Evaluation of the Combined Application of Neuromuscular Electrical Stimulation and Volitional Contractions on Thigh Muscle Strength, Knee Pain, and Physical Performance in Women at Risk for Knee Osteoarthritis: A Randomized Controlled Trial.
Study Goal
The researchers aimed to assess the efficacy of a hybrid training system (HTS) combining neuromuscular electrical stimulation and volitional contractions for improving thigh muscle strength, knee pain relief, and physical performance in women with or at risk for knee osteoarthritis.
Results Summary
The HTS improved quadriceps and hamstring strength, reduced knee pain, and enhanced physical performance, but these benefits were not statistically superior to low-load resistance training alone. Both interventions showed similar effectiveness in pain relief and functional improvement.
Population
Women aged 44-85 years with risk factors for knee osteoarthritis.
Effective Dosage
Biweekly low-load resistance training sessions over 12 weeks.
Duration
12 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
12-week low-load exercise program using a hybrid training system (HTS) | increase | muscle strength | women with risk factors for knee OA | - | resulted in muscle strengthening | #1 |
12-week low-load exercise program using a hybrid training system (HTS) | decrease | knee pain | women with risk factors for knee OA | - | decreased | #2 |
12-week low-load exercise program using a hybrid training system (HTS) | increase | physical performance | women with risk factors for knee OA | - | improved | #3 |
12-week low-load exercise program using a hybrid training system (HTS) | increase | quadriceps strength | HTS group | 0.06 ± 0.04 Nm/kg | increased | #4 |
12-week low-load exercise program using a hybrid training system (HTS) | increase | hamstring strength | HTS group | 0.05 ± 0.02 Nm/kg | increased | #5 |
12-week low-load exercise program using a hybrid training system (HTS) | decrease | knee pain | HTS group | 11.9 ± 11.5 points | decreased | #6 |
12-week low-load exercise program using a hybrid training system (HTS) | decrease | 20-m walk time | HTS group | 1.60 ± 2.04 seconds | decreased | #7 |
12-week low-load exercise program using a hybrid training system (HTS) | decrease | chair stand time | HTS group | 4.8 ± 10.0 seconds | decreased | #8 |
12-week low-load resistance training on an isokinetic dynamometer (control) | increase | muscle strength | women with risk factors for knee OA | - | resulted in muscle strengthening | #9 |
12-week low-load resistance training on an isokinetic dynamometer (control) | decrease | knee pain | women with risk factors for knee OA | - | decreased | #10 |
12-week low-load resistance training on an isokinetic dynamometer (control) | increase | physical performance | women with risk factors for knee OA | - | improved | #11 |
12-week low-load resistance training on an isokinetic dynamometer (control) | increase | quadriceps strength | control group | 0.03 ± 0.04 Nm/kg | increased | #12 |
12-week low-load resistance training on an isokinetic dynamometer (control) | increase | hamstring strength | control group | 0.06 ± 0.02 Nm/kg | increased | #13 |
12-week low-load resistance training on an isokinetic dynamometer (control) | decrease | knee pain | control group | 14.1 ± 15.4 points | decreased | #14 |
12-week low-load resistance training on an isokinetic dynamometer (control) | decrease | 20-m walk time | control group | 0.95 ± 1.2 seconds | decreased | #15 |
12-week low-load resistance training on an isokinetic dynamometer (control) | decrease | chair stand time | control group | 1.9 ± 4.7 seconds | decreased | #16 |
hybrid training system (HTS) | no change | muscle strength | women with risk factors for knee OA | - | does not appear to be superior | #17 |
hybrid training system (HTS) | no change | pain relief | women with risk factors for knee OA | - | does not appear to be superior | #18 |
hybrid training system (HTS) | no change | physical function | women with risk factors for knee OA | - | does not appear to be superior | #19 |
BACKGROUND: Knee osteoarthritis (OA) is a leading cause of disability that is associated with quadriceps weakness. However, strengthening in people with or with risk factors for knee OA can be poorly tolerated. OBJECTIVE: To assess the efficacy of a 12-week low-load exercise program, using a hybrid training system (HTS) that uses the combination of neuromuscular electrical stimulation and volitional contractions, for improving thigh muscle strength, knee pain relief, and physical performance in women with or with risk factors for knee OA. DESIGN: Randomized, single-blinded, controlled trial. SETTING: Exercise training laboratory. PARTICIPANTS: Forty-two women 44-85 years old with risk factors for knee OA. INTERVENTIONS: Participants randomized to 12 weeks of biweekly low-load resistance training with the HTS or on an isokinetic dynamometer (control). OUTCOMES: Maximum isokinetic knee extensor torque. Secondary measures included maximum isokinetic knee flexor torque, knee pain (Knee Injury and Osteoarthritis Outcome Score), and timed 20-m walk and chair stand tests. RESULTS: The HTS and control treatments resulted in muscle strengthening, decreased knee pain, and improved physical performance. HTS group quadriceps and hamstring strength increased by 0.06 ± 0.04 Nm/kg (P > .05) and 0.05 ± 0.02 Nm/kg (P = .02), respectively. Control group quadriceps and hamstring strength increased by 0.03 ± 0.04 Nm/kg (P > .05) and 0.06 ± 0.02 Nm/kg (P = .009), respectively. Knee pain decreased by 11.9 ± 11.5 points (P < .001) for the HTS group and 14.1 ± 15.4 points (P = .001) for the control group. The 20-m walk time decreased by 1.60 ± 2.04 seconds (P = .005) and 0.95 ± 1.2 seconds (P = .004), and chair stand time decreased by 4.8 ± 10.0 seconds (P > .05) and 1.9 ± 4.7 seconds (P > .05) in the HTS and control groups, respectively. These results did not differ statistically between the HTS and control groups. CONCLUSIONS: These results suggest the HTS is effective for alleviating pain and improving physical performance in women with risk factors for knee OA. However, the HTS does not appear to be superior to low-load resistance training for improving muscle strength, pain relief, or physical function. CLINICAL TRIAL REGISTRATION NUMBER: NCT02802878. LEVEL OF EVIDENCE: I.