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Immediate effect of patterned electrical neuromuscular stimulation on pain and muscle activation in individuals with patellofemoral pain [with consumer summary] |
Glaviano NR, Saliba SA |
Journal of Athletic Training 2016 Feb;51(2):118-128 |
clinical trial |
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
CONTEXT: For individuals with patellofemoral pain (PFP), altered muscle activity and pain are common during functional tasks. Clinicians often seek interventions to improve muscle activity and reduce impairments. One intervention that has not been examined in great detail is electrical stimulation. OBJECTIVE: To determine whether a single patterned electrical neuromuscular stimulation (PENS) treatment would alter muscle activity and pain in individuals with PFP during 2 functional tasks, a single-legged squat and a lateral step down. DESIGN: Cohort study. SETTING: Sports medicine research laboratory. PATIENTS OF OTHER PARTICIPANTS: A total of 22 individuals with PFP (15 women, 7 men; age 26.0 +/- 7.9 years, height 173.8 +/- 8.1 cm, mass 75.1 +/- 17.9 kg). INTERVENTION(S): Participants were randomized into 2 intervention groups: a 15-minute PENS treatment that produced a strong motor response or a 15-minute 1-mA subsensory (sham) treatment. MAIN OUTCOME MEASURE(S): Before and immediately after the intervention, we assessed normalized electromyography amplitude, percentage of activation time across functional tasks, and onset of activation for the vastus medialis oblique, vastus lateralis, gluteus medius, adductor longus, biceps femoris, and medial gastrocnemius muscles during a single-legged squat and a lateral step down. Scores on the visual analog scale for pain were recorded before and after the intervention. RESULTS: After a single treatment of PENS, the percentage of gluteus medius activation increased (0.024) during the lateral step down. Visual analog scores decreased during both the single-legged squat (PENS preintervention 2.7 +/- 1.9, postintervention 0.9 +/- 0.7; sham: preintervention 3.2 +/- 1.6, postintervention 2.8 +/- 1.9; group x time interaction p = 0.041) and lateral step down (PENS preintervention 3.4 +/- 2.4, postintervention 1.1 +/- 0.8; sham: preintervention 3.9 +/- 1.7, postintervention 3.3 +/- 2.0; group x time interaction p = 0.023). No changes in electromyography or pain measures were noted in the sham group. CONCLUSIONS: The PFP participants who received PENS had immediate improvement in gluteus medius activation and a reduction in pain during functional tasks.
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