Short-term effects of neuromuscular electrical stimulation and ultrasound therapies on muscle architecture and functional capacity in knee osteoarthritis: a randomized study

Abstract

Objective: To determine the effects of ultrasound therapy and neuromuscular electrical stimulation (NMES) application on the muscle architecture and functional capacity in patients with knee osteoarthritis. Design: A randomized study. Subjects: A total of 60 patients with knee osteoarthritis. Interventions: Participants were randomized into one of the following two intervention groups, five days a week, for three weeks: the combination of NMES application, hot pack, and exercise therapy was applied to the NMES group. The combination of therapeutic ultrasound, hot pack and exercise therapy was applied to the ultrasound therapy group. Main measures: Subjects were evaluated for pain and functional capacity with the use of the visual analog pain scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and 15 meter walking test. The muscle architecture (muscle thickness, pennation angle and fascicle length) was assessed from vastus lateralis and quadriceps femoris muscles bilaterally by ultrasonography. Results: Two groups presented significant improvements in all outcome measures before and after treatment (P < 0.01). There were significant improvements in VAS rest pain (P < 0.05), VAS activity pain (P < 0.05), WOMAC pain (P < 0.05), WOMAC stiffness score (P < 0.05), and WOMAC physical function (P < 0.05) for the ultrasound therapy group in comparison to the NMES group. NMES group exhibited more increases in the muscle thickness and fascicle length values when compared to ultrasound therapy group (P < 0.05). Conclusion: Ultrasound therapy appears to be an effective treatment in reducing pain and improving functional capacity. NMES application has more effects on the muscle architecture.

Influence of Pulse Waveform and Frequency on Evoked Torque, Stimulation Efficiency, and Discomfort in Healthy Subjects

“…The maximal tolerated current condition was selected as it corresponds to the most widely used NMES level in strength training 20,21 and rehabilitation. 22,23 For all waveform-frequency combinations, the current intensity required to reach the NMES sub level was determined by gradual increases until the desired torque was reached. After a 2-min rest interval, testing was performed by increasing current intensity during 2 secs (ramp up) until the determined value was reached, maintaining it constant for 3 secs, and finally decreasing to zero in 1 sec (ramp down).…”

Effects of therapeutic ultrasound for knee osteoarthritis: a systematic review and meta-analysis

“…Common treatments for osteoarthritis include pharmacological and non-pharmacological treatments, as well as surgery. 9 In recent years, physicians have paid increasing attention to non-pharmacological therapies including ultrasound, 10,11 laser therapy 12,13 and electroanalgesia 14,15 for the management of osteoarthritis-related pain. 16 Ultrasound has been used as a non-invasive and safe physiotherapy for musculoskeletal conditions since its initial approval by the Food and Drug Administration (FDA) for the treatment of fractures in 1994.…”

Low Intensity Pulsed Ultrasound and Articular Cartilage Repair

“…In addition to the above examples, and despite the lack of parallel clinical evidence, the past as well as the currently emerging LIPUS associated data are believed to hold considerable promise as regards cartilage repair [41,42] . In particular, very similar LIPUSrelated chondrogenic effects are seen regardless of substrate, such as mesenchymal stem cells [20] , and even among human osteoarthritic chondrocytes [19] , as well as those substrates derived from wellaccepted animal models of osteoarthritis [17,19,29] .…”