RESUMO
OBJECTIVE: To determine the effects of neuromuscular electrical stimulation and low-level laser therapy on neuromuscular parameters and health status in elderly subjects with knee osteoarthritis. DESIGN: A randomized evaluator-blinded clinical trial. SUBJECTS: Forty-five elderly women with knee osteoarthritis. METHODS: Subjects were randomized into 1 of the following 3 intervention groups: electrical stimulation group (18-32 min pulsed current, stimulation frequency 80 Hz, pulse duration 400 µs, stimulation intensity 40% of maximal isometric voluntary contraction), laser group (dose 4-6 J per point, 6 points at the knee joint) or combined group (electrical stimulation plus laser therapy). The outcomes included muscle thickness and anatomical cross-sectional area (ultrasonography), knee extensors' electrical activity (electromyography), torque (dynamometry) and health status (Western Ontario and McMaster Universities Osteoarthritis Index). All groups underwent a 4-week control period (without intervention) followed by an 8-week intervention period. RESULTS: Muscle thickness and anatomical cross-sectional area increased in the electrical stimulation and combined groups. All groups presented similar improvements in torque, electrical activity and health status. CONCLUSION: Electrical stimulation alone or in combination with laser therapy generated positive effects on all evaluated parameters. Laser therapy increased health status and electrical activity, but had no effect on muscle mass.
Assuntos
Terapia por Estimulação Elétrica/métodos , Terapia com Luz de Baixa Intensidade/métodos , Osteoartrite do Joelho/terapia , Idoso , Antropometria/métodos , Terapia Combinada , Eletromiografia , Feminino , Nível de Saúde , Humanos , Contração Isométrica , Articulação do Joelho/fisiopatologia , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Osteoartrite do Joelho/patologia , Osteoartrite do Joelho/fisiopatologia , Índice de Gravidade de Doença , Método Simples-Cego , TorqueRESUMO
PURPOSE: To identify if there is evidence in favor of the use of NMES to quadriceps muscle strengthening in elderly with knee OA. DATA SOURCES AND STUDY SELECTION: A search of PubMed/Medline, PEDro and Cochrane Library produced a total of 76 relevant trials. Six studies that met the inclusion criteria were selected for this review. DATA EXTRACTION: Trials were addressed by inclusion and exclusion criteria and scoring internal validity using PEDro scale. DATA SYNTHESES: A summary of the sample and design characteristics, and muscle strength results from each study were presented on table. CONCLUSION: The best-evidence analysis showed moderate evidence in favor of NMES alone or combined with exercise for isometric quadriceps strengthening in elderly with OA. In addition, for the effects of NMES intervention as an adjunct therapy on isokinetic strength at different angular velocities, there was a limited quality of evidence assessed.