Exercise and Muscle Stimulation in Patients With Knee Osteoarthritis

Neuromuscular Electrical Stimulation (NMES) on Knee Osteoarthritis(OA): an Equivalence Randomized Clinical Trial

Objective: To evaluate the effectiveness of neuromuscular electrical stimulation (NMES) combined with closed kinetic chain (CKC) exercises in patients with knee OA.

Abstract:

Introduction: Osteoarthritis (OA) is a degenerative and debilitating change that affects the synovial joints.

Objective: To evaluate the effectiveness of neuromuscular electrical stimulation (NMES) combined with closed kinetic chain (CKC) exercises in patients with knee OA.

Methods: Nineteen patients with knee OA were enrolled and randomized into two groups: group I was treated with CKC + NMES, and group II was treated with CKC + NMES placebo. Both groups underwent 20 sessions of mini-squat exercises at 30 degrees of knee flexion that were associated with and interspersed with NMES for 5 minutes at a frequency of 40 hertz (Hz), 10 minutes at 70 Hz and an addition 10 minutes at 150 Hz, for a total of 25 minutes. The data were analyzed using SPSS (Statistical Package for the Social Sciences) version 17.0. Data were expressed as a frequency, mean and standard deviation and were statistically analyzed using a one-way analysis of variance (ANOVA) for repeated measurements followed by Bonferroni's post-hoc test. The investigators also used an unpaired Student's t-test and Kruskal-Wallis and Wilcoxon tests with a level of significance of P < 0.05.

Inclusion Criteria:

• patients with grade I or grade II knee OA (based on the Kellgren-Lawrence classification;
• which was diagnosed by a medical traumatologist;
• radiographic changes that demonstrated a reduced joint space in at least one of the compartments of the knee;
• subchondral bone sclerosis;
• consent to participate in the study

Exclusion Criteria:

• patients who had grade III and grade IV knee OA (based on the Kellgren-Lawrence classification);
• who were involved in another rehabilitation program outside the center;
• who presented with clinical symptoms that would prevent them from participating in the exercises;
• who had heart disease;
• cardiac pacemakers;
• periarticular metal implants;
• who experienced changes in sensitivity;
• who had a previous history of knee injury (meniscus, ligaments, sprains);
• who had uncontrolled diabetes;
• neurological disorders with cognitive impairments;
• rheumatic diseases;
• history of knee trauma in the last six months;
• prior knee surgery;
• three consecutive unexcused absences.