Highlights
- •The combination of voluntary contractions with electrical stimulation is effective for reducing peripheral pain sensitivity locally at the knee in women with obesity with knee osteoarthritis.
- •Walking combined with electrical stimulation improves symptomatic knee pain and quality of life.
- •Walking combined with electrical stimulation would be a simple and easy-to-implement means of reducing peripheral sensitivity.
Abstract
Objective
To assess the extent to which pain sensitivity is altered in women with obesity with
frequent knee symptoms who walk with either a hybrid training system (HTS) that provides
antagonist muscle electrical stimulation vs sensory transcutaneous electrical nerve
stimulation (TENS).
Design
Randomized, double-blinded, controlled trial.
Setting
University-based fitness center.
Participants
Twenty-eight women (N=28) with obesity, aged 40-70 years, with daily knee symptoms.
Interventions
Participants were randomized to 12 weeks of biweekly 30-minute walking exercise with
either HTS (HTSW group) or sensory TENS (control group).
Main Outcome Measures
Pressure pain thresholds (PPTs) at the more symptomatic knee (local PPT) and PPT at
the ipsilateral pain-free wrist (remote PPT).
Results
After adjustment for preintervention values and body mass index (BMI), there was a
statistically significant improvement in local PPT in the HTSW group compared with
the control group (P=.039). After adjustment for pretraining value, age, and BMI, changes in remote PPT
when comparing groups did not reach statistical significance, although the HTS group
tended to demonstrate increased remote PPT (P=.052) compared with the control group. Moreover, after adjustment for pretraining
value, knee pain, and quality of life, comparing groups did not reach statistical
significance, although the HTS group tended to demonstrate decreased knee pain (P=.069) compared with the control group.
Conclusions
Augmentation of walking exercise with HTS was more effective than application of sensory
TENS in improving local pain sensitivity at the knee but not at the wrist in women
with obesity with frequent knee symptoms.
Keywords
List of abbreviations:
BMI (body mass index), ES (electrical stimulation), HTS (hybrid training system), HTSW (hybrid training system during walking), KOA (knee osteoarthritis), KOOS (Knee Injury and Osteoarthritis Outcome Score), PPT (pressure pain threshold), TENS (transcutaneous electrical nerve stimulation), VAS (visual analog scale), VC (volitional contraction)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 22, 2022
Accepted:
January 6,
2022
Received:
January 5,
2022
Footnotes
A portion of the results of this study was presented to the American Academy of Physical Medicine and Rehabilitation at the Annual Assembly, October 25-28, 2018, Orlando, Florida.
Supported in part by the Milbank Foundation Chronic Pain Management Research Grant through the Foundation for Physical Medicine and Rehabilitation. This work was supported in part by a CTSA grant from NCRR and NCATS awarded to the University of Kansas Medical Center for Frontiers: The Heartland Institute for Clinical and Translational Research # UL1RR033179, which is now at NCATS # UL1TR000001. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or NCATS.
Clinical Trial Registration No.: NCT02730598.
Disclosures: Dr Segal has financial relationships with Flexion Therapeutics, Pacira CryoHealth, and Tenex Health, outside the submitted work. The other authors have nothing to disclose.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
