Efeitos da estimulação elétrica neuromuscular na dor femoropatelar: ensaio controlado randomizado

Abstract

Introduction: Patellofemoral Pain (PFP) is a very frequent and debilitating musculoskeletal disorder that affects functionality and can compromise the performance of activities of daily living. This condition mainly affects the female population. Neuromuscular electrical stimulation (NMES) has been suggested as a complementary resource to the therapeutic approach, however, evidence of its use in PPD is controversial. Objective: To analyze the effects of adding neuromuscular electrical stimulation to a therapeutic exercise program with emphasis on the knee extensor and hip abductor groups, in women with Patellofemoral Pain. Methods: This is a randomized controlled trial, in which 34 women with PFP, mean age 23.8 (SD 4.1), were randomly distributed into 2 groups: exercises associated with NMES (ESG) and exercises (ExG). The ExG performed an exercise protocol aimed at training the knee extensors and hip abductors, while the ESG performed the same exercises, but associated with the NMES in the vastus medialis oblique (VMO) and gluteus medius (GM). Interventions were carried out in both groups, twice a week, for eight weeks, totaling 16 treatment sessions. The primary outcome measure was pain intensity and functional disability. Secondary outcome measures include VMO, vastus lateralis (VL), GM electromyographic activity, and isokinetic muscle performance of the knee extensors and hip abductors. These parameters were measured 72h before the beggining of the intervention (0 weeks evaluation- baseline), after 4 weeks (4 weeks evaluation), after 8 weeks (8 weeks evaluation) and after 16 weeks (16 weeks). Results: We did not observe any significant difference between the evaluated groups regarding pain intensity variables, functional disability, electromyographic activity, isokinetic performance of the knee extensors and isokinetic performance of the hip abductors (p>0.05). We evidenced a significant difference in the intragroup comparison for pain intensity (p<0.01; F=42.9; ηp2=0.57) and functional disability (p<0.01; F=43.0; ηp2=0, 57), in both groups. Conclusion: NMES did not demonstrate significant additional effects that justify its association with exercise in the treatment of PFP. However, the proposed therapeutic exercises were effective in reducing pain and improving functional disability, with a residual effect that remained eight wee ks after the end of treatment.