Effectiveness of neuromuscular exercises and neuromuscular electrical stimulation on pain, function and balance in patients with knee osteoarthritis - a randomised controlled trial

The current study explores the effect of neuromuscular exercises (NEMEX) and neuromuscular electrical stimulation (NMES) on pain, function, balance, range of motion (ROM), fall risk and dynamic mobility in patients with knee osteoarthritis. A total of 92 subjects were randomly allocated into four groups: Group A- conventional treatment; Group B- NEMEX; Group C- NMES; and Group D- NEMEX in combination with NMES and conventional treatment. Visual analogue scale(VAS), knee injury osteoarthritis and outcome score (KOOS), timed up and go test (TUG), range of motion (ROM), community balance and mobility scale (CBM&S), and dynamic gait index (DGI) were the outcome measures in the study. Statistically significant improvement was found in VAS in Group D with 1.61 +/- 0.50 (mean +/- standard deviation (SD)) followed by Group C with 2.59 +/- 0.50 (mean +/- SD) and Group B with 4.18 +/- 0.50 (mean +/- SD) and at week 10 (follow-up) in Group D with1.74 +/- 0.54 (mean +/- SD) followed by Group C with 3.23 +/- 0.87 (mean +/- SD) and Group B with 4.91 +/- 0.75 (mean +/- SD) and in comparison to Group A at P = 0.0001 at week 6 and at week 10 in comparison to Group A. KOOS subvariables, TUG, ROM (R, L), CBM&S and DGI were also found significant at P = 0.0001 at week 6 and at week 10. This study found that combined application of NEMEX and NMES is helpful in improving pain, function, balance, ROM and reduces fall risks. Trial registration no. CTRI/2021/06/034213