Effects of disinhibitory transcutaneous electrical nerve stimulation and therapeutic exercise on sagittal plane peak knee kinematics and kinetics in people with knee osteoarthritis during gait: a randomized controlled trial

Abstract

Objective: to determine whether sensory transcutaneous electrical nerve stimulation (TENS) augmented with therapeutic exercise and worn for daily activities for four weeks would alter peak gait kinetics and kinematics, compared with placebo electrical stimulation and exercise, and exercise only.

Design: randomized controlled trial.

Setting: motion analysis laboratory.

Subjects: thirty-six participants with radiographically assessed knee osteoarthritis and volitional quadriceps activation below 90% were randomly assigned to electrical stimulation, placebo and comparison (exercise-only) groups.

Interventions: participants in all three groups completed a four-week quadriceps strengthening programme directed by an experienced rehabilitation clinician. Active electrical stimulation units and placebo units were worn in the electrical stimulation and placebo groups throughout the rehabilitation sessions as well as during all activities of daily living.

Main measures: peak external knee flexion moment and angle during stance phase were analysed at a comfortable walking speed before and after the intervention.

Findings: Comfortable walking speed increased for all groups over time (TENS 1.16 ± 0.15 versus 1.32 ± 0.16 m/s; placebo 1.21 ± 0.34 versus 1.3 ± 0.24 m/s; comparison 1.27 ± 0.18 versus 1.5 ± 0.14 m/s), yet no group differences in speed were found. No differences were found for peak flexion moment or angle between groups overtime.

Conclusions: TENS in conjunction with therapeutic exercise does not seem to affect peak flexion moment and angle during stance over a four-week period in participants with tibiofemoral osteoarthritis.