Patellofemoral Pain Syndrome
Conditions
Brief summary
The overall objective of this project is to compare the three home-managed treatment regimens for PFPS: neuromuscular electrical stimulation (NMES), transcutaneous electrical nerve stimulation (TENS), and NMES combined with TENS to a standard home exercise program (HEP). Each of the three treatment arms will be supplemented by HEP and compared to a group receiving standard HEP alone. The central hypothesis is that the combination of NMES with TENS will show significantly greater improvements in muscle strength, mobility, pain, daily activity and quality of life (QOL) than HEP alone. The investigators are examining: 1) whether the three treatment regimens are significantly more efficacious than standard HEP alone in improving lower extremity muscle strength, physical activity, mobility, pain, and quality of life; 2) lower extremity muscle strength, physical activity, mobility, pain, and quality of life differ significantly across the 4 time periods; 3) is there an interaction between treatment and time in relation to lower extremity muscle strength, physical activity, mobility, pain, and quality of life.
Detailed description
Patellofemoral pain syndrome (PFPS) is the most common diagnosis among active duty military presenting with knee pain in the military ambulatory care setting. The incidence of PFPS has shown a striking increase of \>11.3% over the last 4 years, affecting work performance, limiting activity, and impacting military deployment health. The investigators have shown that home-based neuromuscular electrical stimulation (NMES) is safe, portable, easy-to-use and improves quadriceps muscle strength with some pain relief. NMES and transcutaneous electrical nerve stimulation (TENS) devices are widely used by warfighters in the theatre of operation for knee problems. The overall objective of this project is to compare three home-managed treatment regimens for PFPS: NMES, TENS, and NMES combined with TENS to a standard home exercise program (HEP). The central hypothesis is that the combination of NMES with TENS will show significantly greater improvements in muscle strength, mobility, pain, daily activity and quality of life (QOL) than HEP alone. The rationale for this study is that increasing muscle strength and decreasing pain will significantly improve mobility, physical activity and QOL. Such outcomes will ultimately result in improved deployability, retention of military personnel and decreased economic costs in this population. The specific aims are to determine whether the three treatment regimens are significantly more efficacious than standard HEP for improving muscle strength, physical activity, mobility, QOL and symptoms of PFPS including pain. After consent and baseline testing, the investigators will randomly assign active duty male and female subjects, ages 18 to \<45, (n=136) with PFPS to one of the four groups. Each of the three treatment arms will be supplemented by HEP and compared to a group receiving standard HEP alone. All groups will receive 9 weeks of home therapy. Using GEE methods, the investigators will build longitudinal regression models so that differences in time trends for the outcome variables among controls and those in the treatment groups can be statistically assessed. Positive results could translate into accelerated rehabilitation, decreased symptoms and lower medical costs with better patient outcomes.
Interventions
All participants will receive a standard home-based exercise rehabilitation protocol for PFPS. HEP teaches muscle strengthening exercises and self-management strategies to prevent recurrence. This program includes sessions with the study coordinator. A handout and given a demonstration of the daily exercises to be performed at home and weekly communication from the study coordinator regarding compliance with the exercises.
DEVICENMES
To ensure consistent interventions across participants, a specified percentage of baseline maximal voluntary contraction (% MVC) will be used to determine the intensity of the training contraction. The electrical amplitude to obtain the desired intensity will be determined for each participant. Participants will train at 20-30% of MVC during weeks 1-3, 30-40% of MVC during weeks 3-6, and 40-50% of MVC during weeks 6-9. Incremental increases will be made at the 3 and 6 week clinic visits. Individualized instructions for adjusting the amplitude dial settings, with a return demonstration, will be used to maintain the appropriate percentage of MVC. During the home training sessions, participants will adjust the amplitude required to achieve the desired goal, as tolerated.
DEVICETENS
The TENS protocol consists of 20-minutes of TENS stimulation while concurrently performing the HEP. The TENS with HEP and HEP alone will be alternated for 9 weeks. The Active device delivers a pre-set program of pulsed electrostimulation using a patented asymmetrical simple modulated pulse (SMP) waveform. SMP delivers a group of pulses as a repeating 12-second cycle.
Sponsors
Blanchfield Army Community Hospital
University of Tennessee
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
The study will be open to all active duty personal who are: 1. diagnosed with knee pain, categorized as anterior or retropatellar in one or both knees; 2. self-reported difficulty performing at least two or more of the following activities associated with knee pain: prolonged sitting, stair climbing, running, jumping and repetitive movements such as kneeling or squatting or stooping; 3. military service member at the time of diagnosis; 4. age ≥18 and \<45 years; and 5. ability to provide freely given informed consent.
Exclusion criteria
Those who might be at risk of adverse outcomes from the study interventions will be excluded. This includes individuals with 1. Fracture or injury to external knee structures such that knee extension or flexion is impaired; 2. A significant co-morbid medical condition (such as severe hypertension, neurological disorder or pacemaker/defibrillator) in which NMES strength training or unsupervised exercise is contraindicated and would pose a safety threat or impair ability to participate; 3. Previous knee surgeries (i.e., tibiofemoral, patellofemoral) excluding knee arthroscopy; 4. Knee instability or recurrent patella dislocation or subluxation; 5. Inability or unwillingness to participate in a home exercise program or strengthening program; 6. Inability to speak and/or read English; 7. Reduced sensory perception in the lower extremities; 8. Pregnancy; 9. Vision impairment, where participant is classified as legally blind; 10. Unwillingness to accept random assignment; or 11. A score of 23 or greater on the Center for Epidemiological Studies-Depression scale (CES-D).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lower Extremity Mobility- 6-Minute Walk Test | 0, 3, 6, and 9 weeks | Mobility was measured by the distance walked at a fast pace over 6-minutes. |
| Lower Extremity Muscle Strength- Extension | 0, 3, 6, and 9 weeks | The NMMT is a handheld device which measures knee extensor (KE) and flexor (KF) muscle strength. The measurement of KE strength on the PFPS leg is reported. For each test, participants performed three maximal efforts holding each contraction for 4 seconds, separated by 30-second rest; the highest value of the three trials will be accepted in kilograms. |
| Lower Extremity Muscle Strength- Flexion | 0, 3, 6, and 9 weeks | The NMMT is a handheld device which measures knee extensor (KE) and flexor (KF) muscle strength. The measurement of KE strength on the PFPS leg is reported. For each test, participants performed three maximal efforts holding each contraction for 4 seconds, separated by 30-second rest; the highest value of the three trials will be accepted in kilograms. |
| Lower Extremity Strength- 30-Second Chair Stand Test | 0, 3, 6, and 9 weeks | Mobility was measured by the number of complete standing and sitting cycles in 30-seconds |
| Lower Extremity Strength- Timed Stair Climb Test | 0, 3, 6, and 9 weeks | Strength, balance, and power were measured by the number seconds it took to ascend and descend 4 steps (6 in rise, 11.5 in run). |
| Lower Extremity Mobility- Forward Step-down Test | 0, 3, 6, and 9 weeks | Mobility was measured by the number of step down repetitions completed in 30 seconds. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Knee Pain Following Performance Testing- 30-Second Chair Stand Test | 0, 3, 6, and 9 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- Stair Climb Test | 0, 3, 6, and 9 weeks | Knee pain intensity after the Stair Climb 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- Forward Step Down Test | 0, 3, 6, and 9 weeks | Knee pain intensity after the Forward Step Down 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- 6-Minute Walk Test | 0, 3, 6, and 9 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. |
| Current Knee Pain | 0, 3, 6, and 9 weeks | Current Knee Pain 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. |
Countries
United States
Participant flow
Pre-assignment details
2 participants withdrew from the study during baseline testing, and prior to being assigned to a group.
Participants by arm
| Arm | Count |
|---|---|
| Standard Rehabilitation Protocol Home Exercise Program (HEP): HEP taught muscle strengthening exercises and self-management strategies. The exercises were quadriceps strengthening exercises that consist of stretching exercises of the quadriceps and hamstring muscles and a combination of open chain and closed chain exercises. The combined open and closed chain exercises were active straight leg raises, quadriceps straightening, step up, and squats. | 34 |
| Self-Managed NMES Program Neuromuscular electrical stimulation (NMES): NMES training consisted of 20-minute sessions performed concurrently with the HEP for 9 weeks; each 20-minute NMES session included a 2-minute warm-up, a 15-minute work-out and a 3-minute cool down. NMES with the thigh garment was used as the participant is performing the home exercises of stretching and combined open and closed chain exercises. Those in the NMES group received alternate HEP alone and NMES with HEP for a total of 62 sessions (31 sessions of NMES/HEP and 31 sessions HEP alone).
Home Exercise Program (HEP): HEP taught muscle strengthening exercises and self-management strategies. The exercises were quadriceps strengthening exercises that consist of stretching exercises of the quadriceps and hamstring muscles and a combination of open chain and closed chain exercises. The combined open and closed chain exercises were active straight leg raises, quadriceps straightening, step up, and squats. | 33 |
| Self-Managed TENS Program Transcutaneous electrical nerve stimulation (TENS). The TENS treatment groups received the battery-operated Kneehab® XP with lead wire TENS applicator system. The TENS protocol consisted of 20-minutes of TENS stimulation while concurrently performing the HEP. The TENS with HEP and HEP alone was alternated for 9 weeks for a total of 31 TENS/HEP sessions and 31 HEP alone for a total of 62 sessions.
Home Exercise Program (HEP): HEP taught muscle strengthening exercises and self-management strategies. The exercises were quadriceps strengthening exercises that consist of stretching exercises of the quadriceps and hamstring muscles and a combination of open chain and closed chain exercises. The combined open and closed chain exercises were active straight leg raises, quadriceps straightening, step up, and squats. | 33 |
| Combined NMES/TENS Program The combined NMES/TENS treatment group received the Kneehab® XP with the conductive thigh garment and the lead wire TENS applicator. The same parameters for TENS and NMES were used (described above). The NMES and the TENS protocol were performed on alternating days. There was a total of 31 NMES sessions with HEP and 31 TENS sessions with HEP for a total of 62 sessions.
Home Exercise Program (HEP): HEP taught muscle strengthening exercises and self-management strategies. The exercises were quadriceps strengthening exercises that consist of stretching exercises of the quadriceps and hamstring muscles and a combination of open chain and closed chain exercises. The combined open and closed chain exercises were active straight leg raises, quadriceps straightening, step up, and squats. | 30 |
| Total | 130 |
Baseline characteristics
| Characteristic | Total | Self-Managed NMES Program | Self-Managed TENS Program | Standard Rehabilitation Protocol | Combined NMES/TENS Program |
|---|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 130 Participants | 33 Participants | 33 Participants | 34 Participants | 30 Participants |
| Height | 176 cm STANDARD_DEVIATION 9.5 | 174 cm STANDARD_DEVIATION 10.8 | 177 cm STANDARD_DEVIATION 8.1 | 176 cm STANDARD_DEVIATION 11.2 | 175 cm STANDARD_DEVIATION 7.37 |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 5 Participants | 2 Participants | 2 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 41 Participants | 5 Participants | 11 Participants | 12 Participants | 13 Participants |
| Race (NIH/OMB) More than one race | 12 Participants | 5 Participants | 4 Participants | 3 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 0 Participants | 1 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 70 Participants | 21 Participants | 15 Participants | 17 Participants | 17 Participants |
| Region of Enrollment United States | 130 participants | 33 participants | 33 participants | 34 participants | 30 participants |
| Sex: Female, Male Female | 29 Participants | 8 Participants | 7 Participants | 8 Participants | 6 Participants |
| Sex: Female, Male Male | 101 Participants | 25 Participants | 26 Participants | 26 Participants | 24 Participants |
| Weight | 85.3 kg STANDARD_DEVIATION 15.4 | 85 kg STANDARD_DEVIATION 16.1 | 86 kg STANDARD_DEVIATION 14.4 | 86 kg STANDARD_DEVIATION 16.7 | 84 kg STANDARD_DEVIATION 14.8 |
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 / 34 | 0 / 33 | 0 / 33 | 0 / 30 |
| other Total, other adverse events | 0 / 34 | 0 / 33 | 0 / 33 | 0 / 30 |
| serious Total, serious adverse events | 0 / 34 | 0 / 33 | 0 / 33 | 0 / 30 |
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, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Lower Extremity Mobility- 6-Minute Walk Test | Week 0 | 24612 Inches | Standard Deviation 2964 |
| Standard Rehabilitation Protocol | Lower Extremity Mobility- 6-Minute Walk Test | Week 3 | 24373 Inches | Standard Deviation 3053 |
| Standard Rehabilitation Protocol | Lower Extremity Mobility- 6-Minute Walk Test | Week 6 | 24970 Inches | Standard Deviation 2582 |
| Standard Rehabilitation Protocol | Lower Extremity Mobility- 6-Minute Walk Test | Week 9 | 25059 Inches | Standard Deviation 3073 |
| Self-Managed NMES Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 3 | 24919 Inches | Standard Deviation 2804 |
| Self-Managed NMES Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 6 | 25772 Inches | Standard Deviation 3204 |
| Self-Managed NMES Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 9 | 25892 Inches | Standard Deviation 3300 |
| Self-Managed NMES Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 0 | 23931 Inches | Standard Deviation 2772 |
| Self-Managed TENS Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 6 | 25284 Inches | Standard Deviation 3426 |
| Self-Managed TENS Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 3 | 24951 Inches | Standard Deviation 3407 |
| Self-Managed TENS Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 9 | 25847 Inches | Standard Deviation 3763 |
| Self-Managed TENS Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 0 | 23999 Inches | Standard Deviation 2979 |
| Combined NMES/TENS Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 9 | 25227 Inches | Standard Deviation 2655 |
| Combined NMES/TENS Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 3 | 24102 Inches | Standard Deviation 2996 |
| Combined NMES/TENS Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 0 | 23174 Inches | Standard Deviation 2638 |
| Combined NMES/TENS Program | Lower Extremity Mobility- 6-Minute Walk Test | Week 6 | 24753 Inches | Standard Deviation 2311 |
Primary
Lower Extremity Mobility- Forward Step-down Test
Mobility was measured by the number of step down repetitions completed in 30 seconds.
Time frame: 0, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Lower Extremity Mobility- Forward Step-down Test | Week 6 | 17.0 Number of Repetitions | Standard Deviation 4.9 |
| Standard Rehabilitation Protocol | Lower Extremity Mobility- Forward Step-down Test | Week 9 | 17.7 Number of Repetitions | Standard Deviation 5.2 |
| Standard Rehabilitation Protocol | Lower Extremity Mobility- Forward Step-down Test | Week 0 | 13.2 Number of Repetitions | Standard Deviation 3.9 |
| Standard Rehabilitation Protocol | Lower Extremity Mobility- Forward Step-down Test | Week 3 | 15.4 Number of Repetitions | Standard Deviation 5 |
| Self-Managed NMES Program | Lower Extremity Mobility- Forward Step-down Test | Week 6 | 14.0 Number of Repetitions | Standard Deviation 5.6 |
| Self-Managed NMES Program | Lower Extremity Mobility- Forward Step-down Test | Week 3 | 12.9 Number of Repetitions | Standard Deviation 4.3 |
| Self-Managed NMES Program | Lower Extremity Mobility- Forward Step-down Test | Week 0 | 11.3 Number of Repetitions | Standard Deviation 3.6 |
| Self-Managed NMES Program | Lower Extremity Mobility- Forward Step-down Test | Week 9 | 16.3 Number of Repetitions | Standard Deviation 5.3 |
| Self-Managed TENS Program | Lower Extremity Mobility- Forward Step-down Test | Week 6 | 13.9 Number of Repetitions | Standard Deviation 5.4 |
| Self-Managed TENS Program | Lower Extremity Mobility- Forward Step-down Test | Week 0 | 10.8 Number of Repetitions | Standard Deviation 4.9 |
| Self-Managed TENS Program | Lower Extremity Mobility- Forward Step-down Test | Week 3 | 11.8 Number of Repetitions | Standard Deviation 4.8 |
| Self-Managed TENS Program | Lower Extremity Mobility- Forward Step-down Test | Week 9 | 14.9 Number of Repetitions | Standard Deviation 5.7 |
| Combined NMES/TENS Program | Lower Extremity Mobility- Forward Step-down Test | Week 0 | 11.2 Number of Repetitions | Standard Deviation 4 |
| Combined NMES/TENS Program | Lower Extremity Mobility- Forward Step-down Test | Week 6 | 15.3 Number of Repetitions | Standard Deviation 4.9 |
| Combined NMES/TENS Program | Lower Extremity Mobility- Forward Step-down Test | Week 9 | 18.0 Number of Repetitions | Standard Deviation 6 |
| Combined NMES/TENS Program | Lower Extremity Mobility- Forward Step-down Test | Week 3 | 14.4 Number of Repetitions | Standard Deviation 5.6 |
Primary
Lower Extremity Muscle Strength- Extension
The NMMT is a handheld device which measures knee extensor (KE) and flexor (KF) muscle strength. The measurement of KE strength on the PFPS leg is reported. For each test, participants performed three maximal efforts holding each contraction for 4 seconds, separated by 30-second rest; the highest value of the three trials will be accepted in kilograms.
Time frame: 0, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 3 | 41.41 Kg-Force | Standard Deviation 14.92 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 0 | 45.07 Kg-Force | Standard Deviation 17.83 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 3 | 42.81 Kg-Force | Standard Deviation 15.79 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 0 | 41.58 Kg-Force | Standard Deviation 16.56 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 9 | 43.83 Kg-Force | Standard Deviation 14.72 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 6 | 44.35 Kg-Force | Standard Deviation 12.4 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 9 | 41.78 Kg-Force | Standard Deviation 13.46 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 6 | 42.74 Kg-Force | Standard Deviation 14.5 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 0 | 37.74 Kg-Force | Standard Deviation 15.39 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 9 | 46.22 Kg-Force | Standard Deviation 18.31 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 0 | 44.56 Kg-Force | Standard Deviation 18.75 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 6 | 43.31 Kg-Force | Standard Deviation 17.52 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 3 | 42.70 Kg-Force | Standard Deviation 18.66 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 9 | 47.87 Kg-Force | Standard Deviation 20.64 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 3 | 47.16 Kg-Force | Standard Deviation 19.24 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 6 | 47.58 Kg-Force | Standard Deviation 18.51 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 3 | 46.64 Kg-Force | Standard Deviation 18.58 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 6 | 46.31 Kg-Force | Standard Deviation 16.6 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 9 | 46.69 Kg-Force | Standard Deviation 18.93 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 3 | 43.21 Kg-Force | Standard Deviation 21.49 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 0 | 37.14 Kg-Force | Standard Deviation 15.36 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 6 | 41.67 Kg-Force | Standard Deviation 20.6 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 9 | 45.44 Kg-Force | Standard Deviation 23.16 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 0 | 43.75 Kg-Force | Standard Deviation 17.33 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 9 | 50.62 Kg-Force | Standard Deviation 18.32 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 0 | 40.42 Kg-Force | Standard Deviation 18.87 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 3 | 43.07 Kg-Force | Standard Deviation 17.8 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 6 | 43.03 Kg-Force | Standard Deviation 16.54 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Extension | Injured Knee: Week 9 | 46.89 Kg-Force | Standard Deviation 17.78 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 0 | 45.42 Kg-Force | Standard Deviation 18.67 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 3 | 44.61 Kg-Force | Standard Deviation 18.6 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Extension | Unaffected Knee: Week 6 | 46.14 Kg-Force | Standard Deviation 15.84 |
Primary
Lower Extremity Muscle Strength- Flexion
The NMMT is a handheld device which measures knee extensor (KE) and flexor (KF) muscle strength. The measurement of KE strength on the PFPS leg is reported. For each test, participants performed three maximal efforts holding each contraction for 4 seconds, separated by 30-second rest; the highest value of the three trials will be accepted in kilograms.
Time frame: 0, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 9 | 24.54 Kg-Force | Standard Deviation 8.27 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 6 | 22.84 Kg-Force | Standard Deviation 7.36 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 6 | 25.13 Kg-Force | Standard Deviation 8.8 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 3 | 24.71 Kg-Force | Standard Deviation 8.58 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 0 | 23.89 Kg-Force | Standard Deviation 7.2 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 0 | 21.85 Kg-Force | Standard Deviation 7.61 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 9 | 24.15 Kg-Force | Standard Deviation 9.67 |
| Standard Rehabilitation Protocol | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 3 | 22.07 Kg-Force | Standard Deviation 8.05 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 0 | 20.32 Kg-Force | Standard Deviation 7.35 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 3 | 22.49 Kg-Force | Standard Deviation 8.76 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 6 | 23.72 Kg-Force | Standard Deviation 7.35 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 9 | 26.95 Kg-Force | Standard Deviation 8.17 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 0 | 23.11 Kg-Force | Standard Deviation 7.3 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 3 | 24.93 Kg-Force | Standard Deviation 8.49 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 6 | 24.64 Kg-Force | Standard Deviation 7.53 |
| Self-Managed NMES Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 9 | 26.21 Kg-Force | Standard Deviation 8.16 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 0 | 24.34 Kg-Force | Standard Deviation 7.5 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 9 | 25.01 Kg-Force | Standard Deviation 9.11 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 0 | 21.33 Kg-Force | Standard Deviation 7.13 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 3 | 22.99 Kg-Force | Standard Deviation 8.04 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 9 | 25.30 Kg-Force | Standard Deviation 8.3 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 6 | 22.43 Kg-Force | Standard Deviation 8.76 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 3 | 23.93 Kg-Force | Standard Deviation 7.95 |
| Self-Managed TENS Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 6 | 23.65 Kg-Force | Standard Deviation 8.61 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 0 | 21.95 Kg-Force | Standard Deviation 9.13 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 9 | 26.96 Kg-Force | Standard Deviation 8.53 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 6 | 25.20 Kg-Force | Standard Deviation 7.79 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 0 | 25.20 Kg-Force | Standard Deviation 8.67 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 9 | 26.64 Kg-Force | Standard Deviation 10.02 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Flexion | Unaffected Knee: Week 3 | 24.40 Kg-Force | Standard Deviation 8.43 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 3 | 22.56 Kg-Force | Standard Deviation 8.84 |
| Combined NMES/TENS Program | Lower Extremity Muscle Strength- Flexion | Injured Knee: Week 6 | 23.86 Kg-Force | Standard Deviation 8.47 |
Primary
Lower Extremity Strength- 30-Second Chair Stand Test
Mobility was measured by the number of complete standing and sitting cycles in 30-seconds
Time frame: 0, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Lower Extremity Strength- 30-Second Chair Stand Test | Week 0 | 11.6 rises | Standard Deviation 2.8 |
| Standard Rehabilitation Protocol | Lower Extremity Strength- 30-Second Chair Stand Test | Week 3 | 13.2 rises | Standard Deviation 3.5 |
| Standard Rehabilitation Protocol | Lower Extremity Strength- 30-Second Chair Stand Test | Week 6 | 14.2 rises | Standard Deviation 3.4 |
| Standard Rehabilitation Protocol | Lower Extremity Strength- 30-Second Chair Stand Test | Week 9 | 15.3 rises | Standard Deviation 4 |
| Self-Managed NMES Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 3 | 12.3 rises | Standard Deviation 4 |
| Self-Managed NMES Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 6 | 12.8 rises | Standard Deviation 4.4 |
| Self-Managed NMES Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 9 | 14.4 rises | Standard Deviation 4.4 |
| Self-Managed NMES Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 0 | 11.0 rises | Standard Deviation 3 |
| Self-Managed TENS Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 6 | 13.0 rises | Standard Deviation 2.9 |
| Self-Managed TENS Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 3 | 11.7 rises | Standard Deviation 3 |
| Self-Managed TENS Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 9 | 13.4 rises | Standard Deviation 3.5 |
| Self-Managed TENS Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 0 | 11.0 rises | Standard Deviation 3.1 |
| Combined NMES/TENS Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 9 | 15.1 rises | Standard Deviation 4.8 |
| Combined NMES/TENS Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 3 | 12.6 rises | Standard Deviation 4.1 |
| Combined NMES/TENS Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 0 | 11.0 rises | Standard Deviation 3.8 |
| Combined NMES/TENS Program | Lower Extremity Strength- 30-Second Chair Stand Test | Week 6 | 13.6 rises | Standard Deviation 3.9 |
Primary
Lower Extremity Strength- Timed Stair Climb Test
Strength, balance, and power were measured by the number seconds it took to ascend and descend 4 steps (6 in rise, 11.5 in run).
Time frame: 0, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Lower Extremity Strength- Timed Stair Climb Test | Week 0 | 3.7 Seconds | Standard Deviation 1.1 |
| Standard Rehabilitation Protocol | Lower Extremity Strength- Timed Stair Climb Test | Week 3 | 3.6 Seconds | Standard Deviation 0.8 |
| Standard Rehabilitation Protocol | Lower Extremity Strength- Timed Stair Climb Test | Week 6 | 3.4 Seconds | Standard Deviation 0.6 |
| Standard Rehabilitation Protocol | Lower Extremity Strength- Timed Stair Climb Test | Week 9 | 3.3 Seconds | Standard Deviation 0.7 |
| Self-Managed NMES Program | Lower Extremity Strength- Timed Stair Climb Test | Week 3 | 3.7 Seconds | Standard Deviation 1 |
| Self-Managed NMES Program | Lower Extremity Strength- Timed Stair Climb Test | Week 6 | 3.5 Seconds | Standard Deviation 1.1 |
| Self-Managed NMES Program | Lower Extremity Strength- Timed Stair Climb Test | Week 9 | 3.5 Seconds | Standard Deviation 1.2 |
| Self-Managed NMES Program | Lower Extremity Strength- Timed Stair Climb Test | Week 0 | 4.0 Seconds | Standard Deviation 1.4 |
| Self-Managed TENS Program | Lower Extremity Strength- Timed Stair Climb Test | Week 6 | 3.7 Seconds | Standard Deviation 0.9 |
| Self-Managed TENS Program | Lower Extremity Strength- Timed Stair Climb Test | Week 3 | 3.8 Seconds | Standard Deviation 1 |
| Self-Managed TENS Program | Lower Extremity Strength- Timed Stair Climb Test | Week 9 | 3.3 Seconds | Standard Deviation 1 |
| Self-Managed TENS Program | Lower Extremity Strength- Timed Stair Climb Test | Week 0 | 4.2 Seconds | Standard Deviation 1.4 |
| Combined NMES/TENS Program | Lower Extremity Strength- Timed Stair Climb Test | Week 9 | 3.4 Seconds | Standard Deviation 0.9 |
| Combined NMES/TENS Program | Lower Extremity Strength- Timed Stair Climb Test | Week 3 | 3.6 Seconds | Standard Deviation 1.3 |
| Combined NMES/TENS Program | Lower Extremity Strength- Timed Stair Climb Test | Week 0 | 4.1 Seconds | Standard Deviation 1.6 |
| Combined NMES/TENS Program | Lower Extremity Strength- Timed Stair Climb Test | Week 6 | 3.7 Seconds | Standard Deviation 0.9 |
Secondary
Current Knee Pain
Current Knee Pain 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, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Current Knee Pain | Week 0 | 3.48 score on a scale | Standard Deviation 1.84 |
| Standard Rehabilitation Protocol | Current Knee Pain | Week 9 | 2.77 score on a scale | Standard Deviation 2.22 |
| Standard Rehabilitation Protocol | Current Knee Pain | Week 6 | 2.90 score on a scale | Standard Deviation 2.2 |
| Standard Rehabilitation Protocol | Current Knee Pain | Week 3 | 2.99 score on a scale | Standard Deviation 1.99 |
| Self-Managed NMES Program | Current Knee Pain | Week 6 | 2.28 score on a scale | Standard Deviation 1.5 |
| Self-Managed NMES Program | Current Knee Pain | Week 9 | 2.44 score on a scale | Standard Deviation 1.79 |
| Self-Managed NMES Program | Current Knee Pain | Week 0 | 3.42 score on a scale | Standard Deviation 1.66 |
| Self-Managed NMES Program | Current Knee Pain | Week 3 | 2.78 score on a scale | Standard Deviation 1.71 |
| Self-Managed TENS Program | Current Knee Pain | Week 6 | 3.76 score on a scale | Standard Deviation 2.05 |
| Self-Managed TENS Program | Current Knee Pain | Week 9 | 3.01 score on a scale | Standard Deviation 2.33 |
| Self-Managed TENS Program | Current Knee Pain | Week 3 | 3.44 score on a scale | Standard Deviation 2.13 |
| Self-Managed TENS Program | Current Knee Pain | Week 0 | 4.24 score on a scale | Standard Deviation 1.76 |
| Combined NMES/TENS Program | Current Knee Pain | Week 9 | 3.27 score on a scale | Standard Deviation 2.26 |
| Combined NMES/TENS Program | Current Knee Pain | Week 0 | 3.98 score on a scale | Standard Deviation 1.77 |
| Combined NMES/TENS Program | Current Knee Pain | Week 6 | 2.72 score on a scale | Standard Deviation 1.8 |
| Combined NMES/TENS Program | Current Knee Pain | Week 3 | 3.02 score on a scale | Standard Deviation 1.91 |
Secondary
Knee Pain Following Performance Testing- 30-Second 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, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 0 | 2.9 score on a scale | Standard Deviation 1.8 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 9 | 2.8 score on a scale | Standard Deviation 2.2 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 3 | 2.9 score on a scale | Standard Deviation 1.9 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 6 | 2.8 score on a scale | Standard Deviation 2.2 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 3 | 2.2 score on a scale | Standard Deviation 1.7 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 6 | 2.3 score on a scale | Standard Deviation 1.7 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 0 | 2.8 score on a scale | Standard Deviation 1.7 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 9 | 2.5 score on a scale | Standard Deviation 1.9 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 3 | 3.5 score on a scale | Standard Deviation 2 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 0 | 3.9 score on a scale | Standard Deviation 1.8 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 6 | 3.6 score on a scale | Standard Deviation 2.1 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 9 | 2.6 score on a scale | Standard Deviation 2.2 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 0 | 3.6 score on a scale | Standard Deviation 2 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 3 | 2.9 score on a scale | Standard Deviation 2.2 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 9 | 2.6 score on a scale | Standard Deviation 2.4 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- 30-Second Chair Stand Test | Week 6 | 2.9 score on a scale | Standard Deviation 2.3 |
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, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 3 | 3.3 score on a scale | Standard Deviation 2 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 9 | 3.0 score on a scale | Standard Deviation 2.1 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 0 | 3.2 score on a scale | Standard Deviation 1.7 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 6 | 3.1 score on a scale | Standard Deviation 2.2 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 0 | 2.7 score on a scale | Standard Deviation 2.2 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 3 | 2.5 score on a scale | Standard Deviation 1.6 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 6 | 2.9 score on a scale | Standard Deviation 2.1 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 9 | 2.3 score on a scale | Standard Deviation 2 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 0 | 4.5 score on a scale | Standard Deviation 1.7 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 6 | 3.9 score on a scale | Standard Deviation 2.4 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 3 | 4.3 score on a scale | Standard Deviation 2 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 9 | 2.9 score on a scale | Standard Deviation 2.3 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 3 | 3.2 score on a scale | Standard Deviation 2.2 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 6 | 2.6 score on a scale | Standard Deviation 1.9 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 9 | 2.7 score on a scale | Standard Deviation 2.5 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- 6-Minute Walk Test | Week 0 | 3.6 score on a scale | Standard Deviation 2.3 |
Secondary
Knee Pain Following Performance Testing- Forward Step Down Test
Knee pain intensity after the Forward Step Down 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, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- Forward Step Down Test | Week 6 | 3.6 score on a scale | Standard Deviation 2.2 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- Forward Step Down Test | Week 9 | 3.5 score on a scale | Standard Deviation 2.2 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- Forward Step Down Test | Week 3 | 3.8 score on a scale | Standard Deviation 2 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- Forward Step Down Test | Week 0 | 4.2 score on a scale | Standard Deviation 1.5 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 3 | 3.2 score on a scale | Standard Deviation 2 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 9 | 2.8 score on a scale | Standard Deviation 2.1 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 0 | 4.2 score on a scale | Standard Deviation 2.2 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 6 | 3.3 score on a scale | Standard Deviation 1.7 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 3 | 4.7 score on a scale | Standard Deviation 2 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 6 | 4.2 score on a scale | Standard Deviation 2.1 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 9 | 3.3 score on a scale | Standard Deviation 2.1 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 0 | 5.2 score on a scale | Standard Deviation 1.9 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 0 | 5.3 score on a scale | Standard Deviation 2.1 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 3 | 3.5 score on a scale | Standard Deviation 2.3 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 9 | 3.2 score on a scale | Standard Deviation 2.5 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- Forward Step Down Test | Week 6 | 3.6 score on a scale | Standard Deviation 2.2 |
Secondary
Knee Pain Following Performance Testing- Stair Climb Test
Knee pain intensity after the Stair Climb 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, 3, 6, and 9 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- Stair Climb Test | Week 0 | 2.7 score on a scale | Standard Deviation 1.9 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- Stair Climb Test | Week 3 | 2.6 score on a scale | Standard Deviation 2.1 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- Stair Climb Test | Week 6 | 2.7 score on a scale | Standard Deviation 2 |
| Standard Rehabilitation Protocol | Knee Pain Following Performance Testing- Stair Climb Test | Week 9 | 2.7 score on a scale | Standard Deviation 2 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 3 | 2.3 score on a scale | Standard Deviation 1.5 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 6 | 2.1 score on a scale | Standard Deviation 1.7 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 9 | 2.0 score on a scale | Standard Deviation 1.8 |
| Self-Managed NMES Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 0 | 2.7 score on a scale | Standard Deviation 1.8 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 6 | 3.6 score on a scale | Standard Deviation 2.3 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 3 | 3.4 score on a scale | Standard Deviation 2 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 9 | 2.7 score on a scale | Standard Deviation 2.3 |
| Self-Managed TENS Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 0 | 3.5 score on a scale | Standard Deviation 1.9 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 9 | 1.9 score on a scale | Standard Deviation 2.1 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 3 | 2.4 score on a scale | Standard Deviation 2.1 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 0 | 3.0 score on a scale | Standard Deviation 2.2 |
| Combined NMES/TENS Program | Knee Pain Following Performance Testing- Stair Climb Test | Week 6 | 2.2 score on a scale | Standard Deviation 2.1 |