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Published on: February 1, 2018
Effect of Different Neuromuscular Electrical Stimulation Modalities on Clinical and Functional Outcomes in Older
Camila Cadena De Almeida1, Klaus Porto Azevedo1, José Roberto De Souza Júnior1,2
1Universidade de Brasília, Laboratory of Muscle and Tendon Plasticity, Brasília, DF, Brazil.
Introduction:
Osteoarthritis (OA) is a chronic degenerative disease characterized by progressive cartilage degeneration, most commonly affecting the knee. Clinical symptoms such as pain, stiffness, and functional limitations significantly impact quality of life. Although neuromuscular electrical stimulation (NMES) is considered a complementary treatment, evidence comparing different waveforms in clinical management remains limited.
Objective:
To compare the effects of three different NMES waveforms versus a placebo, applied for four weeks, on pain intensity, disability, and other functional outcomes in individuals with knee osteoarthritis (KOA).
Methods:
A randomized clinical trial with 100 participants equally assigned to four groups: transcutaneous electric nerve stimulation (TENS) (n=25), interferential current (IFC) (n=25), Aussie current (n=25), and placebo (n=25). Primary outcomes were pain intensity, disability, and pressure pain threshold and secondary outcomes included aerobic capacity, gait speed, lower limb strength, functional mobility, superficial knee temperature, stability, and fall risk. Primary and secondary outcomes were assessed before and after four weeks.
Results:
A significant group x time interaction, with a moderate effect size, was found for the WOMAC index (P = 0.022; η2 = 0.10). Participants of the IFC, Aussie, and Placebo groups presented less disability after the treatment. No significant group × time interactions were observed for the other outcomes (all P > 0.05); however, a main effect of time was identified, with positive changes at week 4 in most variables, except for superficial knee temperature, stability, and risk of falls.
Conclusion:
Different NMES protocols did not provide additional benefits over placebo for pain intensity, disability or functional outcomes in people with KOA. These findings highlight the need for further research to refine stimulation protocols and identify patient subgroups that may benefit most from NMES in the management of knee osteoarthritis.
