Treatment of Knee Osteoarthritis: Neuromuscular Electrical Stimulation and Low-level Laser.

Study Overview
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Brief Summary
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The purpose of this study is to determine the effects of low-level laser therapy in combination with neuromuscular electrical stimulation on neuromuscular (muscular strength and morphology) and functional parameters (pain and functional tests) in elderly with knee osteoarthritis. The hypothesis is that the association of low-level laser therapy with neuromuscular electrical stimulation could reduce joint pain associated with the inflammation and consequently potentiates the effects of electrical stimulation on the muscular system.

Detailed Description
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Participants was randomized into one of three intervention groups (intervention period = 8 weeks after a 4 weeks control period in all groups). Electrical stimulation group (18-32 min of pulsed current, stimulation frequency of 80Hz (Hertz), pulse duration of 200μs and stimulation intensity fixed near to maximal tolerated), Laser group (low-level laser therapy dose of 4-6J (Joules) per point, six points at the knee joint) Combined group (electrical stimulation and low-level laser therapy).

Official Title
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Neuromuscular Electrical Stimulation and Low-level Laser: Combined Use for the Treatment of Knee Osteoarthritis in Elderly

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Other: Laser Therapy
* Other: Electrical Stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: elderly. symptomatic knee osteoarthritis. radiographic diagnostic of Grade 2 or 3 knee osteoarthritis. Exclusion Criteria: a body mass index higher than 40 Kg/m2. a diagnosis of hip, ankle, or toe osteoarthritis. the use of crutches for locomotion. participation in a strength-training programme or physiotherapy treatment for knee osteoarthritis in the past six months. neurological or cognitive disorders. rheumatoid arthritis. electronic implants. previous or upcoming surgery (within three months). any cardiorespiratory, neuromuscular, or metabolic disease that could represent an absolute contraindication or a contraindication to the performance of maximum strength tests.

Ages Eligible for Study
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Minimum Age: 60 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Electrical stimulation<br>18-32 min of pulsed current. stimulation frequency of 80Hz (hertz). pulse duration of 200μs (microseconds). stimulation intensity fixed near to maximal tolerated. | Other: Electrical Stimulation<br>* Neuromuscular electrical stimulation was administered twice a week with a minimum of 48h between sessions over a period of eight weeks and with progressive intensity and volume.<br>* Other names: neuromuscular electrical stimulation;|
| Experimental: Laser Therapy<br>λ = 810 nm (nanometers) continuous wave 200 mW (milliwatts) output power low-level laser therapy dose of 4-6J (Joules) per point six points at the knee joint | Other: Laser Therapy<br>* Low-level laser therapy was administered twice a week with a minimum of 48h between sessions over a period of eight weeks.<br>* Other names: Phototherapy;|
| Experimental: Combined Treatment<br>Electrical Stimulation: 18-32 min of pulsed current, stimulation frequency of 80Hz (hertz). pulse duration of 200μs (microseconds). stimulation intensity fixed near to maximal tolerated. and Laser Therapy: λ = 810 nm (nanometers) continuous wave 200 mW (milliwatts) output power low-level laser therapy dose of 4-6J (Joules) per point. six points at the knee joint. | Other: Laser Therapy<br>* Low-level laser therapy was administered twice a week with a minimum of 48h between sessions over a period of eight weeks.<br>* Other names: Phototherapy;Other: Electrical Stimulation<br>* Neuromuscular electrical stimulation was administered twice a week with a minimum of 48h between sessions over a period of eight weeks and with progressive intensity and volume.<br>* Other names: neuromuscular electrical stimulation;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Torque change | Torque is an expression of the muscular strength and was assessed by dynamometry. | Torque was measured 3 times during the study: baseline (week -4), before intervention (week 0) and post intervention (week 9). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscular architecture change | Muscular architecture (muscle thickness, pennation angle and fascicle length) were assessed by ultrasonography. | Architecture was measured 3 times during the study: baseline (week -4), before intervention (week 0) and post intervention (week 9). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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neuromuscular electrical stimulation, low-level laser therapy, knee osteoarthritis, muscle architecture, functionality, neuromuscular parameters