Electrical Stimulation for Osteoarthritis of the Knee

Improving quadriceps strength is a big factor in reducing the pain of osteoarthritis in the knee. Strong muscles around the joint will stabilize the joint and take pressure off the cartilage. Exercise has been shown to improve the symptoms, severity and functionality associated with osteoarthritis of the knee. However in SOME cases the exercise may be too painful. Here we will explore electrical stimulation as another option for treatment.

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Research was done by Dr Laura Talbot from The Johns Hopkins University on how Neuromuscular Electrical Stimulation (NMES) can be used as a treatment option for osteoarthritis of the knee.

What is NMES?
It is basically sending small electrical impulses through the skin to the underlying nerves and muscles to create muscle contraction.

How was the study conducted?
34 Adults with osteoarthritis of the knee were involved. Each of the participants were given standard arthritis education, a 12 week self management course, with or without NMES. The NMES group used a portable electrical muscle stimulator 3 times a week for quadricep training and strengthening. The intensity of the contraction was increased gradually.

The primary outcome (what was measured) of the study was isometric quadriceps femoris (QF) torque (basically the power produced). Secondary outcomes included:

  • daily step counts
  • total activity vector magnitude
  • 100-foot walk-turn-walk
  • timed stair climb
  • chair rise
  • pain level

What were the results?

  • The quadriceps showed a 9.1% increase in peak torque.
  • The chair rise time of the NMES group was reduced by 11%, a 7% reduction was seen in the education only group
  • Both groups improved their walk time by 7%
  • The severity of pain after the intervention was no different between each group.

What does this mean?

A home based NMES treatment plan does seem promising as a means of increasing quadriceps strength. The advantage is that there is no impact whilst doing this and it will not aggravate other symptoms. However it does not replace exercise and the many benefits it can produce for arthritis sufferers. A careful strength plan will increase the strength of the quadriceps much more, however NMES does prove a very interesting option for those whose pain is enough to stop them from conducting such a program.