The effectiveness of 6-week superimposed neuromuscular electrical stimulation in knee osteoarthritis: an assessor blinded randomized controlled clinical trial
Bibliographic record
Abstract
INTRODUCTION: Conservative treatment of knee osteoarthritis (KOA) is crucial for alleviating patient complaints and postponing disability from the onset of symptoms until the disease progresses to the point where surgery is inevitable. Although as a part of conservative management, Superimposed Neuromuscular Electrical Stimulation (sNMES), which combines electrical stimulation with voluntary contraction, has gained popularity in clinical practice, the effects of sNMES in KOA are unknown. Therefore, the study aimed to investigate the effects of sNMES in patients with KOA. MATERIALS AND METHODS: Fifty-eight participants with KOA were randomly divided into three groups (sNMES + CP (conventional physiotherapy), NMES (Neuromuscular Electrical Stimulation) + CP, and only CP). The treatments lasted 3 times for 6 weeks. Before and after treatments, the quadriceps and femoral cartilage thickness, sensorimotor function (balance and proprioception), physical function (quadriceps muscle strength, knee range of motion, and 30-second sit-to-stand test), and functional status (Short Form-36 (SF36) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) were evaluated. RESULTS: Regarding timeXgroup effect when comparing groups, the sNMES + CP showed significant improvements over NMES + CP and only CP in quadriceps muscle strength (p < 0.01), SF36_Energy (p < 0.01), and SF36_Social Functioning (p < 0.01). Both the sNMES + CP (p < 0.01) and only CP groups (p < 0.01) showed significant changes in SF36_Pain scores, while all groups had significant reductions in WOMAC Scores (p < 0.05), with the sNMES + CP group showing the greatest improvement (p < 0.01). No adverse effects were reported in all treatment groups. CONCLUSION: sNMES + CP proved more effective than NMES + CP or only CP in enhancing quadriceps muscle strength and improving functional status. Incorporating sNMES instead of NMES into CP could be a more effective intervention for treating KOA, particularly when the goal is to enhance quadriceps strength, thereby improving functional status. In conservative management of KOA, collaboration between orthopedists and physiatrists is crucial for addressing functional improvement regarding the effect of sNMES.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".