Effect of ultrasound-guided percutaneous neuromodulation applied to the femoral nerve on pain and range of motion in patients with anterior knee pain: A case study

Paula García-Bermejo; Carlos Romero-Morales; Blanca de-la-Cruz-Torres

doi:10.1055/s-0040-1701431

Revista Fisioterapia Invasiva / Journal of Invasive Techniques in Physical Therapy, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Revista Fisioterapia Invasiva / Journal of Invasive Techniques in Physical Therapy 2020; 03(01): 030-034
DOI: 10.1055/s-0040-1701431

Case Series

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Effect of ultrasound-guided percutaneous neuromodulation applied to the femoral nerve on pain and range of motion in patients with anterior knee pain: A case study

Artikel in mehreren Sprachen: English | español

Paula García-Bermejo

¹DINAMIA Physiotherapy Clinic, Madrid, Spain

,

Carlos Romero-Morales

²Facultad de Ciencias del Deporte, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain

,

Blanca de-la-Cruz-Torres

³Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain

› Institutsangaben

Abstract

Introduction Anterior knee pain (AKP) is one of the most frequent reasons for physical therapy consultations, remaining a difficult treatment challenge for professionals. The aim of this study was to evaluate the effects of an intervention using ultrasound-guided percutaneous neuromodulation (US-guided PNM) applied to the femoral nerve on pain and knee flexion range of motion (ROM), in patients with unilateral chronic anterior knee pain.

Methods Eight patients received a single intervention of NMP-e on the femoral nerve of the symptomatic knee. The level of pain and ROM were measured before, immediately after and 24 hours after the intervention.

Results A decrease in pain and an increase of ROM were observed after the intervention and at 24 hours. For pain values, a medium effect size was observed (ES = 0.63 ± 0.43) after the intervention, and a large effect size (ES = 1.73 ± 0.44) was found at 24h. Concerning ROM, the effect size was large at both moments (ES = − 1.30 ± 1.14; −1.76 ± 0.80, respectively).

Conclusion A single intervention of US-guided PNM on the femoral nerve produces a decrease of pain and increases the ROM, which is greater 24h after the stimulation.

Level of Evidence Level II-3.

Keywords

anterior knee pain - femoral nerve - percutaneous neuromodulation - ultrasound

Volltext

Referenzen

References
1 Aglietti P, Buzzi R, Pisaneschi A. Patella pain. J Sports Trauma Rel Res. 1990; 12: 131-150
2 Goldberg B. Chronic anterior knee pain in the adolescent. Pediatr Ann 1991; 20 (04) 186-187 , 190–193
3 Sanchis-Alfonso V, Dye SF. How to deal with anterior knee pain in the active young patient. Sports Health 2017; 9 (04) 346-351
4 Sanchis-Alfonso V. Holistic approach to understanding anterior knee pain. Clinical implications. Knee Surg Sports Traumatol Arthrosc 2014; 22 (10) 2275-2285
5 Günther KP, Thielemann F, Bottesi M. [Anterior knee pain in children and adolescents. Diagnosis and conservative treatment]. Orthopade 2003; 32 (02) 110-118
6 Fairbank JC, Pynsent PB, van Poortvliet JA, Phillips H. Mechanical factors in the incidence of knee pain in adolescents and young adults. J Bone Joint Surg Br 1984; 66 (05) 685-693
7 Lin PL, Shih YF, Chen WY, Ma HL. Neurodynamic responses to the femoral slump test in patients with anterior knee pain syndrome. J Orthop Sports Phys Ther 2014; 44 (05) 350-357
8 de la Cruz Torres B. Strength-duration curve of radial nerve in patients with lateral elbow pain. J Sport Rehabil 2019; 18: 1-6
9 Rodríguez-Fernández ÁL, Rebollo-Roldán J, Jiménez-Rejano JJ, Güeita-Rodríguez J. Strength-Duration curves of the common fibular nerve show hypoexcitability in people with functional ankle instability. PM R 2016; 8 (06) 536-544
10 White JC, Sweet WH. Pain and the neurosurgeon: a forty-year experience. Springfield: Thomas; 1969: 894-899
11 Stuart RM, Winfree CJ. Neurostimulation techniques for painful peripheral nerve disorders. Neurosurg Clin N Am 2009; 20 (01) 111-120 , vii–viii
12 Valera-Garrido F, Minaya-Muñoz F. Fisioterapia Invasiva. Barcelona: Elsevier España SL; 2016
13 De-la-Cruz-Torres B. Ultrasound-guided Percutaneous neuromodulation in patients with unilateral refractory lateral epicondylitis. J Manipulative Physiol Ther 2019 ; In press
14 Rossi M, DeCarolis G, Liberatoscioli G, Iemma D, Nosella P, Nardi LF. A novel mini-invasive approach to the treatment of neuropathic pain: the PENS study. Pain Physician 2016; 19 (01) E121-E128
15 de la Cruz-Torres B, Barrera-García-Martín I, Albornoz-Cabello M. Immediate effects of ultrasound-guided percutaneous neuromodulation versus physical exercise on performance of the flexor hallucis longus muscle in professional dancers: a randomised clinical trial. Acupunct Med 2019; 37 (02) 91-97
16 Recoules-Arché D, Gayet A. [L4 crural neuralgia and disc hernia of the L4-L5 intervertebral foramen]. Rev Rhum Mal Osteoartic 1986; 53 (03) 161-165
17 Hjermstad MJ, Fayers PM, Haugen DF. , et al; European Palliative Care Research Collaborative (EPCRC). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage 2011; 41 (06) 1073-1093
18 Norkin C, White DJ. Goniometría, evaluación de la movilidad articular. Marban; 2007
19 Brosseau L, Tousignant M, Budd J. , et al. Intratester and intertester reliability and criterion validity of the parallelogram and universal goniometers for active knee flexion in healthy subjects. Physiother Res Int 1997; 2 (03) 150-166
20 Hopkins WG, Marshall SW, Batterham AM, Hanin J. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc 2009; 41 (01) 3-13
21 Suarez-Arrones L, Arenas C, López G, Requena B, Terrill O, Mendez-Villanueva A. Positional differences in match running performance and physical collisions in men rugby sevens. Int J Sports Physiol Perform 2014; 9 (02) 316-323
22 Ilfeld BM, Gilmore CA, Grant SA. , et al. Ultrasound-guided percutaneous peripheral nerve stimulation for analgesia following total knee arthroplasty: a prospective feasibility study. J Orthop Surg Res 2017; 12 (01) 4
23 Ilfeld BM, Said ET, Finneran IV JJ. , et al. Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation: Neuromodulation of the Femoral Nerve for Postoperative Analgesia Following Ambulatory Anterior Cruciate Ligament Reconstruction: A Proof of Concept Study. Neuromodulation 2019; 22 (05) 621-629
24 Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965; 150 (3699): 971-979
25 de-la-Cruz-Torres B, Barrera-García-Martín I, Romero-Morales C. Comparative Effects of One-Shot Electrical Stimulation on Performance of the Flexor Hallucis Longus Muscle in Professional Dancers: Percutaneous Versus Transcutaneous?. Neuromodulation 2019 ; In press
26 Ilfeld BM, Grant SA, Gilmore CA. , et al. Neurostimulation for Postsurgical Analgesia: A Novel System Enabling Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation. Pain Pract 2017; 17 (07) 892-901
27 Álvarez-Prats D, Carvajal-Fernández O, Pérez-Mellada N, Minaya-Muñoz F. Changes in Maximal Isometric Quadriceps Strength after the Application of Ultrasound-Guided Percutaneous Neuromodulation of the Femoral Nerve: A Case Series. Rev Fisioter Invasiva 2019; 2: 39-45
28 Brosseau L, Balmer S, Tousignant M. , et al. Intra- and intertester reliability and criterion validity of the parallelogram and universal goniometers for measuring maximum active knee flexion and extension of patients with knee restrictions. Arch Phys Med Rehabil 2001; 82 (03) 396-402