The effectiveness of neuromuscular electrical stimulation on pain, function, and quadriceps muscle strength in adults with patellofemoral pain: A systematic review and meta-analysis
Abstract
Patellofemoral pain (PFP) is a chronic musculoskeletal disorder, with Neuromuscular electrical stimulation (NMES) often used as a complementary treatment option, however no definitive evidence supports its benefits. This systematic review aimed to evaluate the efficacy of adding NMES to exercise programs for treating PFP. PubMed, Cochrane CENTRAL, Web of Science, Scopus, PEDro, ClinicalTrails.gov and International Clinical Trials Registry Platform were searched up to July 2024 for randomized controlled trials (RCTs) investigating the effectiveness of NMES in people with PFP. Two researchers independently screened titles and abstracts; another pair filtered full-text articles. The studies had to report pain, functionality, and strength as outcome measures. The risk of bias was assessed using the revised Cochrane Collaboration tool (RoB 2.0). Meta-analysis was conducted using RevMan 5.4.1 software, and the quality of evidence was evaluated using the GRADE approach. Eleven RCTs, involving 571 participants, were included. Most of the studies were of high risk of bias. NMES combined with exercise was favored in the long course for improving function (SMD: 3.74, 95% CI 1.35, 5.81; P = 0.0004) and quadriceps muscle strength (SMD: 0.53, 95% CI 0.18, 0.89; P = 0.003) compared to exercise; however, it did not differ from exercise in relieving pain and improving EMG activity level, and participation. The GRADE certainty rating of the results was rated as very low mostly due to…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 571 participants or records.
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