OBJECTIVES: To determine the effects of low-level laser therapy in combination with neuromuscular electrical stimulation on the muscle architecture and functional capacity of elderly patients with knee osteoarthritis. DESIGN: A randomized, evaluator-blinded clinical trial with sequential allocation of patients to three different treatment groups. SETTING: Exercise Research Laboratory. SUBJECTS: A total of 45 elderly females with knee osteoarthritis, 2 to 4 osteoarthritis degrees, aged 66 to 75 years. INTERVENTION: Participants were randomized into one of the following three intervention groups: electrical stimulation group (18 to 32 minutes of pulsed current, stimulation frequency of 80 Hz, pulse duration of 200 mus and stimulation intensity fixed near the maximal tolerated), laser group (low-level laser therapy dose of 4 to 6 J per point, six points at the knee joint) or combined group (electrical stimulation and low-level laser therapy). All groups underwent a four-week control period (without intervention) followed by an eight-week intervention period. MAIN MEASURES: The muscle thickness, pennation angle and fascicle length were assessed by ultrasonography, and the functional capacity was assessed using the 6-minute walk test and the Timed Up and Go Test. RESULTS: After intervention, only the electrical stimulation and combined groups exhibited significant increases in the muscle thickness (27% to 29%) and pennation angle (24% to 34%) values. The three groups exhibited increased performance on the walk test (5% to 9%). However, no significant differences in terms of functional improvements were observed between the groups. CONCLUSIONS: Neuromuscular electrical stimulation reduced the deleterious effects of osteoarthritis on the quadriceps structure. Low-level laser therapy did not potentiate the effects of electrical stimulation on the evaluated parameters.

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