A controlled randomized trial with a 12-week follow-up investigating the effects of medium-frequency neuromuscular electrical stimulation on pain, VMO thickness, and functionality in patients with knee osteoarthritis.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2024;12(8):6 BMC Musculoskelet Disord . 2024 Feb 20;25(1):158.What this means for my practice?
Clinicians should keep in mind that the combination of NMES and exercise therapy presents an efficient approach for managing knee osteoarthritis, enhancing knee flexion range, thigh girth, VMO thickness, and improving WOMAC scores. Nevertheless, NNMES alone is effective in improving the physical function of patients with KOA. These findings suggest that tailored interventions incorporating NMES, either alone or with exercise, can significantly benefit clinical practice by reducing pain and enhancing muscle function and physical performance in patients with KOA. However, it needs to be noted that the generalizability of this study is uncertain due to the small sample size and female only study population.
Study Summary
Eighty female patients diagnosed with knee osteoarthritis were randomized to receive neuromuscular electrical stimulation only (NMES,n=27), exercise therapy alone (n=27), or a combination of NMES and exercise (n=26). The outcomes of interest were pain intensity measured by the visual analog scale (VAS), knee flexion range of motion (FROM), thigh muscle girth (TG), thickness of the Vastus Medialis Oblique (VMO), timed up and go test (TUG), six-minute walk test (6MWT), and WOMAC scores. Outcomes were assessed immediately after treatment and after 12 weeks. Overall, the results of the study revealed that the combination of NMES and exercise therapy was most effective in improving FROM, TG, VMO thickness, and WOMAC stiffness scores both post-intervention and at the 12-week follow-up. Meanwhile, NMES alone showed significant improvements in reducing pain and enhancing physical function tests and WOMAC total scores during the follow-up period. Therefore, in patients with knee osteoarthritis, these findings suggest that while NMES alone can improve physical function, combining NMES and exercise can effectively improve all other aspects of knee parameters studied.
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