رشدي محمد كامل
أستاذ مساعد
The effectiveness of neuromuscular electrical stimulation on pain, function, and quadriceps muscle strength in adults with patellofemoral pain: A systematic review and meta-analysis
BMC Musculoskeletal Disorders • 2025
معلومات البحث
المؤلفون
Ahmed Ibrahim Abdelhamed
, Hossam Mortada, Ahmed Hendawy
, Amr Elfeky
, Roshdy M. Kamel and Shorouk Elshennawy
الكلمات المفتاحية
Patellofemoral pain, Neuromuscular electrical stimulation, Quadriceps muscle strength, Pain
المجلة العلمية
BMC Musculoskeletal Disorders
الناشر
Springer Nature
المجلد
26
العدد
70
الصفحات
1-13
publication.type
International
رابط البحث
Open Link
المواد المرفقة
Not Available
الملخص
Background Patellofemoral pain (PFP) is a chronic musculoskeletal disorder, with Neuromuscular electrical
stimulation (NMES) often used as a complementary treatment option, however no definitive evidence supports its
benefits. This systematic review aimed to evaluate the efficacy of adding NMES to exercise programs for treating PFP.
Methods PubMed, Cochrane CENTRAL, Web of Science, Scopus, PEDro, ClinicalTrails.gov and International Clinical
Trials Registry Platform were searched up to July 2024 for randomized controlled trials (RCTs) investigating the
effectiveness of NMES in people with PFP. Two researchers independently screened titles and abstracts; another pair
filtered full-text articles. The studies had to report pain, functionality, and strength as outcome measures. The risk
of bias was assessed using the revised Cochrane Collaboration tool (RoB 2.0). Meta-analysis was conducted using
RevMan 5.4.1 software, and the quality of evidence was evaluated using the GRADE approach.
Results Eleven RCTs, involving 571 participants, were included. Most of the studies were of high risk of bias.
NMES combined with exercise was favored in the long course for improving function (SMD: 3.74, 95% CI 1.35, 5.81;
P=0.0004) and quadriceps muscle strength (SMD: 0.53, 95% CI 0.18, 0.89; P=0.003) compared to exercise; however, it
did not differ from exercise in relieving pain and improving EMG activity level, and participation. The GRADE certainty
rating of the results was rated as very low mostly due to inconsistency and high risk of bias.
Conclusion Very low certainty of evidence suggests that adding NMES to an exercise program may improve the
knee joint function and quadriceps strength with treatment courses of six weeks or more in patients with PFP, but it
is not superior to control for reliving pain and improving EMG activity, activity level, and participation. Larger, highquality RCTs on the long-term are needed to reach an incisive conclusion.
Registration: The protocol was registered at Open Science Framework Register under https://doi.org/10.17605/OSF.I
O/Y2JUZ
stimulation (NMES) often used as a complementary treatment option, however no definitive evidence supports its
benefits. This systematic review aimed to evaluate the efficacy of adding NMES to exercise programs for treating PFP.
Methods PubMed, Cochrane CENTRAL, Web of Science, Scopus, PEDro, ClinicalTrails.gov and International Clinical
Trials Registry Platform were searched up to July 2024 for randomized controlled trials (RCTs) investigating the
effectiveness of NMES in people with PFP. Two researchers independently screened titles and abstracts; another pair
filtered full-text articles. The studies had to report pain, functionality, and strength as outcome measures. The risk
of bias was assessed using the revised Cochrane Collaboration tool (RoB 2.0). Meta-analysis was conducted using
RevMan 5.4.1 software, and the quality of evidence was evaluated using the GRADE approach.
Results Eleven RCTs, involving 571 participants, were included. Most of the studies were of high risk of bias.
NMES combined with exercise was favored in the long course for improving function (SMD: 3.74, 95% CI 1.35, 5.81;
P=0.0004) and quadriceps muscle strength (SMD: 0.53, 95% CI 0.18, 0.89; P=0.003) compared to exercise; however, it
did not differ from exercise in relieving pain and improving EMG activity level, and participation. The GRADE certainty
rating of the results was rated as very low mostly due to inconsistency and high risk of bias.
Conclusion Very low certainty of evidence suggests that adding NMES to an exercise program may improve the
knee joint function and quadriceps strength with treatment courses of six weeks or more in patients with PFP, but it
is not superior to control for reliving pain and improving EMG activity, activity level, and participation. Larger, highquality RCTs on the long-term are needed to reach an incisive conclusion.
Registration: The protocol was registered at Open Science Framework Register under https://doi.org/10.17605/OSF.I
O/Y2JUZ