Knee Injury
Conditions
Keywords
Muscle strength, Electrical muscle stimulation, Strength training
Brief summary
The purpose of this project is to compare three treatment regimens for knee injury to the standard rehabilitation protocol: 1) NMES, 2) graduated strength walking (via a weighted vest), and 3) NMES combined with graduated strength walking. Each treatment arm will be supplemented by the standard of care and compared to a group who receive the standard rehabilitation only. The Study will compare the effects of NMES, Strength Walking and combined NMES/ Strength Walking on strength, mobility, symptomatology, and Quality of Life (QOL) in military members with knee injury to a standard rehabilitation protocol program only. All groups will participate in standard rehabilitation protocol. The groups will be assessed over 18 weeks to compare main and interactive effects over time.
Detailed description
The prevalence of knee injuries has shown a striking increase of \>24% over the last 5 years, affecting work performance, limiting mobility, and impacting military deployment health. This increase reflects the current high op-tempo and frequent deployments of a nation at war including activities related to military operations, physical fitness, and demanding training. We have shown that neuromuscular electrical stimulation (NMES) improves quadriceps muscle strength. We have also shown that a pedometer-based protocol improves fitness. The overall objective of this project is to compare three treatment regimens for knee injury to the standard rehabilitation protocol as potential treatments for improving strength, work efficiency, and mobility in active duty military personnel with a knee injury. Our central hypothesis is that the combination of NMES and walking while wearing a weighted vest will demonstrate greater improvements in muscle strength, work efficiency, and mobility, as compared to the usual care alone. The rationale is that NMES combined with graduated strength walking could produce marked improvements in muscle strength and thereby enhance work performance, readiness and fitness, decrease physical symptoms and faster return to duty. NMES and graduated strength walking, simulate the current uniform in the theatre of operation (body armor).The specific aims are to compare the effectiveness of three treatment regimens to the usual care in improving: (1) muscle strength, (2) work efficiency, (3) mobility, (4) symptoms/pain, and (5) quality of life. After baseline testing, we propose to randomly assign male and female subjects (n=132) ages 18 to 50 years with a knee injury to one of 4 groups: 1) NMES, 2) strength walking, 3) NMES and strength walking, or 4) usual care. All groups will receive 12-weeks of the intervention and 6-weeks of follow-up. Generalized estimating equation (GEE) methods will be used to build regression models for statistical analysis of longitudinal data. If the interventions are effective with respect to parameters of strength, mobility, work performance, and symptoms, recommendations for future treatments can be made. This is hugely important, given the rising rate of knee injuries and the possibility that provider-managed care would be critical for assisting our warriors in a rapid recovery and return to duty.
Interventions
DEVICENMES
Participants will train at 15-20% of maximal voluntary contraction (MVC) during weeks 1-3, 21-30% of MVC during weeks 3-6 and 31-40% of MVC during weeks 6-9, 41-50% of MVC during weeks 9-12, then sustain 50% of MVC during weeks 12-18. Incremental increases will be made at the 3, 6, 9, and 12-week clinic visits.
BEHAVIORALStrength Walking
Strength Walking participants will maintain a daily training log. Pedometer readings will form the basis for setting activity goals. Initial step goals will be 10% above the average 3-day pedometer step count taken at baseline, with a 10% increase every other week, and then a gradual increase when 30% above the baseline step count has been achieved. At week 7, participants will be given a weighted vest to begin the strengthening component. Participants will be instructed to wear the vest during their 30-minute walk, 3 to 4 days a week. The beginning weight load for the vest will be calculated using 2% of baseline body weight and it will be increased by that same amount every week thereafter until the end of the 12 weeks.
BEHAVIORALStandard Rehabilitation Protocol
All participants will receive the current standard of care at the 2 military sites (Walter Reed National Military Medical Center (WRNMMC) and Malcolm Grow Medical Clinics and Surgery Center (MGMCSC)) of the physical therapy rehabilitation protocol for knee injuries. This program includes treatment with a physical therapist at WRNMMC and MGMCSC physical therapy clinic.
Sponsors
Walter Reed National Military Medical Center
Malcolm Grow Medical Clinics and Surgery Center
University of Tennessee
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* A diagnosis of knee injury (internal derangement of the knee with new effusion, including knee sprain or strains, meniscal tear, cruciate ligamentous tear, and chondral flap or injury); * A diagnosis of knee pain that is anterior knee pain, overuse pain, patella-femoral pain, and chronic pain (less than 6 months) associated with overuse syndromes which negatively impacts performance by (a) pain in 1 or both knees on most days of the month; b) self reported difficulty performing at least one or more tasks due to pain: stair climbing, rising from a chair, walking or running a quarter mile, repetitive movements such as kneeling or squatting or stooping, pain that inhibits job performance and daily activities; * Military service member at the time of injury (active duty military and Reserve/ National Guard in active duty status); * Age ≥18 and ≤50 years; * Ability to provide freely given informed consent.
Exclusion criteria
* Fracture or injury to external knee structures such that knee extension or flexion is impaired; * Evidence of a fracture on radiographs or clinical evidence of unstable tendon tear/rupture; * A significant co-morbid medical condition (such as severe hypertension or neurological disorder in which NMES strength training or unsupervised exercise is contraindicated and would pose a safety threat or impair ability to participate; * Inability or unwillingness to participate in a walking or strengthening program; * Inability to speak and/or read English; * Reduced sensory perception in the lower extremities; * Inability to walk on a treadmill without an assistive device; * Vision impairment, where participant is classified as legally blind; * Unwillingness to accept random assignment; * Pregnancy; * A score of 23 or greater on the Center for Epidemiological Studies- Depression scale (CES-D); * If the person has a demand type implanted pacemaker or defibrillator.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lower Extremity Muscle Strength- Extension | 0, 3, 6, 9, 12, and 18 weeks | Muscle strength was measured with a handheld dynamometer for extensor knee strength of the injured and uninjured knee. |
| Lower Extremity Muscle Strength- Flexion | 0, 3, 6, 9, 12, and 18 weeks | Muscle strength was measured with a handheld dynamometer for flexor knee strength of the injured and uninjured knee. |
| Lower Extremity Mobility- 6-Minute Walk Test | 0, 6, 12, and 18 weeks | Mobility was measured by the distance walked at a fast pace over 6-minutes, |
| Lower Extremity Strength- Chair Test | 0, 6, 12, and 18 weeks | Mobility was measured by the number of complete standing and sitting cycles in 30-seconds |
| Lower Extremity Mobility and Endurance- Step Test | 0, 6, 12, and 18 weeks | Mobility and endurance were measured by the number of up and down step cycles completed in 2-minutes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall Pain Severity | 0, 3, 6, 9, 12, and 18 weeks | Pain severity was measured using item 3 from the IDKC Subjective Knee Evaluation: If you have knee pain, how severe is it? Participants responded using a scale of 0 (no pain) to 10 (worst pain imaginable). A mean pain score was calculated. |
| Knee Pain Following Performance Testing- 6-Minute Walk Test | 0, 6, 12, and 18 weeks | Knee pain intensity after the 6-Minute Walk Test was assessed using the Visual Analog Scale, an 11-point numerical rating scale. Participants rated current knee pain intensity on a scale of 0 (no pain) to 10 (worst pain imaginable). A mean pain score was calculated. |
| Knee Pain Following Performance Testing- Chair Stand Test | 0, 6, 12, and 18 weeks | Knee pain intensity after the 30-Second Chair Stand Test was assessed using the Visual Analog Scale, an 11-point numerical rating scale. Participants rated current knee pain intensity on a scale of 0 (no pain) to 10 (worst pain imaginable). A mean pain score was calculated. |
| Knee Pain Following Performance Testing- 2-Minute Step Test | 0, 6, 12, and 18 weeks | Knee pain intensity after the 2-Minute Step Test was assessed using the Visual Analog Scale, an 11-point numerical rating scale. Participants rated current knee pain intensity on a scale of 0 (no pain) to 10 (worst pain imaginable). A mean pain score was calculated. |
| Activities of Daily Living- Knee Symptoms | 0, 3, 6, 9, 12, and 18 weeks | The Activities of Daily Living Scale was used to measure self-perceived knee symptoms while performing typical activities. The knee symptom subscale ranges from I do not have the symptom to The symptom prevents me from all daily activity. Scores ranged from 0-35. Higher scores are associated with diminished symptoms. A mean score was calculated. |
| Activities of Daily Living- Activity Limitation | 0, 3, 6, 9, 12, and 18 weeks | The Activities of Daily Living Scale was used to measure self-perceived limitations while performing typical activities. The limitation subscale ranges from Activity is not difficult to I am unable to do the activity. Scores range from 0-45. Higher scores are associated with diminished symptoms. A mean score was calculated. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Standard Rehabilitation Protocol (SRP) Standard Rehabilitation Protocol: All participants will receive the current standard of care at the 2 military sites (Walter Reed National Military Medical Center (WRNMMC) and Malcolm Grow Medical Clinics and Surgery Center (MGMCSC)) of the physical therapy rehabilitation protocol for knee injuries. This program includes treatment with a physical therapist at WRNMMC and MGMCSC physical therapy clinic. | 19 |
| NMES w/ SRP NMES (EMPI 300PV stimulator) plus SRP: NMES training consisted of four 30-minute stimulation sessions per week for 12 weeks; each 30-minute session entails 15 minutes/leg with 15 contractions per leg.
Weeks 1-3: 15-20% of maximal voluntary contraction (MVC); Weeks 3-6: 20-30% of MVC; Weeks 6-9: 30-40% of MVC; Weeks 9-12: 40-50% of MVC; Weeks 12-18: sustain 50% of MVC. Incremental increases made at the 3, 6, 9, and 12-week clinic visits. | 19 |
| Strength Walking w/ SRP Home-Based Pedometer-Driven Walking Program plus SRP: Participants were given a pedometer to monitor daily steps and a weighted exercise vest at Week 7 to begin the strengthening component. A series of 10-minute lessons focused on increasing physical activity through lifestyle education and the use of a pedometer as a motivational tool.
Participants maintain a daily training log. Pedometer readings used for setting activity goals. Initial step goals: 10% above the average 3-day pedometer step count at baseline. A 10% increase every other week, then a gradual increase when 30% above the baseline step count has been achieved. At week 7, participants will be given a vest to begin the strengthening component. The beginning weight load for the vest is calculated using 2% of baseline body weight and increased by the same amount every week until the end of the 12 weeks. | 20 |
| NMES/Strength Walking w/ SRP NMES, Home-Based Pedometer-Driven Walking Program plus SRP: This group will follow the protocol for both the NMES training and Strength Walking. | 20 |
| Total | 78 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Overall Study | Lost to Follow-up | 3 | 4 | 0 | 3 |
| Overall Study | Withdrawal by Subject | 3 | 4 | 9 | 2 |
Baseline characteristics
| Characteristic | Standard Rehabilitation Protocol (SRP) | NMES w/ SRP | Strength Walking w/ SRP | NMES/Strength Walking w/ SRP | Total |
|---|---|---|---|---|---|
| Age, Continuous | 33 years STANDARD_DEVIATION 8.4 | 35 years STANDARD_DEVIATION 7.9 | 35 years STANDARD_DEVIATION 11.3 | 33 years STANDARD_DEVIATION 6.1 | 34 years STANDARD_DEVIATION 8.5 |
| Race/Ethnicity, Customized Race African-American | 8 Participants | 6 Participants | 7 Participants | 5 Participants | 26 Participants |
| Race/Ethnicity, Customized Race Asian/Pacific | 0 Participants | 0 Participants | 2 Participants | 1 Participants | 3 Participants |
| Race/Ethnicity, Customized Race Caucasian | 8 Participants | 11 Participants | 8 Participants | 13 Participants | 40 Participants |
| Race/Ethnicity, Customized Race Missing | 0 Participants | 1 Participants | 1 Participants | 0 Participants | 2 Participants |
| Race/Ethnicity, Customized Race Multi-racial | 3 Participants | 1 Participants | 2 Participants | 1 Participants | 7 Participants |
| Sex: Female, Male Female | 10 Participants | 10 Participants | 11 Participants | 11 Participants | 42 Participants |
| Sex: Female, Male Male | 9 Participants | 9 Participants | 9 Participants | 9 Participants | 36 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 19 | 0 / 19 | 0 / 20 | 0 / 20 |
| other Total, other adverse events | 0 / 19 | 0 / 19 | 0 / 20 | 0 / 20 |
| serious Total, serious adverse events | 0 / 19 | 0 / 19 | 0 / 20 | 0 / 20 |
Outcome results
Primary
Lower Extremity Mobility- 6-Minute Walk Test
Mobility was measured by the distance walked at a fast pace over 6-minutes,
Time frame: 0, 6, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Mobility- 6-Minute Walk Test | Week 0 | 19800 Inches | Standard Deviation 3398 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Mobility- 6-Minute Walk Test | Week 6 | 21822 Inches | Standard Deviation 4346 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Mobility- 6-Minute Walk Test | Week 12 | 21404 Inches | Standard Deviation 2534 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Mobility- 6-Minute Walk Test | Week 18 | 21210 Inches | Standard Deviation 3718 |
| NMES w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 6 | 21696 Inches | Standard Deviation 3905 |
| NMES w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 12 | 22210 Inches | Standard Deviation 3991 |
| NMES w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 18 | 22984 Inches | Standard Deviation 3390 |
| NMES w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 0 | 20224 Inches | Standard Deviation 5162 |
| Strength Walking w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 12 | 21595 Inches | Standard Deviation 3092 |
| Strength Walking w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 6 | 22197 Inches | Standard Deviation 3242 |
| Strength Walking w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 18 | 22105 Inches | Standard Deviation 3718 |
| Strength Walking w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 0 | 19728 Inches | Standard Deviation 5347 |
| NMES/Strength Walking w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 18 | 22945 Inches | Standard Deviation 2883 |
| NMES/Strength Walking w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 6 | 21696 Inches | Standard Deviation 3905 |
| NMES/Strength Walking w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 0 | 18974 Inches | Standard Deviation 4603 |
| NMES/Strength Walking w/ SRP | Lower Extremity Mobility- 6-Minute Walk Test | Week 12 | 20824 Inches | Standard Deviation 6223 |
Primary
Lower Extremity Mobility and Endurance- Step Test
Mobility and endurance were measured by the number of up and down step cycles completed in 2-minutes.
Time frame: 0, 6, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Mobility and Endurance- Step Test | Week 6 | 185 Step Cycles | Standard Deviation 76 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Mobility and Endurance- Step Test | Week 0 | 189 Step Cycles | Standard Deviation 67 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Mobility and Endurance- Step Test | Week 18 | 202 Step Cycles | Standard Deviation 92 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Mobility and Endurance- Step Test | Week 12 | 180 Step Cycles | Standard Deviation 82 |
| NMES w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 0 | 162 Step Cycles | Standard Deviation 62 |
| NMES w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 6 | 178 Step Cycles | Standard Deviation 78 |
| NMES w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 12 | 235 Step Cycles | Standard Deviation 46 |
| NMES w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 18 | 233 Step Cycles | Standard Deviation 75 |
| Strength Walking w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 0 | 199 Step Cycles | Standard Deviation 60 |
| Strength Walking w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 12 | 258 Step Cycles | Standard Deviation 42 |
| Strength Walking w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 6 | 224 Step Cycles | Standard Deviation 64 |
| Strength Walking w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 18 | 224 Step Cycles | Standard Deviation 56 |
| NMES/Strength Walking w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 6 | 205 Step Cycles | Standard Deviation 75 |
| NMES/Strength Walking w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 12 | 202 Step Cycles | Standard Deviation 73 |
| NMES/Strength Walking w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 18 | 216 Step Cycles | Standard Deviation 73 |
| NMES/Strength Walking w/ SRP | Lower Extremity Mobility and Endurance- Step Test | Week 0 | 172 Step Cycles | Standard Deviation 67 |
Primary
Lower Extremity Muscle Strength- Extension
Muscle strength was measured with a handheld dynamometer for extensor knee strength of the injured and uninjured knee.
Time frame: 0, 3, 6, 9, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 9 | 27.2 Kilograms | Standard Deviation 14 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 18 | 27.6 Kilograms | Standard Deviation 12 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 3 | 26 Kilograms | Standard Deviation 15.5 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 0 | 27.5 Kilograms | Standard Deviation 12.4 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 6 | 25.4 Kilograms | Standard Deviation 11.2 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 6 | 23.3 Kilograms | Standard Deviation 11.5 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 9 | 26 Kilograms | Standard Deviation 15.1 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 3 | 25.4 Kilograms | Standard Deviation 15.9 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 12 | 25.8 Kilograms | Standard Deviation 14.2 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 12 | 27.8 Kilograms | Standard Deviation 16 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 18 | 28.5 Kilograms | Standard Deviation 17.3 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 0 | 28.2 Kilograms | Standard Deviation 13 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 3 | 32 Kilograms | Standard Deviation 10.4 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 0 | 37.2 Kilograms | Standard Deviation 16.4 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 9 | 33.9 Kilograms | Standard Deviation 13.6 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 6 | 35.9 Kilograms | Standard Deviation 13.9 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 9 | 35.9 Kilograms | Standard Deviation 15.1 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 3 | 38.3 Kilograms | Standard Deviation 18.8 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 0 | 32.6 Kilograms | Standard Deviation 14.7 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 18 | 36.2 Kilograms | Standard Deviation 10.2 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 12 | 33 Kilograms | Standard Deviation 10.6 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 6 | 33.7 Kilograms | Standard Deviation 11.5 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 18 | 32.3 Kilograms | Standard Deviation 9.1 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 12 | 35.8 Kilograms | Standard Deviation 12.6 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 3 | 34.5 Kilograms | Standard Deviation 14.9 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 0 | 32.1 Kilograms | Standard Deviation 15.5 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 3 | 30.4 Kilograms | Standard Deviation 10.3 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 6 | 29.8 Kilograms | Standard Deviation 10 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 9 | 29.2 Kilograms | Standard Deviation 13.7 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 12 | 32.7 Kilograms | Standard Deviation 16.6 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 18 | 31 Kilograms | Standard Deviation 16.6 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 0 | 36.2 Kilograms | Standard Deviation 21.2 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 6 | 34.2 Kilograms | Standard Deviation 15.1 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 9 | 29.8 Kilograms | Standard Deviation 19.9 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 12 | 33.8 Kilograms | Standard Deviation 15.9 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 18 | 33.2 Kilograms | Standard Deviation 20.3 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 18 | 33.5 Kilograms | Standard Deviation 15.8 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 12 | 30.8 Kilograms | Standard Deviation 14.8 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 0 | 24.3 Kilograms | Standard Deviation 11.4 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 9 | 36.2 Kilograms | Standard Deviation 18.3 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 9 | 34 Kilograms | Standard Deviation 16.8 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 6 | 27.1 Kilograms | Standard Deviation 13.4 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 18 | 38.6 Kilograms | Standard Deviation 22.1 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 12 | 38.7 Kilograms | Standard Deviation 22.6 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 3 | 28 Kilograms | Standard Deviation 13.8 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 0 | 27.6 Kilograms | Standard Deviation 14 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 3 | 27.8 Kilograms | Standard Deviation 13.7 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Extension | Uninjured Knee: Week 6 | 33.5 Kilograms | Standard Deviation 19.4 |
Primary
Lower Extremity Muscle Strength- Flexion
Muscle strength was measured with a handheld dynamometer for flexor knee strength of the injured and uninjured knee.
Time frame: 0, 3, 6, 9, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 0 | 20 Kilograms | Standard Deviation 6.7 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 6 | 16.9 Kilograms | Standard Deviation 7.2 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 12 | 17.3 Kilograms | Standard Deviation 8.4 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 9 | 15.6 Kilograms | Standard Deviation 12.6 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 3 | 20.1 Kilograms | Standard Deviation 7.9 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 0 | 16.2 Kilograms | Standard Deviation 9.4 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 3 | 15.3 Kilograms | Standard Deviation 8.3 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 12 | 14.5 Kilograms | Standard Deviation 7.3 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 6 | 15.4 Kilograms | Standard Deviation 9.9 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 18 | 18.1 Kilograms | Standard Deviation 6.8 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 9 | 17.5 Kilograms | Standard Deviation 12.6 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 18 | 14.7 Kilograms | Standard Deviation 7.8 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 6 | 21.3 Kilograms | Standard Deviation 12.1 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 6 | 22.9 Kilograms | Standard Deviation 6.6 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 3 | 23.5 Kilograms | Standard Deviation 8.2 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 0 | 22.5 Kilograms | Standard Deviation 8.4 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 3 | 16.9 Kilograms | Standard Deviation 4.8 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 12 | 22.7 Kilograms | Standard Deviation 6.4 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 18 | 17.4 Kilograms | Standard Deviation 4 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 0 | 16.6 Kilograms | Standard Deviation 7 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 9 | 15.3 Kilograms | Standard Deviation 4.9 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 18 | 23.1 Kilograms | Standard Deviation 8.2 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 9 | 20.8 Kilograms | Standard Deviation 5.2 |
| NMES w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 12 | 16.5 Kilograms | Standard Deviation 4.5 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 3 | 22.7 Kilograms | Standard Deviation 7.4 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 0 | 22.6 Kilograms | Standard Deviation 8 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 0 | 16.2 Kilograms | Standard Deviation 8.6 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 3 | 17.8 Kilograms | Standard Deviation 5.5 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 6 | 15 Kilograms | Standard Deviation 4.5 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 9 | 15.9 Kilograms | Standard Deviation 5.6 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 12 | 18.4 Kilograms | Standard Deviation 5.7 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 18 | 15.4 Kilograms | Standard Deviation 5.5 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 6 | 19.8 Kilograms | Standard Deviation 6.4 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 9 | 23 Kilograms | Standard Deviation 10.4 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 12 | 25.9 Kilograms | Standard Deviation 12.2 |
| Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 18 | 24.1 Kilograms | Standard Deviation 12 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 12 | 17.3 Kilograms | Standard Deviation 7.4 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 9 | 16.6 Kilograms | Standard Deviation 7.2 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 0 | 19.8 Kilograms | Standard Deviation 8.6 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 9 | 27.4 Kilograms | Standard Deviation 15.7 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 6 | 14.8 Kilograms | Standard Deviation 5.9 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 3 | 14.9 Kilograms | Standard Deviation 7.4 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 18 | 24.2 Kilograms | Standard Deviation 11.3 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 12 | 23 Kilograms | Standard Deviation 11.1 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 3 | 20.2 Kilograms | Standard Deviation 7.5 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 18 | 19.3 Kilograms | Standard Deviation 10.4 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 0 | 13.7 Kilograms | Standard Deviation 6.9 |
| NMES/Strength Walking w/ SRP | Lower Extremity Muscle Strength- Flexion | Uninjured Knee: Week 6 | 19.9 Kilograms | Standard Deviation 10.3 |
Primary
Lower Extremity Strength- Chair Test
Mobility was measured by the number of complete standing and sitting cycles in 30-seconds
Time frame: 0, 6, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Strength- Chair Test | Week 0 | 11.3 Rises | Standard Deviation 3.7 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Strength- Chair Test | Week 6 | 12.7 Rises | Standard Deviation 3.8 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Strength- Chair Test | Week 12 | 13.3 Rises | Standard Deviation 4.8 |
| Standard Rehabilitation Protocol (SRP) | Lower Extremity Strength- Chair Test | Week 18 | 13.3 Rises | Standard Deviation 3.7 |
| NMES w/ SRP | Lower Extremity Strength- Chair Test | Week 6 | 13.6 Rises | Standard Deviation 2.6 |
| NMES w/ SRP | Lower Extremity Strength- Chair Test | Week 12 | 13.9 Rises | Standard Deviation 2.3 |
| NMES w/ SRP | Lower Extremity Strength- Chair Test | Week 18 | 14.4 Rises | Standard Deviation 1.5 |
| NMES w/ SRP | Lower Extremity Strength- Chair Test | Week 0 | 11.4 Rises | Standard Deviation 1.8 |
| Strength Walking w/ SRP | Lower Extremity Strength- Chair Test | Week 12 | 14.4 Rises | Standard Deviation 2.3 |
| Strength Walking w/ SRP | Lower Extremity Strength- Chair Test | Week 6 | 14.4 Rises | Standard Deviation 4 |
| Strength Walking w/ SRP | Lower Extremity Strength- Chair Test | Week 18 | 15 Rises | Standard Deviation 2.7 |
| Strength Walking w/ SRP | Lower Extremity Strength- Chair Test | Week 0 | 12.7 Rises | Standard Deviation 3.9 |
| NMES/Strength Walking w/ SRP | Lower Extremity Strength- Chair Test | Week 18 | 15.2 Rises | Standard Deviation 2.2 |
| NMES/Strength Walking w/ SRP | Lower Extremity Strength- Chair Test | Week 6 | 13.2 Rises | Standard Deviation 1.9 |
| NMES/Strength Walking w/ SRP | Lower Extremity Strength- Chair Test | Week 0 | 10.7 Rises | Standard Deviation 2.8 |
| NMES/Strength Walking w/ SRP | Lower Extremity Strength- Chair Test | Week 12 | 14.5 Rises | Standard Deviation 2.1 |
Secondary
Activities of Daily Living- Activity Limitation
The Activities of Daily Living Scale was used to measure self-perceived limitations while performing typical activities. The limitation subscale ranges from Activity is not difficult to I am unable to do the activity. Scores range from 0-45. Higher scores are associated with diminished symptoms. A mean score was calculated.
Time frame: 0, 3, 6, 9, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Activity Limitation | Week 0 | 32.9 score on a scale | Standard Deviation 6.1 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Activity Limitation | Week 3 | 33.4 score on a scale | Standard Deviation 6.4 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Activity Limitation | Week 6 | 33.5 score on a scale | Standard Deviation 8.1 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Activity Limitation | Week 9 | 31.8 score on a scale | Standard Deviation 6.9 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Activity Limitation | Week 12 | 32.9 score on a scale | Standard Deviation 7.7 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Activity Limitation | Week 18 | 36.4 score on a scale | Standard Deviation 6.7 |
| NMES w/ SRP | Activities of Daily Living- Activity Limitation | Week 18 | 38.1 score on a scale | Standard Deviation 4.9 |
| NMES w/ SRP | Activities of Daily Living- Activity Limitation | Week 9 | 39.8 score on a scale | Standard Deviation 4.1 |
| NMES w/ SRP | Activities of Daily Living- Activity Limitation | Week 0 | 30.9 score on a scale | Standard Deviation 4.9 |
| NMES w/ SRP | Activities of Daily Living- Activity Limitation | Week 6 | 35.5 score on a scale | Standard Deviation 5.5 |
| NMES w/ SRP | Activities of Daily Living- Activity Limitation | Week 3 | 33.3 score on a scale | Standard Deviation 5.2 |
| NMES w/ SRP | Activities of Daily Living- Activity Limitation | Week 12 | 35.7 score on a scale | Standard Deviation 5.9 |
| Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 3 | 34.8 score on a scale | Standard Deviation 5.8 |
| Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 6 | 34.9 score on a scale | Standard Deviation 6.1 |
| Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 9 | 35.3 score on a scale | Standard Deviation 5.8 |
| Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 18 | 36.9 score on a scale | Standard Deviation 6 |
| Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 12 | 36.7 score on a scale | Standard Deviation 5.1 |
| Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 0 | 30.9 score on a scale | Standard Deviation 7.2 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 12 | 36.6 score on a scale | Standard Deviation 5.4 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 18 | 38.6 score on a scale | Standard Deviation 5.6 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 3 | 33 score on a scale | Standard Deviation 3 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 9 | 36.5 score on a scale | Standard Deviation 4.4 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 0 | 31.5 score on a scale | Standard Deviation 2.4 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Activity Limitation | Week 6 | 35.6 score on a scale | Standard Deviation 4.4 |
Secondary
Activities of Daily Living- Knee Symptoms
The Activities of Daily Living Scale was used to measure self-perceived knee symptoms while performing typical activities. The knee symptom subscale ranges from I do not have the symptom to The symptom prevents me from all daily activity. Scores ranged from 0-35. Higher scores are associated with diminished symptoms. A mean score was calculated.
Time frame: 0, 3, 6, 9, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Knee Symptoms | Week 0 | 25.4 score on a scale | Standard Deviation 4.7 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Knee Symptoms | Week 3 | 25.0 score on a scale | Standard Deviation 5.5 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Knee Symptoms | Week 6 | 24.4 score on a scale | Standard Deviation 6.5 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Knee Symptoms | Week 9 | 25 score on a scale | Standard Deviation 6.1 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Knee Symptoms | Week 12 | 27.8 score on a scale | Standard Deviation 6.3 |
| Standard Rehabilitation Protocol (SRP) | Activities of Daily Living- Knee Symptoms | Week 18 | 29.6 score on a scale | Standard Deviation 5.2 |
| NMES w/ SRP | Activities of Daily Living- Knee Symptoms | Week 18 | 29.7 score on a scale | Standard Deviation 4.7 |
| NMES w/ SRP | Activities of Daily Living- Knee Symptoms | Week 9 | 29.3 score on a scale | Standard Deviation 6.6 |
| NMES w/ SRP | Activities of Daily Living- Knee Symptoms | Week 0 | 23.3 score on a scale | Standard Deviation 6.3 |
| NMES w/ SRP | Activities of Daily Living- Knee Symptoms | Week 6 | 27.9 score on a scale | Standard Deviation 6.4 |
| NMES w/ SRP | Activities of Daily Living- Knee Symptoms | Week 3 | 24.6 score on a scale | Standard Deviation 6.9 |
| NMES w/ SRP | Activities of Daily Living- Knee Symptoms | Week 12 | 26.5 score on a scale | Standard Deviation 7.6 |
| Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 3 | 26.2 score on a scale | Standard Deviation 6 |
| Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 6 | 28.1 score on a scale | Standard Deviation 4.7 |
| Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 9 | 29.6 score on a scale | Standard Deviation 4.1 |
| Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 18 | 30.9 score on a scale | Standard Deviation 4.3 |
| Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 12 | 30.8 score on a scale | Standard Deviation 3 |
| Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 0 | 25.1 score on a scale | Standard Deviation 5.2 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 12 | 27.6 score on a scale | Standard Deviation 4.8 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 18 | 29.8 score on a scale | Standard Deviation 4.7 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 3 | 26 score on a scale | Standard Deviation 2.8 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 9 | 27.2 score on a scale | Standard Deviation 4.7 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 0 | 22.9 score on a scale | Standard Deviation 4.3 |
| NMES/Strength Walking w/ SRP | Activities of Daily Living- Knee Symptoms | Week 6 | 27.4 score on a scale | Standard Deviation 4 |
Secondary
Knee Pain Following Performance Testing- 2-Minute Step Test
Knee pain intensity after the 2-Minute Step Test was assessed using the Visual Analog Scale, an 11-point numerical rating scale. Participants rated current knee pain intensity on a scale of 0 (no pain) to 10 (worst pain imaginable). A mean pain score was calculated.
Time frame: 0, 6, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 6 | 3.5 score on a scale | Standard Deviation 2.8 |
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 0 | 4.0 score on a scale | Standard Deviation 2.4 |
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 12 | 2.9 score on a scale | Standard Deviation 2.6 |
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 18 | 2.6 score on a scale | Standard Deviation 2.4 |
| NMES w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 6 | 2.1 score on a scale | Standard Deviation 2.5 |
| NMES w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 12 | 3.0 score on a scale | Standard Deviation 2.4 |
| NMES w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 0 | 3.7 score on a scale | Standard Deviation 2.7 |
| NMES w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 18 | 1.7 score on a scale | Standard Deviation 2.4 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 0 | 3.0 score on a scale | Standard Deviation 2.1 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 6 | 2.5 score on a scale | Standard Deviation 2.5 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 18 | 2.1 score on a scale | Standard Deviation 2.7 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 12 | 3.0 score on a scale | Standard Deviation 2.4 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 18 | 1.8 score on a scale | Standard Deviation 2.6 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 12 | 1.9 score on a scale | Standard Deviation 2.3 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 6 | 2.4 score on a scale | Standard Deviation 1.4 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- 2-Minute Step Test | Week 0 | 3.7 score on a scale | Standard Deviation 2.4 |
Secondary
Knee Pain Following Performance Testing- 6-Minute Walk Test
Knee pain intensity after the 6-Minute Walk Test was assessed using the Visual Analog Scale, an 11-point numerical rating scale. Participants rated current knee pain intensity on a scale of 0 (no pain) to 10 (worst pain imaginable). A mean pain score was calculated.
Time frame: 0, 6, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 0 | 2.4 score on a scale | Standard Deviation 2.2 |
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 6 | 3.2 score on a scale | Standard Deviation 2.5 |
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 12 | 2.7 score on a scale | Standard Deviation 2.1 |
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 18 | 2.3 score on a scale | Standard Deviation 2.1 |
| NMES w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 6 | 1.6 score on a scale | Standard Deviation 1.9 |
| NMES w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 12 | 1.9 score on a scale | Standard Deviation 2.1 |
| NMES w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 18 | 1.6 score on a scale | Standard Deviation 2.2 |
| NMES w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 0 | 2.9 score on a scale | Standard Deviation 2.4 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 12 | 1.6 score on a scale | Standard Deviation 2 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 6 | 1.7 score on a scale | Standard Deviation 2.8 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 18 | 2.1 score on a scale | Standard Deviation 2.9 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 0 | 1.8 score on a scale | Standard Deviation 2.1 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 18 | 1.2 score on a scale | Standard Deviation 2.1 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 6 | 1.4 score on a scale | Standard Deviation 1.2 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 0 | 2.5 score on a scale | Standard Deviation 2.1 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 12 | 1.6 score on a scale | Standard Deviation 1.7 |
Secondary
Knee Pain Following Performance Testing- Chair Stand Test
Knee pain intensity after the 30-Second Chair Stand Test was assessed using the Visual Analog Scale, an 11-point numerical rating scale. Participants rated current knee pain intensity on a scale of 0 (no pain) to 10 (worst pain imaginable). A mean pain score was calculated.
Time frame: 0, 6, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- Chair Stand Test | Week 0 | 3.7 score on a scale | Standard Deviation 2.3 |
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- Chair Stand Test | Week 6 | 3.5 score on a scale | Standard Deviation 2.6 |
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- Chair Stand Test | Week 12 | 2.8 score on a scale | Standard Deviation 2.2 |
| Standard Rehabilitation Protocol (SRP) | Knee Pain Following Performance Testing- Chair Stand Test | Week 18 | 2.4 score on a scale | Standard Deviation 2 |
| NMES w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 6 | 1.4 score on a scale | Standard Deviation 1.8 |
| NMES w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 12 | 2.0 score on a scale | Standard Deviation 2.6 |
| NMES w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 18 | 0.7 score on a scale | Standard Deviation 0.9 |
| NMES w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 0 | 2.5 score on a scale | Standard Deviation 2.4 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 12 | 1.7 score on a scale | Standard Deviation 2.5 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 6 | 1.4 score on a scale | Standard Deviation 2 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 18 | 1.5 score on a scale | Standard Deviation 2.2 |
| Strength Walking w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 0 | 2.1 score on a scale | Standard Deviation 1.9 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 18 | 0.8 score on a scale | Standard Deviation 1.5 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 6 | 1.2 score on a scale | Standard Deviation 1.4 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 0 | 2.7 score on a scale | Standard Deviation 1.4 |
| NMES/Strength Walking w/ SRP | Knee Pain Following Performance Testing- Chair Stand Test | Week 12 | 1.2 score on a scale | Standard Deviation 1.5 |
Secondary
Overall Pain Severity
Pain severity was measured using item 3 from the IDKC Subjective Knee Evaluation: If you have knee pain, how severe is it? Participants responded using a scale of 0 (no pain) to 10 (worst pain imaginable). A mean pain score was calculated.
Time frame: 0, 3, 6, 9, 12, and 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol (SRP) | Overall Pain Severity | Week 0 | 5.4 score on a scale | Standard Deviation 1.9 |
| Standard Rehabilitation Protocol (SRP) | Overall Pain Severity | Week 3 | 5.9 score on a scale | Standard Deviation 2.3 |
| Standard Rehabilitation Protocol (SRP) | Overall Pain Severity | Week 6 | 6.2 score on a scale | Standard Deviation 2.5 |
| Standard Rehabilitation Protocol (SRP) | Overall Pain Severity | Week 9 | 5.8 score on a scale | Standard Deviation 2.4 |
| Standard Rehabilitation Protocol (SRP) | Overall Pain Severity | Week 12 | 5.3 score on a scale | Standard Deviation 2.6 |
| Standard Rehabilitation Protocol (SRP) | Overall Pain Severity | Week 18 | 4.7 score on a scale | Standard Deviation 3.1 |
| NMES w/ SRP | Overall Pain Severity | Week 18 | 3.6 score on a scale | Standard Deviation 2.4 |
| NMES w/ SRP | Overall Pain Severity | Week 9 | 4.1 score on a scale | Standard Deviation 1.9 |
| NMES w/ SRP | Overall Pain Severity | Week 0 | 4.9 score on a scale | Standard Deviation 2.1 |
| NMES w/ SRP | Overall Pain Severity | Week 6 | 3.8 score on a scale | Standard Deviation 1.6 |
| NMES w/ SRP | Overall Pain Severity | Week 3 | 5 score on a scale | Standard Deviation 2.3 |
| NMES w/ SRP | Overall Pain Severity | Week 12 | 4.2 score on a scale | Standard Deviation 2.1 |
| Strength Walking w/ SRP | Overall Pain Severity | Week 3 | 5.4 score on a scale | Standard Deviation 1.9 |
| Strength Walking w/ SRP | Overall Pain Severity | Week 6 | 5.3 score on a scale | Standard Deviation 2.5 |
| Strength Walking w/ SRP | Overall Pain Severity | Week 9 | 4.4 score on a scale | Standard Deviation 1.7 |
| Strength Walking w/ SRP | Overall Pain Severity | Week 18 | 4.3 score on a scale | Standard Deviation 2.4 |
| Strength Walking w/ SRP | Overall Pain Severity | Week 12 | 5.1 score on a scale | Standard Deviation 2.7 |
| Strength Walking w/ SRP | Overall Pain Severity | Week 0 | 5.7 score on a scale | Standard Deviation 1.7 |
| NMES/Strength Walking w/ SRP | Overall Pain Severity | Week 12 | 4.5 score on a scale | Standard Deviation 2 |
| NMES/Strength Walking w/ SRP | Overall Pain Severity | Week 18 | 3.9 score on a scale | Standard Deviation 2.3 |
| NMES/Strength Walking w/ SRP | Overall Pain Severity | Week 3 | 5.0 score on a scale | Standard Deviation 1.8 |
| NMES/Strength Walking w/ SRP | Overall Pain Severity | Week 9 | 4.3 score on a scale | Standard Deviation 2.4 |
| NMES/Strength Walking w/ SRP | Overall Pain Severity | Week 0 | 5.1 score on a scale | Standard Deviation 1.9 |
| NMES/Strength Walking w/ SRP | Overall Pain Severity | Week 6 | 5.0 score on a scale | Standard Deviation 2.3 |