (4 Hz) TENS, at strong, but comfortable sensory intensity, were applied for 20 minutes through 4 electrodes placed around the surgical incision immediately after Surgery. Pain was assessed before and after application of TENS when patients were at postanesthesia care unit (PACU). Results: Both high and low frequency TENS significantly decreased postoperative pain intensity when compared with before administration of TENS using the numeric rating scale (P = 0.001), pain rating index (P = 0.001), and number of words chosen (P 0.001) compared with placebo TENS (P = 0.001). TENS in combination with standard pharmacologic analgesic treatment was efficacious for postoperative pain relief after LS. Conclusions: We recommend regular use of multimodal therapy with TENS and analgesic drugs after LS with placement of Yoon rings.