Training program and additional electric muscle stimulation for patellofemoral pain syndrome: a pilot study.
OBJECTIVE
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.


METHODS
A randomized clinical trial.


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


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


METHODS
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 40 Hz, with a pulse duration of .2 6ms, at 5 seconds on and 10 seconds off. Maximal tolerable stimulation intensity was up to 80 mA.


METHODS
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.
Bily
Walter
W
Department of Physical Medicine and Rehabilitation, Wilhelminenspital Vienna, Austria. walter.bily@wienkav.at
Trimmel
Lukas
L
Mödlin
Michaela
M
Kaider
Alexandra
A
Kern
Helmut
H
D000328:Adult; D004599:Electric Stimulation Therapy; D026241:Exercise Movement Techniques; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D053580:Muscle Strength; D052580:Muscle Stretching Exercises; D010147:Pain Measurement; D046788:Patellofemoral Pain Syndrome / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D020127:Recovery of Function; D016896:Treatment Outcome