Exercise and Muscle Stimulation in Patients With Knee Osteoarthritis
Condition: Osteoarthritis, Knee; Self Stimulation; Exercise Addiction
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      Objective: To evaluate the effectiveness of neuromuscular electrical stimulation (NMES)
      combined with closed kinetic chain (CKC) exercises in patients with knee OA.
    

Detailed description: 
      Abstract:

      Introduction: Osteoarthritis (OA) is a degenerative and debilitating change that affects the
      synovial joints.

      Objective: To evaluate the effectiveness of neuromuscular electrical stimulation (NMES)
      combined with closed kinetic chain (CKC) exercises in patients with knee OA.

      Methods: Nineteen patients with knee OA were enrolled and randomized into two groups: group I
      was treated with CKC + NMES, and group II was treated with CKC + NMES placebo. Both groups
      underwent 20 sessions of mini-squat exercises at 30 degrees of knee flexion that were
      associated with and interspersed with NMES for 5 minutes at a frequency of 40 hertz (Hz), 10
      minutes at 70 Hz and an addition 10 minutes at 150 Hz, for a total of 25 minutes. The data
      were analyzed using SPSS (Statistical Package for the Social Sciences) version 17.0. Data
      were expressed as a frequency, mean and standard deviation and were statistically analyzed
      using a one-way analysis of variance (ANOVA) for repeated measurements followed by
      Bonferroni's post-hoc test. The investigators also used an unpaired Student's t-test and
      Kruskal-Wallis and Wilcoxon tests with a level of significance of P < 0.05.
    

Intervention name(s): NMES; Closed Kinetic Chain
Intervention type(s): Procedure; Procedure
Intervention description(s): We used a electrical stimulation device with a 2500-Hz carrier frequency. We used four channels in the synchronous mode, with surface electrodes that were simultaneously fixed at the motor points of the quadriceps and hamstrings. Initially, a warm-up protocol that was five minutes long was used at a stimulation frequency of 40 Hz to activate the slow fibers. These fibers activated with a four-second-contraction time (on), a four-second-stimulus rise time, a four-second-stimulation decay time and a 12-second relaxation time (off).
We then increased the frequency to 70 Hz to activate the fast fibers for an additional 10 minutes using the parameters described above, and finally, the frequency was increase to 150 Hz for 10 minutes to achieve maximal muscle potentiation.; During the stimulation period, i.e., the on time, the patient remained in a mini-squat position at thirty degrees and returned to zero degrees during the decay period. During the electrical stimulation off period, the patient spontaneously performed another mini-squat at 30 degrees without electrical stimulation. The patients in the CKC + NMES placebo group simulated the same work applied to the NMES group. Notably, this group was also connected to the electrodes, but the equipment was set at a stimulus intensity of zero.
Other intervention name(s): 10-channel NEURODYN electrical stimulation IBRAMED; Closed Kinetic Chain exercises
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Closed Kinetic Chain; NMES; Knee Osteoarthritis