Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 7 , Pages 1230-1236, July 2008

Training Program and Additional Electric Muscle Stimulation for Patellofemoral Pain Syndrome: A Pilot Study

  • Walter Bily, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Wilhelminenspital Vienna, Austria
    • Corresponding Author InformationReprint requests to Walter Bily, MD, Dept of Physical Medicine, Wilhelminenspital, Montleartstr 37, A-1160 Vienna, Austria
    • ,
  • Lukas Trimmel, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Wilhelminenspital Vienna, Austria
    • ,
  • Michaela Mödlin, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Wilhelminenspital Vienna, Austria
    • ,
  • Alexandra Kaider, MSc

      Affiliations

    • Core Unit for Medical Statistics and Informatics, Section of Clinical Biometrics, Medical University of Vienna, Austria.
    • ,
  • Helmut Kern, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Wilhelminenspital Vienna, Austria

Abstract 

Bily W, Trimmel L, Mödlin M, Kaider A, Kern H. Training program and additional electric muscle stimulation for patellofemoral pain syndrome: a pilot study.

Objectives

To evaluate the beneficial effect of training in patients with patellofemoral pain syndrome (PFPS) and influence of additional electric muscle stimulation (EMS) of the knee extensor muscles.

Design

A randomized clinical trial.

Setting

Supervised physiotherapy (PT) training and home-based EMS.

Participants

Patients (N=38; 14 men, 24 women) with bilateral PFPS.

Interventions

One group (PT) received supervised PT training for 12 weeks. The other received PT and EMS. The stimulation protocol was applied to the knee extensors for 20 minutes, 2 times daily, 5 times a week for 12 weeks at 40Hz, with a pulse duration of .26ms, at 5 seconds on and 10 seconds off. Maximal tolerable stimulation intensity was up to 80mA.

Main Outcome Measures

Patellofemoral pain assessment with visual analog scale during activities of daily life, Kujala patellofemoral score, and isometric strength measurement before and after 12 weeks treatment as well as after 1 year.

Results

Thirty-six patients completed the 12-week follow-up. There was a statistically significant reduction of pain in both groups (PT group, P=.003; PT and EMS group, P<.001) and significant improvement of the Kujala score in both groups (PT group, P<.001; PT and EMS group, P<.001) after 12 weeks of treatment with improvement of function and reduction of pain at the 1-year follow-up. The difference between the 2 treatment groups was statistically not significant. We could not measure any significant change in isometric knee extensor strength in either group.

Conclusions

A supervised PT program can reduce pain and improve function in patients with PFPS. We did not detect a significant additional effect of EMS with the protocol described previously.

Key Words: Electric stimulation, Knee, Rehabilitation

List of Abbreviations: EMS, electric muscle stimulation, ICC, intraclass correlation coefficient, KPS, Kujala patellofemoral score, PFPS, patellofemoral pain syndrome, PT, physiotherapy, VAS, visual analog scale, VMO, vastus medialis oblique

 

 Supported by Hochschuljubiläumsstiftung der Stadt Wien (grant no. 30/2000).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(08)00211-6

doi:10.1016/j.apmr.2007.10.048

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 7 , Pages 1230-1236, July 2008

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