Yeşilöz Özgür, Kasapoğlu Aksoy Meliha
Department of Physical Medicine and Rehabilitation, Bozüyük State Hospital, Bilecik, Türkiye.
Department of Physical Medicine and Rehabilitation, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Türkiye.
Turk J Phys Med Rehabil. 2023 Jun 9;69(3):317-326. doi: 10.5606/tftrd.2023.10998. eCollection 2023 Sep.
This study aimed to compare the effectiveness of neuromuscular electrical stimulation (NMES) combined with peroneal nerve stimulation (PNS) on muscle strength around the knee, proprioception, pain, functional status, and quality of life in patients with knee osteoarthritis (OA).
The prospective, randomized, single-blinded, controlled trial included 63 patients with clinical and radiological diagnoses of knee OA between December 2019 and March 2020. The patients were divided into two groups: Group 1 (NMES+PNS, n=31) and Group 2 (NMES, n=32). The patients were followed up at two and six weeks. Main outcome measures were the Visual Analog Scale, Western Ontario and McMaster Universities Arthritis Index, Nottingham Health Profile, and 100-m walking test, quadriceps muscle strength, hamstring muscle strength (HMS), and joint position sense were evaluated using a computer-controlled isokinetic dynamometer at 60°/sec, 90°/sec, and 120°/sec angular velocities. The proprioception was evaluated at 30° and 60° flexion angles using the same device.
Two patients from Group 1 and two patients from Group 2 were excluded from the study after they failed to show up for the six-week control. As a result, the study was completed with 59 patients (30 females, 29 males; 55.9±6.1 years; range, 40 to 65 years). There was a significant difference between the two groups in the 100-m walking test parameter at the six-week control in favor of Group 1 (p<0.05). There was a significant difference in favor of Group 1 in the parameters of proprioception (30° and 60°) and HMS (60° and 90°) in both the two-week evaluation and six-week controls (p<0.05). The HMS 120° parameter showed a significant difference in favor of Group 1 at the six-week control (p<0.05).
In patients with knee OA, we believe that PNS combined with NMES may be more effective than NMES treatment alone in terms of proprioception, HMS, and functional status.
本研究旨在比较神经肌肉电刺激（NMES）联合腓总神经刺激（PNS）对膝骨关节炎（OA）患者膝关节周围肌肉力量、本体感觉、疼痛、功能状态和生活质量的影响。
这项前瞻性、随机、单盲、对照试验纳入了2019年12月至2020年3月期间63例临床和影像学诊断为膝OA的患者。患者分为两组：第1组（NMES+PNS，n=31）和第2组（NMES，n=32）。在两周和六周时对患者进行随访。主要结局指标为视觉模拟量表、西安大略和麦克马斯特大学关节炎指数、诺丁汉健康量表和100米步行试验，使用计算机控制的等速测力计在60°/秒、90°/秒和120°/秒的角速度下评估股四头肌力量、腘绳肌力量（HMS）和关节位置觉。使用同一设备在30°和60°屈曲角度评估本体感觉。
第1组和第2组各有两名患者在六周对照时未出现，被排除在研究之外。结果，该研究共纳入59例患者（女性30例，男性29例；年龄55.9±6.1岁；范围40至65岁）。在六周对照时，两组在100米步行试验参数上存在显著差异，第1组更优（p<0.05）。在两周评估和六周对照中，第1组在本体感觉（30°和60°）和HMS（60°和90°）参数方面均更优，差异有统计学意义（p<0.05）。在六周对照时，HMS 120°参数显示第1组更优，差异有统计学意义（p<0.05）。
对于膝OA患者，我们认为PNS联合NMES在本体感觉、HMS和功能状态方面可能比单纯NMES治疗更有效。
