Isokinetic strengthening and neuromuscular electrical stimulation protocol impact on physical performances, functional status and quality of life in knee osteoarthritis overweight/obese women

• Published in: The knee 2022-12, Vol.39, p.106-115
• Main Authors: Hammami, Nadhir, Jdidi, Hela, Khezami, Mehrzia Amani, Ghidaoui, Leila, Talbi, Amal, Hannachi, Chaima, Farinha, Pedro Martins, Behlouli, Emna, Bouassida, Anissa, Dziri, Catherine, Ben Salah, Fatma-Zohra
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Daily living activities; Electric Stimulation - methods; Electrical stimulation therapy; Female; Humans; Knee osteoarthritis; Life quality; Muscle Strength - physiology; Muscle strength dynamometer; Obesity - complications; Obesity - therapy; Osteoarthritis, Knee - complications; Osteoarthritis, Knee - therapy; Physical Functional Performance; Quadriceps Muscle; Quality of Life; Randomized Controlled Trials as Topic
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2022.09.004

•Knee osteoarthritis causes several repercussions on muscle strength and flexibility, strength asymmetry, physical performances, joint range of motion amplitude, pain tolerance and quality of life,•Physical exercise should be considered as the primary therapy for knee osteoarthritis,•Knee periarticular muscles strengthening help to maintain and/or increase physical performances and functional status leading to improved range of motion and better quality of life,•Isokinetic muscle strengthening (IMS) and neuromuscular electrical stimulation (NMES) are recommended to be included in the knee osteoarthritis rehabilitation programs,•The combined modality of IMS and NMES is recommended to increase physical and functional performances and quality of life in overweight or obese women with knee osteoarthritis. Knee muscle weakness associated with overweight/obesity can lead to impairment of vital daily function in knee osteoarthritis patients. This study investigated the effect of a knee eccentric isokinetic muscle strength (IMS) training program combined with neuromuscular electrical stimulation (NMES) on muscle strength and flexibility, joint ROM, functional status, physical performance, and quality of life in knee osteoarthritis overweight/obese women. Thirty-six women were randomized into three groups, two experimental groups (EG) and a control group following a classic rehabilitation program. During 6 weeks of two sessions/week, one of the two EGs performed an IMS program (ISO.G); the other underwent combined IMS and NMES training (ISO + NMES.G). All patients were evaluated with clinical examination, isokinetic test at 60°/s and 240°/s speeds, physical performance tests related to activities of daily living, and Knee injury and Osteoarthritis Outcome Score (KOOS) quality of life questionnaire, before and after the intervention. In the 10-m walk, chair stand, stair climb and monopodal stance tests, muscle flexibility and quality of life scores showed significant improvement for ISO.G (P = 0.000) and ISO + NMES.G (P = 0.000). Concentric strength at 240°/s was improved in ISO + NMES.G (P = 0.000) unlike the muscle strength at 60°/s (quadriceps, P = 0.104; hamstrings, P = 0.171), force asymmetry (P = 0.481) and post-intervention joint ROM (P = 0.309). The combination of IMS and NMES shows significant superiority over the usual rehabilitation program for the majority of the parameters measured for optimal management of knee osteoarthritis.