Efficacy of Neuromuscular Electrical Stimulation on Quadriceps Femoris Muscle in Patients with Knee Osteoarthritis

Abstract

Objectives:

Neuromuscular electrical stimulation (NMES) has been used in rehabilitation protocols for patients suffering from muscle weakness. The purpose of the present study was to assess the effect of NMES on isometric quadriceps femoris (QF) muscle strength and functional outcomes in patients with knee osteoarthritis (OA).

Methods:

A total of 30 patients of OA with a mean age of 61.17±4.3 years were participated in the study. Eligible subjects were randomly assigned in to one of the 2 groups, group A and B (n=15) in each group. Patients in group-B were undergone NMES to the QF along with conventional physiotherapeutic regime for 3 weeks whereas, group-A was given only conventional physiotherapeutic regime. The study outcomes such as isometric strength at 20, 40 and 60° of knee flexion, mean isometric muscle strength and functional outcomes by WOMAC index score were measured at baseline, 9 days and end of 3 weeks of post intervention.

Results:

Comparison of quadriceps muscle strength at 20,40 and 60° and its mean in knee flexion and WOMAC index score were within group-A were non-significant (p>0.05) whereas, in group-B (p<0.05). The quadriceps muscle strength at 20° between groups at base line, 9^th day and post test at 21^st day showed significant improvement in NMES group (p<0.05). Similar difference was repeated with NMES group at 40 and 60° and WOMAC functional index score also.

Conclusions:

Study result indicates that NMES is effective in improving muscle strength thereby improving the functional activities of patients with knee OA. NMES along with conventional physiotherapeutic approach is a better choice for the management of knee OA.

Zusammenfassung

Zielstellung:

Neuromuskuläre elektrische Stimu­lation (NMES) wurde im Rahmen von Rehabilitationsprotokollen zur Therapie von Patienten mit Muskelschwäche eingesetzt. Ziel der vorliegenden Studie war die Untersuchung des Effektes von NMES auf die isometrische Muskelkraft des Qua­driceps femoris (QF) sowie das funktionelle Outcome bei Patienten mit Osteoarthritis (OA) des Kniegelenks.

Methoden:

Insgesamt 30 unter OA leidende Patienten mit einem Durchschnittsalter von 61,17±4,3 Jahren nahmen an der Studie teil. Geeignete Teilnehmer wurden randomisiert und einer von 2 Gruppen, A oder B (n=25), zuge­wiesen. Die Patienten in Gruppe B erhielten NMES des QF im Verbindung mit konventioneller Physio­therapie für einen Zeitraum von 3 Wochen, während Gruppe A lediglich mit konventioneller Physiotherapie behandelt wurde. Die Erhebung der Messparameter wie isometrische Kraft bei 20, 40 und 60° Knieflexion, die durchschnittliche isometrische Muskelkraft und das funktionelle Assessment (WOMAC) erfolgte als Baseline, nach 9 Tagen und 3 Wochen nach Intervention.

Ergebnisse:

Der Vergleich der Quadrizeps-Muskelkraft bei 20, 40 sowie 60° und die mit­tlere Kraft bei Knieflexion sowie der WOMAC-Score in Gruppe A waren nicht signifikant (p>0,05) im Gegensatz zu den Werten in Gruppe B (p<0,05). Die Muskelkraft des Quadriceps bei 20°-Flexion zu Beginn, am 9. Tag sowie nach der Intervention am 21. Tag zeigten signifikante Verbesserungen innerhalb der NMES-Gruppe (p<0,05). Gleiche Ergebnisse der NMES-Gruppe konnten bei 40 und 60° sowie beim WOMAC Index Score nachgewiesen werden.

Schlussfolgerung:

Die Studienergebnisse weisen auf eine Wirksamkeit von NMES hinsichtlich der Verbesserung der Muskelkraft hin mit dem Ergebnis einer Verbesserung der funktionellen Akti­vitäten von Patienten mit Osteoarthritis des Knies. Zusammen mit konventioneller Physiotherapie bildet NMES eine bessere Option hinsichtlich der Therapie von Knie-OA.

Key words

osteoarthritis - neuromuscular stimulation - quadriceps strength - WOMAC

Schlüsselwörter

Osteoarthritis - neuromuskuläre Stimulation - Quadrizepskraft - WOMAC

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