Neuromuscular electrical stimulation (NMES) for patellofemoral pain syndrome

Martimbianco ALC, Torloni MR, Andriolo BN, Porfírio GJ, Riera R · Cochrane Database of Systematic Reviews

The review's own conclusion is that the trial evidence is insufficient and inconclusive. Very low quality evidence from one laboratory study of a single 15-minute session in 22 people found less pain during two functional activities, with a confidence interval that also admits a difference too small to matter clinically. For a multi-session programme with exercise against exercise alone, the reviewers say they are uncertain whether it changes pain or function at the end of treatment or at one year. No trial reported adverse effects such as muscle fatigue or discomfort.

Population

345 participants across eight heterogeneous randomised trials in people with patellofemoral pain, a knee problem distinct from osteoarthritis

Intervention

Neuromuscular electrical stimulation, alone or added to exercise

Comparator

Sham stimulation, or the same other treatment without stimulation

Limitations

Patellofemoral pain is not osteoarthritis and the review says nothing about cartilage. The reviewers downgraded the one placebo comparison three levels — risk of bias, indirectness (a single 15-minute session is not clinical practice) and imprecision. Internal support from the Brazilian Cochrane Centre; no external sources; all five authors declare no interests.