THU0428 THE EFFECTS OF NEUROMUSCULAR ELECTRICAL STIMULATION ON STRENGHT, PAIN, AND FUNCTION IN INDIVIDUALS WITH KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW WITH META-ANALYSIS
Authors: Camila Cadena, Vinícius Bispo, Karenina Modesto, Gerson Cipriano, João Luiz Durigan
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Even thought Neuromuscular electrical stimulation (NMES) has been widely used as a non-pharmacological intervention in patients with knee osteoarthritis (OA) to improve muscle strength and function, prior research has shown conflicting results regarding NMES effectiveness in knee OA treatment. <h3>Objectives</h3> The aim of this systematic review and meta-analysis was to investigate the effectiveness of NMES in muscle strengthen, pain, and function in individuals with knee OA. <h3>Methods</h3> Only randomized controlled trials (RCTs) were included in this study. Two authors independently performed the study selection. We use Pubmed, Embase, LILACS, PEDro and Cochrane Central Register of Controlled Trials as data sources. The main outcome evaluated was muscle strength. Function and pain were assessed as secondary outcomes using the Western Ontario Macmaster (WOMAC) questionnaire and Timed get up and go (TUG) test. The methodological quality was assessed using PEDro scale. <h3>Results</h3> A total of 23,215 were initially identified. After selection of titles and abstracts, studies were selected for the full-text analysis, ten studies were included with a total sample size of 622 patients. The methodological quality of the selected studies was moderate, with a mean score of 5.5 on a 0-10 scale (PEDro). The following analysis were performed: <h3>Legend</h3> All measurements were standardized in N/m. A homogeneity in the data (Chi² = 5.01; I² = 0%) was identified, with a significant difference in favor of NMES (Z = 4.52, p = 0.01). NMES - Neuromuscular electro stimulation. <h3>Legend</h3> A heterogeneity in the data was identified (Chi² = 4.80, I² = 58%), with no significant difference in favor of NMES (Z = 1.04, p = 0.30). <h3>Legend</h3> A homogeneity in the data (Chi² = 4.04; I² = 26%) was identified, with a significant difference in favor of NMES (Z = 4.56, p = 0.01). N <h3>Legend</h3> Data homogeneity (Chi² = 5.03; I² = 21%) was identified, with no significant difference in favor of NMES (Z = 0.07, p = 0.95). NMES - Neuromuscular electro stimulation. <h3>Legend</h3> Data homogeneity (Chi² = 12.29; I² = 84%) was identified, with no significant difference in favor of NMES (Z = 0.90, p = 0.37). <h3>Legend</h3> A homogeneity in the data (Chi² = 0.51; I² = 0%) was identified, with no significant difference in favor of NMES associated with exercise (Z = 0.97, p = 0.33). <h3>Conclusion</h3> NMES increased muscle strength in patients with OA compared to the active control group. However, the evidence to date did not demonstrate effects for pain control nor improvement in physical function. <h3>References</h3> [1] Elboim-Gabyzon M, Rozen N, Laufer Y. 2013 Does neuromuscular electrical stimulation enhance the effectiveness of an exercise programme in subjects with knee osteoarthritis? A randomized controlled trial. Clinical Rehabilitation.27(3):246-257. [2] De Oliveira Melo M, Aragão FA, Vaz MA. 2013Neuromuscular electrical stimulation for muscle strengthening in elderly with knee osteoarthritis - A systematic review. Complementary Therapies in Clinical Practice.19(1):27-31. <h3>Acknowledgement</h3> This research was supported by University of Brasília. <h3>Disclosure of Interests</h3> None declared