Effects of Functional Electrostimulation on Pain, Muscular Strength, and Functional Capacity in Patients With Osteoarthritis of the Knee

Rosemffet, Marcos; Schneeberger, Emilce Edith; Citera, Gustavo; Sgobba, María E; Laiz, Claudia; Schmulevich, Haydee; Artçanuturry, Patricia; Gagliardi, Susana; Cocco, J. A. Maldonado

doi:10.1097/01.rhu.0000141831.40350.91

Cited by 36 publications

(63 citation statements)

References 13 publications

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“…Durmus et al 26 found increments of about 35% in the one maximal repetition test after 5 weekly sessions of NMES training during 4 weeks, while Rosemffet et al 25 did not observe any significant gain in isometric force after 8 weeks of training with three NMES sessions per week. These different outcomes with apparently similar NMES stimulation training protocols might be associated with the methods for evaluating maximal strength, to the level of impairment of the OA patients, or the detailed parameters chosen for the NMES training programs (current, duration, frequency, etc.).…”

Section: Discussionmentioning

confidence: 96%

“…34 Specifically, OA patients have shown a significant decrease in pain, [23][24][25][26][27][28] a reduction in joint stiffness, 26,27 an increase in joint range of motion, 28 and an improvement in functional performance 23,26 following NMES training. Although we cannot establish a direct causative association between muscle strength and health status, stronger knee extensor muscles are thought to decrease impact forces at the knee joint, 16,17 and might reduce the mechanical stimuli for pain, 18 thereby relieving the pain symptoms of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…The Western Ontario and McMaster Universities Arthritis Index (WOMAC), including all three subscales (measured by a Likert version and the possible range of scores is 0 ¼ none to 4 ¼ extreme) 25 were used to determine the degree of functionality of the OA patients before and after NMES strength training program.…”

Section: Clinical Evaluationmentioning

confidence: 99%

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Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis

Vaz¹,

Baroni²,

Geremia³

et al. 2012

Journal Orthopaedic Research

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Knee osteoarthritis (OA) is associated with quadriceps atrophy and weakness, so muscle strengthening is an important point in the rehabilitation process. Since pain and joint stiffness make it often difficult to use conventional strength exercises, neuromuscular electrical stimulation (NMES) may be an alternative approach for these patients. This study was aimed at (1) identifying the associations of knee OA with quadriceps muscle architecture and strength, and (2) quantifying the effects of a NMES training program on these parameters. In phase 1, 20 women with knee OA were compared with 10 healthy female, asymptomatic, age-matched control subjects. In phase 2, 12 OA patients performed an 8-week NMES strength training program. OA patients presented smaller vastus lateralis thickness (11.9 mm) and fascicle length (20.5%) than healthy subjects (14.1 mm; 24.5%), and also had a 23% smaller knee extensor torque compared to the control group. NMES training increased vastus lateralis thickness (from 12.6 to 14.2 mm) and fascicle length (from 19.6% to 24.6%). Additionally, NMES training increased the knee extensor torque by 8% and reduced joint pain, stiffness, and functional limitation. In conclusion, OA patients have decreased strength, muscle thickness, and fascicle length in the knee extensor musculature compared to control subjects. NMES training appears to offset the changes in quadriceps structure and function, as well as improve the health status in patients with knee OA. Keywords: osteoarthritis; muscle architecture; muscle strength; WOMAC; electrical stimulation Osteoarthritis (OA) is one of the major degenerative diseases and it affects elderly women more frequently than elderly men.1,2 The prevalence of OA is expected to increase dramatically in the near future due to the increased life expectancy and an increasing rate of obesity of the world population.3 The knee is the most affected joint with 13.6% of women above 60 years showing radiographic evidence of OA and/or clinical symptoms. 2OA causes erosion of articular cartilage, weakening of subchondral bone, meniscal degeneration, inflammation of the synovium, and intra-articular osteophytes. 4 These changes lead to a reduction in the range of motion, and increase in joint stiffness and pain. 5In addition to the effects on the joint structure and function, OA also has a negative effect on the musculoskeletal system. Patients with knee OA have decreased knee extensor strength compared to healthy subjects 6-10 and compared to the healthy contralateral limb.11,12 Evidence also suggests that the muscle weakness is associated with a decrease in muscle mass. 11,12However, although a reduction in muscle thickness 11 and anatomical cross-sectional area 12 have been described in OA patients, we were unable to find evidence on how muscle weakness was related to changes in other muscle architecture parameters associated with strength, such as fascicle length, and pennation angle.Fascicle length is related to the number of sarcomeres aligned in series in the ...

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis

Vaz¹,

Baroni²,

Geremia³

et al. 2012

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…A number of researches considered several aspects related to muscle function, such as strength and aerobic capacity as well as other clinical aspects, such as pain, stifness, range of motion of the knee, and WOMAC in patients with OA [14][15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Effect of Nonpharmacological Therapies on Pain and Health Perception in Patients with Knee Osteoarthritis

Lizis¹,

Kobza²,

Mańko³

et al. 2017

Pain Relief - From Analgesics to Alternative Therapies

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Objective: Comparing the eiciency of ultrasound therapy (US) versus extracorporeal shock wave therapy (ESWT) on pain and perceived health in men with bilateral knee osteoarthritis (OA). Design: A pilot randomized trial with concealed allocation, assessor blinding and intention-to-treat analysis was conducted.Participants: 60 men, 44-66 years old were randomized to an experimental (US) and a control (ESWT) group. Intervention: The participants in both groups atended 5-week treatments. The experimental group received continuous US and a series of 10 treatments two times per week. The control group received 5 ESWT treatments once per week. Outcome measures:The primary outcome was visual analogue scale (VAS) pain ratings. The secondary outcome measured perceived health using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The examinations were taken before and after the treatment. Results: After 5-week treatment the experimental group had signiicantly worse scores than the control group on the VAS for pain, and on the WOMAC for perceived health. Conclusion: Patients with knee OA can achieve signiicant beter health beneits caused by ESWT than by US.

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“…Its main objective is to increase the musculature force that is inhibited due to joint pain, through the artificial generation of muscle contractions. [9][10][11][12][13][14] However, there is little evidence describing the use of NMES and its relation to an improvement in neuromuscular and mechanical properties in elderly patients with OA. Similarly, the effects of NMES training on the root mean square (RMS)/torque ratio have not yet been fully explained.…”

Section: Introductionmentioning

confidence: 99%

Efeitos de oito semanas de treinamento com estimulação elétrica neuromuscular nas razões de ativação muscular / torque de idosas com osteoartrite

Lanferdini

Silva

Dias

et al. 2015

Rev. bras. geriatr. gerontol.

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Introduction: Aging affects the musculoskeletal system, which can lead to osteoarthritis, causing degeneration of the articular cartilage and consequently resulting in functional impairment among elderly patients. However, neuromuscular electrical stimulation (NMES) training can be used as a mode of muscle strengthening. Objective: To investigate the effects of eight weeks of NMES training of the knee extensors on the RMS/torque ratio of elderly persons with osteoarthritis. Methods: Twenty-four elderly women were assigned into two groups: a healthy group (HE; n=12) and an osteoarthritis group (OA; n=12). The OA group was submitted to eight weeks of NMES training. Results: In the OA group, the RMS values increased from the pre-training to the post-training periods ( p<0.05). The HE group did not differ from the OA group in the post-training period ( p>0.05). Quadriceps torque was higher in the OA group in the post-training period at 90º of knee flexion ( p<0.05) but the torque in the HE group remained higher than in the OA group for all the angles evaluated ( p<0.05). The RMS/torque ratios increased in the post-training period at 60º, 75º and 90º of knee flexion ( p<0.05), but did not differ between the HE and OA groups ( p>0.05). Conclusion: Eight weeks of NMES training resulted in a significant increase in the RMS and torque values of the quadriceps, but these neural adaptations were not sufficient to improve the osteoarthritis group to levels similar to the healthy group.

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Effects of Functional Electrostimulation on Pain, Muscular Strength, and Functional Capacity in Patients With Osteoarthritis of the Knee

Cited by 36 publications

References 13 publications

Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis

Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis

Effect of Nonpharmacological Therapies on Pain and Health Perception in Patients with Knee Osteoarthritis

Efeitos de oito semanas de treinamento com estimulação elétrica neuromuscular nas razões de ativação muscular / torque de idosas com osteoartrite

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