Neuromuscular exercise with neuromuscular electrical stimulation in knee osteoarthritis: A randomised controlled pilot trial

Abstract

Introduction: The present study describes the findings of a randomized controlled trial (RCT) investigating the effects of neuromuscular exercise (NEMEX) with neuromuscular electrical stimulation (NMES) on pain, physical function, balance, range of motion and gait, based on various outcome measures, in patients with knee osteoarthritis (KOA). Material and methods: A group of 48 subjects with knee osteoarthritis was randomly allocated into four groups (group A: Conventional treatment; group B: NEMEX; group C: NMES; group D: NEMEX in combination with NMES & Conventional) with the following primary outcomes: feasibility, assessment procedure, adherence and acceptability of the intervention. The secondary outcomes were pain, on the visual analog scale (VAS), knee injury osteoarthritis outcome score (KOOS), timed up & go (TUG), range of motion (ROM), community balance & mobility scale (CBM&S) and dynamic gait index (DGI). Feasibility and acceptability were evaluated by number of subjects completed the pre and post-treatment data. Results: A significant improvement in VAS was noted after six weeks of treatment in group D (p = 0.0001) as compared to group A. KOOS sub variables and TUG test were significant at p = 0.0001, ROM (R) was significant at p = 0.01, ROM (L) significant at p = 0.11 and CBM&S, DGI were significant at p = 0.0001. Conclusions: This pilot trial suggests that fully-powered RCT is a feasible approach to investigating the effect of NEMEX with NMES in KOA. NEMEX with NMES may significantly reduce pain and fall risks, and improve ROM, balance and dynamic mobility in patients with KOA.