Treatment of Knee Osteoarthritis: Neuromuscular Electrical Stimulation and Low-level Laser.

Neuromuscular Electrical Stimulation and Low-level Laser: Combined Use for the Treatment of Knee Osteoarthritis in Elderly

• The purpose of this study is to determine the effects of low-level laser therapy in combination with neuromuscular electrical stimulation on neuromuscular (muscular strength and morphology) and functional parameters (pain and functional tests) in elderly with knee osteoarthritis.
• The hypothesis is that the association of low-level laser therapy with neuromuscular electrical stimulation could reduce joint pain associated with the inflammation and consequently potentiates the effects of electrical stimulation on the muscular system.

• Participants was randomized into one of three intervention groups (intervention period = 8 weeks after a 4 weeks control period in all groups).
• Electrical stimulation group (18-32 min of pulsed current, stimulation frequency of 80Hz (Hertz), pulse duration of 200μs and stimulation intensity fixed near to maximal tolerated),
• Laser group (low-level laser therapy dose of 4-6J (Joules) per point, six points at the knee joint)
• Combined group (electrical stimulation and low-level laser therapy).

Inclusion Criteria:

• elderly.
• symptomatic knee osteoarthritis.
• radiographic diagnostic of Grade 2 or 3 knee osteoarthritis.

Exclusion Criteria:

• a body mass index higher than 40 Kg/m2.
• a diagnosis of hip, ankle, or toe osteoarthritis.
• the use of crutches for locomotion.
• participation in a strength-training programme or physiotherapy treatment for knee osteoarthritis in the past six months.
• neurological or cognitive disorders.
• rheumatoid arthritis.
• electronic implants.
• previous or upcoming surgery (within three months).
• any cardiorespiratory, neuromuscular, or metabolic disease that could represent an absolute contraindication or a contraindication to the performance of maximum strength tests.