Patient case (clinical description): A 66-year-old woman comes to the office due to joint pain in the hands and periodic morning stiffness that lasts less than 15 minutes.  The pain is moderately severe and worsens with daily activity. The patient used Tylenol with minimal relief.  Past medical history is notable for hypertension and hypercholesteremia.  Physical examination shows firm nodules over the distal interphalangeal joints, bilaterally. The patient has pain in her knees as well. The knees are stiff in the morning for less than 30 minutes and become worse with climbing stairs. She has some sensation of bone friction during activity. X-ray shows narrowing of the joint space, subchondral bone sclerosis and osteophyte formation along the joints.

Patient's own account: I'm a 66-year-old woman and I went to my doctor's office because of a bloody joint pain in my hands that has been lasting for a while. The pain comes and go in the morning usually. I feel like a stiffness that last less than 15 minutes. The pain is moderately severe but it gets worse when I'm using my hands. I used Tylenol which helped a little. Apart from that, I suffer from hypertension and high cholesterol. The doctor made me notice that I have bumps around both of my hand joints. I also suffer from my knees and they are also stiff in the morning for around 30 min. It's even worse when I climb up the stairs! I also feel like my bones are rubbing against each other when I'm moving. The X-ray showed that I have narrow joint space, I have sclerosis, and abnormal growths of bone along my joints.

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