Change in Pain Perception and TENS Pulse Amplitude, and Progression in Aerobic and Resistance Exercises over a Series of Ten-session Rehabilitation for Anterior Knee Pain

OBJECTIVES The purpose of this study was to report changes in pain perception and the transcutaneous electrical nerve stimulation (TENS) pulse amplitude, and progressions in aerobic and resistance exercise at each session during a ten-session rehabilitation programme for patients with anterior knee pain.METHODS Eleven patients with anterior knee pain (4 females and 7 males: 20.8 ± 2.8 years, 169.7 ± 8.1 cm, 72.9 ± 25.0 kg, painful duration: 51.3 ± 42.0 months, Kujala anterior knee pain scale: 73.4 out of 100) participated in the rehabilitation programme. Each session of rehabilitation consisted of a 30-min simultaneous application of TENS and focal knee joint cooling, followed by a 30-min of therapeutic exercises (aerobic, flexibility, and strengthening exercise). Pain perception (using a 10-cm visual analogue scale) before and after each session, transcutaneous electrical nerve stimulation pulse amplitude (mA), treadmill jogging speed (km/h), and external load during resistance exercises (knee extensions, squats, and lunges in kg/kg) at each session were recorded.RESULTS Overall pain perception was reduced (49%, p=0.0008) and the TENS pulse amplitude was increased (20%, p=0.002) at the fourth session. The jogging speed increased at the third (9%, p=0.008), fifth (7%, p=0.03), and ninth (9%, p=0.0007) session. External loads in resistance exercises were increased every session that the total improvement was 98% in lunges (p<0.0001), 95% in knee extensions (p<0.007), 105% in squats (p<0.0001).CONCLUSIONS The observed changes and progressions could be used as general guidelines for the establishment and implementation of a short-term conservative treatment of anterior knee pain.