Frequency-Dependent Effects of Percutaneous Femoral Nerve Stimulation on Strength in Athletes With Patellar Tendinopathy: a Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 19
- 试验地点
- 1
- 主要终点
- Change in Quadriceps Maximal Isometric Voluntary Contraction (MVC)
研究概览
简要总结
This study investigates the immediate effects of different peripheral electrical nerve stimulation protocols applied to the femoral nerve on quadriceps strength in athletes with patellar tendinopathy. Patellar tendinopathy is a common overuse injury that often reduces quadriceps activation and limits sports performance. Peripheral percutaneous nerve stimulation (PPNS) and transcutaneous electrical nerve stimulation (TENS) are frequently used in rehabilitation, but their frequency-dependent effects on muscle strength are not well established.
In this randomized crossover trial, each participant receives three stimulation protocols in separate sessions: high-frequency PPNS (100 Hz), low-frequency PPNS (2 Hz), and conventional TENS. All stimulation is delivered at the maximal tolerated motor threshold and, for PPNS conditions, under ultrasound guidance. Quadriceps maximal isometric strength is evaluated using an isometric force sensor before and after each intervention.
The primary objective is to compare the acute changes in maximal voluntary contraction (MVC) following each stimulation protocol. The study aims to clarify whether different stimulation frequencies can enhance, reduce, or have no effect on quadriceps strength in this athletic population.
By identifying frequency-specific neuromodulatory responses, this study may help clinicians and sports practitioners select the most appropriate stimulation parameters to optimize rehabilitation and performance in individuals with patellar tendinopathy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •Adults aged 18 to 40 years.
- •Recreational or competitive athletes with clinically diagnosed patellar tendinopathy for at least 3 months.
- •Ultrasound-confirmed patellar tendinopathy, including hypoechoic areas, tendon thickening, or neovascularization consistent with clinical diagnosis.
- •Presence of pain during tendon-loading activities (e.g., jumping, running, squatting).
- •Ability to perform maximal voluntary isometric contractions of the quadriceps.
- •Ability to comply with all study procedures and attend all experimental sessions.
- •Written informed consent obtained prior to participation.
排除标准
- •Previous knee surgery or traumatic knee injury within the past 12 months.
- •Complete or partial patellar tendon rupture.
- •Neurological disorders affecting lower limb strength or motor control.
- •Contraindications to electrical stimulation, including implanted electrical devices (e.g., pacemaker).
- •Current lower-limb radiculopathy or neuropathy.
- •Skin infections, open wounds, or dermatological conditions at the stimulation site.
- •Use of analgesics, anti-inflammatories, or corticosteroid injections within the past 48 hours.
- •Participation in another interventional study in the previous 30 days.
- •Pregnancy or suspected pregnancy.
研究组 & 干预措施
High-Frequency PPNS (100 Hz)
Participants receive peripheral percutaneous nerve stimulation (PPNS) applied to the femoral nerve at 100 Hz.
干预措施: Electrical stimulation (Device)
Low-Frequency PPNS (2 Hz)
Participants receive peripheral percutaneous nerve stimulation (PPNS) applied to the femoral nerve at 2 Hz.
干预措施: Electrical stimulation (Device)
Transcutaneous Electrical Nerve Stimulation (TENS)
Participants receive conventional transcutaneous electrical nerve stimulation (TENS) applied over the femoral nerve region using surface electrodes. Intensity is set at the maximal tolerated motor threshold to elicit visible quadriceps activation. The stimulation frequency and parameters are consistent with standard clinical practice for motor-level TENS.
干预措施: Electrical stimulation (Device)
结局指标
主要结局
Change in Quadriceps Maximal Isometric Voluntary Contraction (MVC)
时间窗: Baseline (pre-intervention), and at 2 minutes, 10 minutes, 15 minutes, and 30 minutes post-intervention.
Quadriceps maximal isometric voluntary contraction (MVC) is measured using a calibrated isometric force sensor with the participant seated and the knee positioned at 60° of flexion. MVC is recorded as the peak force output during a standardized 5-second maximal contraction. The primary endpoint is the change in MVC from pre-intervention to immediately post-intervention across the three stimulation conditions (high-frequency PPNS, low-frequency PPNS, and TENS). Higher values indicate greater quadriceps force production.
次要结局
- Change in Quadriceps Rate of Force Development (RFD 0-250 ms)(Baseline (pre-intervention), and at 2 minutes, 10 minutes, 15 minutes, and 30 minutes post-intervention.)
- Incidence of Adverse Events Assessed Through Post-Intervention Questionnaires(Immediately after each intervention session.)
- Change in Quadriceps Impulse (0-250 ms)(Baseline (pre-intervention), and at 2 minutes, 10 minutes, 15 minutes, and 30 minutes post-intervention.)
研究者
Xavier Picañol Parraga
Phd in Neuroscience
Hospital Clinic of Barcelona