Abstract
Background 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. Objectives 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. Methods 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. Results 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: Legend 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. Legend 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). Legend 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 Legend 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. Legend Data homogeneity (Chi² = 12.29; I² = 84%) was identified, with no significant difference in favor of NMES (Z = 0.90, p = 0.37). Legend 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). Conclusion 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.
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