Abe T1, Miyake J1, Kouma S1, Kawazoe K1, Koyama M1, Abe H1, Abiko S2
1Nonprofit Organization Think About Home Rehabilitation, Nagoya-shi, Japan, 2ITO CO., LTD, Science, Saitama, Japan
Background: Treatment methods to alleviate knee pain in Community dwelling elderly people are not sufficiently established. Under the Community-based integrated care systems in Japan, in order to facilitate Self-reliance support in individuals going to day care and who present knee pain, we thought it is an urgent issue to verify the effect of Electrical Stimulation in decreasing the degree of knee.
Purpose: The purpose of this study was to verify the effect of Transcutaneous electrical nerve stimulation (TENS) and Neuromuscular electrical stimulation (NMES) in decreasing knee pain in multiple facilities.
Methods: All participants were explained about the study and through written consent they agreed to participate. Total of 11 Day care facilities enrolled in this study and 50 people were assigned to the Electrical Stimulation (ES) group and 44 to the control group. Subjects were people over the age 65, presenting knee pain for more than an year during activities of daily living, cognitive level able to answer the questionnaires, and indoor ambulation is independent to require monitoring level, and certified as long-term care level or support need level. Protocols for electrical stimulation was TENS at frequency sweeping from 1 to 250 pps, phase width of 100µs, tolerable intensity without pain for 20 minutes followed be NMES at the frequency of 80pps, phase width of 100µs, on time of 12seconds, off time of 30 seconds to the Quadriceps for 20 minutes. Treatment was applied twice a week for 4 weeks. All electrical stimulation was applied using ESPURGE (ITO CO., LTD., Japan). The Japanese Knee Osteoarthritis Measure (JKOM), Timed up and go test(TUG), Quadriceps muscle strength, Pain catastrophizing scale, Visual Analogue Scale(VAS) for knee pain and Ikigai-9 was evaluated before and after the study. Analysis of variance was compared before and after treatment and also between groups. Significance level was set at 5%.
Results: In the ES group JKOM, TUG, VAS, Ikigai-9, and PCS all showed improvement. JKOM presented significant improvement in the ES group between before and after treatment from 46.8±27.5 to 40.1±19.7 (p value 0.05) and VAS also from 46.8±27.5 to 20.6±21.6 (p value 0.05). But in the control group there were no test results that showed significant improvement. In between group comparison JKOM and VAS showed significant improvement in the ES group compared to the control group (p value 0.01).
Conclusion(s): Electrical stimulation had effect on decreasing knee pain and the mechanism behind this is thought to be the gate control theory, and secretion of endogenous opioids, combined with synaptic plasticity.
Implications: TENS and NMES showed to have effect on alleviating chronic knee pain.
Implications: This study can contribute to the improvement of the living functions of many elderly residents who complain of knee joint pain.
Keywords: Community dwelling elderly people, Knee pain, Electrical stimulation
Funding acknowledgements: None
Purpose: The purpose of this study was to verify the effect of Transcutaneous electrical nerve stimulation (TENS) and Neuromuscular electrical stimulation (NMES) in decreasing knee pain in multiple facilities.
Methods: All participants were explained about the study and through written consent they agreed to participate. Total of 11 Day care facilities enrolled in this study and 50 people were assigned to the Electrical Stimulation (ES) group and 44 to the control group. Subjects were people over the age 65, presenting knee pain for more than an year during activities of daily living, cognitive level able to answer the questionnaires, and indoor ambulation is independent to require monitoring level, and certified as long-term care level or support need level. Protocols for electrical stimulation was TENS at frequency sweeping from 1 to 250 pps, phase width of 100µs, tolerable intensity without pain for 20 minutes followed be NMES at the frequency of 80pps, phase width of 100µs, on time of 12seconds, off time of 30 seconds to the Quadriceps for 20 minutes. Treatment was applied twice a week for 4 weeks. All electrical stimulation was applied using ESPURGE (ITO CO., LTD., Japan). The Japanese Knee Osteoarthritis Measure (JKOM), Timed up and go test(TUG), Quadriceps muscle strength, Pain catastrophizing scale, Visual Analogue Scale(VAS) for knee pain and Ikigai-9 was evaluated before and after the study. Analysis of variance was compared before and after treatment and also between groups. Significance level was set at 5%.
Results: In the ES group JKOM, TUG, VAS, Ikigai-9, and PCS all showed improvement. JKOM presented significant improvement in the ES group between before and after treatment from 46.8±27.5 to 40.1±19.7 (p value 0.05) and VAS also from 46.8±27.5 to 20.6±21.6 (p value 0.05). But in the control group there were no test results that showed significant improvement. In between group comparison JKOM and VAS showed significant improvement in the ES group compared to the control group (p value 0.01).
Conclusion(s): Electrical stimulation had effect on decreasing knee pain and the mechanism behind this is thought to be the gate control theory, and secretion of endogenous opioids, combined with synaptic plasticity.
Implications: TENS and NMES showed to have effect on alleviating chronic knee pain.
Implications: This study can contribute to the improvement of the living functions of many elderly residents who complain of knee joint pain.
Keywords: Community dwelling elderly people, Knee pain, Electrical stimulation
Funding acknowledgements: None
Topic: Pain & pain management; Electrophysical & isothermal agents; Disability & rehabilitation
Ethics approval required: No
Institution: Itabashi Ward Office Clinic
Ethics committee: Itabashi Ward Office Clinic
Reason not required: The purpose of this study is to verify the effectiveness of the health promotion program for the elderly living in the region. Therefore, musculoskeletal damage risk is not expected. In addition, participation is the free will of the person, confirming that they can abstain at any time, and have obtained approval.
All authors, affiliations and abstracts have been published as submitted.
