title: Current evidence demonstrates similar effects of kilohertz-frequency and low-frequency current on quadriceps evoked torque and discomfort in healthy individuals: a systematic review with meta-analysis.
abstract: BACKGROUND
  Neuromuscular electrical stimulation (NMES) is widely utilized to enhance muscle performance. However, the optimal NMES waveform with respect to treatment effect has not been established.
  
  
  OBJECTIVE
  To investigate the effects of kilohertz-frequency alternating current (KFAC) and low-frequency pulsed current (PC) on quadriceps evoked torque and self-reported discomfort.
  
  
  METHODS
  PubMed, The Cochrane Library, EMBASE, MEDLINE, Physiotherapy Evidence Database (PEDro), SinoMed, ISI Web of Knowledge, and CINAHL were searched for randomized controlled trials (RCTs) and quasi-randomized controlled trials (QRCTs).
  
  
  METHODS
  Two reviewers independently selected potential studies according to the inclusion criteria, extracted data, and assessed methodological quality.
  
  
  METHODS
  Studies were eligible if they compared KFAC versus PC interventions. Studies that included outcome measures for percentage of maximal isometric voluntary contraction (%MIVC) torque and self-reported discomfort level were eligible for evaluation. Seven studies involving 127 individuals were included. The methodological quality of eligible trials was moderate, with a mean of 5 on the 10-point PEDro scale. Overall, PC was no better than KFAC in terms of evoked torque and there was no difference in self-reported discomfort level.
  
  
  CONCLUSIONS
  KFAC and PC have similar effects on quadriceps evoked torque and self-reported discomfort level in healthy individuals. The small number and overall methodological quality of currently available studies included in this meta-analysis indicate that new RCTs are needed to better determine optimal NMES treatment parameters.
authors.affiliation: a Division of Physical Therapy , Hospital de Base do Distrito Federal , Brasilia , Brazil .
authors.forename: Vinicius Zacarias Maldaner
authors.initials: VZ
authors.lastname: da Silva
authors.affiliation: b Division of Physical Therapy - Ceilandia College , University of Brasilia , Brasilia , Brazil .
authors.forename: João Luiz Quaglioti
authors.initials: JL
authors.lastname: Durigan
authors.affiliation: c Department of Physical Therapy , College of Applied Health Sciences, University of Illinois Chicago , Chicago , IL , USA .
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.affiliation: d Department of Allied Health , Faculty of Health Sciences, La Trobe University , Bendigo , Australia , and.
authors.forename: Marcos
authors.initials: M
authors.lastname: de Noronha
authors.affiliation: e Division of Physical Therapy , Department of Orthopaedics and Latin American and Iberian Institute, University of New Mexico , Albuquerque , NM , USA.
authors.forename: Burke
authors.initials: B
authors.lastname: Gurney
authors.affiliation: b Division of Physical Therapy - Ceilandia College , University of Brasilia , Brasilia , Brazil .
authors.forename: Gerson
authors.initials: G
authors.lastname: Cipriano
mesh_terms: D001696:Biomechanical Phenomena; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D064368:Healthy Volunteers; D006801:Humans; D007537:Isometric Contraction; D053580:Muscle Strength; D063806:Myalgia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D017288:Pain Threshold; D052097:Quadriceps Muscle / Q000294:innervation*; D019415:Torque
keywords: Electrical stimulation; muscle strength; pain; physical therapy