Effect of Neuromuscular Exercises and Neuromuscular Electrical Stimulation in Patients with Knee Osteoarthritis

Knee OA is a prevalent arthritic condition which leads to reduced physical function and pain leading to poor quality of life.exercises are a vital part of physiotherapy intervention in the management of knee osteoarthritis. Neuromuscular exercises are individualized and goal-based exercise program that address the functional instability and impaired muscle function for the lower extremities. Neuromuscular exercises typically involve multiple joints and muscle groups performed in functional weight-bearing positions. Emphasis is on the quality and efficiency of movement, as well as alignment of the trunk and lower limb joints. The neuromuscular training method is based on biomechanical and neuromuscular principles and aims to improve sensorimotor control and achieve compensatory functional stability.One emerging method of quadriceps muscle strengthening and rehabilitation in knee OA patients is the use of neuromuscular electrical stimulation therapy . This therapy entails the use of low-level electrical impulses that cause involuntary contractions in the targeted muscles through stimulating surface electrodes directly applied to the desired muscle group.  Neuromuscular electrical stimulation (NMES) may be an alternative, low cost, efficient, and less painful treatment approach than voluntary knee exercises for patients with knee OA. NMES is considered an efficient technique for quadriceps strengthening and also known to improve muscle architecture. Therefore, use of combination of the electrical impulses applied via neuromuscular electrical stimulation and unique exercise strategies such as neuromuscular exercises may improve both the clinical and functional outcomes in patients of knee osteoarthritis.