The effectiveness of pulsed electrical stimulation in the management of osteoarthritis of the knee: results of a randomised controlled trial.
Dr Robyn Fary, A/Prof Graeme Carroll (Notre Dame University), A/Prof Tom Briffa (University of WA), A/Prof. Kathy Briffa,
Osteoarthritis (OA) is a major cause of pain and disability in the community and OA of the knee is one of the most common causes of musculoskeletal disability in the Western world. Short-term pulsed electrical stimulation (PES), an intervention like TENS and interferential, offers potential to manage the symptoms of OA. It is inexpensive, has few contraindications to its use and has a putative disease-modifying effect.
This project aimed to determine the effectiveness of sub-sensory PES over 26 weeks in treating symptoms and improving function and physical activity in people with knee OA.
Seventy people with clinician diagnosed, radiologically confirmed knee OA were randomised to either active PES treatment (n=34) or placebo-control (n=36) in this randomised, controlled trial. Participants were directed to use the device for at least 7 hours/day for 26 weeks. Measurements were taken of participants’ pain, patient global assessment, functional ability, quality of life and physical activity levels at the beginning of the study and at various intervals over the 26 weeks.
Results showed that while participants’ pain levels improved substantially over the duration of the study, there was no difference evident between those people using the active PES device and those using the placebo device. No differences were found between groups in any of the other measures. Additionally, only two more people in the PES group achieved clinically relevant improvement in their pain when compared with the placebo group. Adjustment for covariates of sample characteristics, baseline measures and amount of time the devices were used did not influence the primary findings.
In this sample of people with OA of the knee, PES was no better than placebo in improving symptoms, functional ability and physical activity levels. Clinically meaningful improvements with PES though cannot be excluded in those who have more debilitating OA of the knee.
Arthritis Australia, Physiotherapy Research Foundation, Curtin University School of Physiotherapy
Scholarly Journal – Refereed Article
Fary R. E., & Briffa N. K. (2010)
Monophasic electrical stimulation produces high rates of adverse skin reactions in healthy subjects. Physiotherapy Theory and Practice. (In press).
Fary, R. E., Briffa, N. K., & Briffa, T. G. (2009)
Effectiveness of pulsed electrical stimulation in the management of osteoarthritis of the knee: three case reports. Physiother Theory Pract, 25(1), 21-29.
Fary, R. E., Carroll, G. J., Briffa, T. G., Gupta, R., & Briffa, N. K. (2008)
The effectiveness of pulsed electrical stimulation (E-PES) in the management of osteoarthritis of the knee: a protocol for a randomised controlled trial. BMC Musculoskelet Disord, 9, 18.
The effectiveness of pulsed electrical stimulation in the management of osteoarthritis of the knee: results of a randomised controlled trial. Presented by Robyn Fary at the American College of Rheumatology Annual Scientific Meeting, Philadelphia, USA, October 2009
Pulsed electrical stimulation is no better than placebo in managing osteoarthritis of the knee. Presented by Robyn Fary at the European League Against Rheumatism Congress, Rome, Italy, June 2010