Study Summary

126 patients with pre-radiographic to mild knee osteoarthritis were randomized to receive Transcutaneous Electrical Nerve Stimulation (TENS) combined with home exercise or sham TENS combined with home exercise. The primary outcome of interest was knee pain during activity measured by visual analog scale (VAS). Secondary outcomes of interest included painful and non-painful knee extensor strength, gait speed, timed up-and-go test (TUG), step count, metabolic equivalent hours, pain disability assessment scale (PDAS), hospital anxiety and depression scale (HADS) (anxiety and depression), and pain catastrophizing scale (PCS). Outcomes were assessed at baseline, 2 weeks, 4 weeks, and 4 weeks post-intervention. Overall, the results of the study revealed that TENS combined with home exercise led to greater reductions in knee pain during activity and greater improvements in extensor strength of the painful knee compared with sham, while no between-group differences were observed in gait ability, physical activity, or psychosocial outcomes. These findings suggest that TENS may be a useful addition to exercise for early-stage knee osteoarthritis, with benefits primarily limited to pain and strength.