Patient case (clinical description): A 47-year-old woman comes to the office complaining of pain in the calf and knee when she bends down. The pain limits her activity. Her medical history is significant for osteoarthritis, for which she uses nonsteroidal anti-inflammatory drugs (NSAIDs) for the past two years. She is living with her husband and has 3 children. She doesn't smoke but drinks alcohol occasionally. Her vital signs are normal. On physical examination, there is a small effusion in the right knee. The effusion grew a little larger and she developed a tender swelling in the popliteal fossa and calf. Both the pain and swelling worsened as she bent and straightened her knee.

Patient's own account: I'm a 47-year-old woman, married with 3 kids. I don't smoke and I drink occasionally. I went to the doctor because of pain in my calf and knee when I was bending down. This has been limiting my daily activities. I have been diagnosed with osteoarthritis for which I have taken anti-inflammatory drugs for the past 2 years. The doctor saw a small fluid buildup in my right knee. This buildup became a bit bigger and I have a swollen calf. The pain is worse when I bend and straighten my knee.

Clinical trial: Combined Application of Electrical Stimulation and Volitional Contractions for Muscle Strengthening and Knee Pain Inhibition (Seated Study)

Eligibility criteria:
Inclusion Criteria:

          1. Female

          2. Age 40-85 years

          3. One or more of the following:

               1. Knee symptoms (pain, aching, or stiffness) on most of the last 30 days;
                  categorically defined, so all severity of symptoms ok, but must have knee
                  symptoms on most days

               2. History of knee injury or surgery

               3. Body Mass Index (BMI) greater than or equal to 25 kg/m2

          4. BMI less than 45 kg/m2

        Exclusion Criteria:

          1. Knee injection within 6 weeks prior to the study

          2. Resistance training at any time in the last 3 months prior to the study

          3. Bilateral knee replacement

          4. Lower limb amputation

          5. Lower limb surgery in the last 6 months that affects walking ability or ability to
             exercise

          6. Back, hip or knee problems that affect walking ability or ability to exercise

          7. Unable to walk without a cane or walker

          8. Inflammatory joint or muscle disease such as rheumatoid or psoriatic arthritis or
             polymyalgia rheumatica

          9. Multiple sclerosis or other neurodegenerative disorder

         10. Known neuropathy

         11. Self-report of Diabetes

         12. Currently being treated for cancer or having untreated cancer

         13. Terminal illness (cannot be cured or adequately treated and there is a reasonable
             expectation of death in the near future)

         14. Peripheral Vascular Disease

         15. History of myocardial infarction or stroke in the last year

         16. Chest pain during exercise or at rest

         17. Use of supplemental oxygen

         18. Inability to follow protocol (e.g. lack of ability to attend visits or understand
             instructions)

         19. Staff concern for participant health (such as history of dizziness/faintness or
             current restrictions on activity)

         20. Unable to attend 12 or more sessions during the study

         21. Implanted cardiac pacemaker, spinal cord stimulator, baclofen or morphine pump or
             other implanted electrical device.

         22. Dermatitis or skin sensitivity.

         23. Pregnancy
Female
No healthy subjects accepted to join the trial.
Subject must be at least 40 Years old.
Subject must be at most 85 Years

Eligibility (NLI label): Entailment