Short-term effectiveness of high- and low-intensity percutaneous electrolysis in patients with patellofemoral pain syndrome: A pilot study

Abstract

BACKGROUND Unilateral patellofemoral pain syndrome (PFPS) is the most frequently diagnosed knee condition in populations aged < 50 years old. Although the treatment of myofascial trigger points (MTrPs) is a common and effective tool for reducing pain, previous studies showed no additional benefits compared with placebo in populations with PFPS. Percutaneous electrolysis is a minimally invasive approach frequently used in musculotendinous pathologies which consists of the application of a galvanic current through dry needling (DN). AIM To evaluate changes in sensitivity, knee pain perception and perceived pain during the application of these three invasive techniques. METHODS A triple-blinded, pilot randomized controlled trial was conducted on fifteen patients with unilateral PFPS who were randomized to the high-intensity percutaneous electrolysis (HIPE) experimental group, low-intensity percutaneous electrolysis (LIPE) experimental group or DN active control group. All interventions were conducted in the most active MTrP, in the rectus femoris muscle. The HIPE group received a 660 mA galvanic current for 10 s, the LIPE group 220 mA × 30 s and the DN group received no galvanic current. The MTrP and patellar tendon pain pressure thresholds (PPTs) and subjective anterior knee pain perception (SAKPP) were assessed before, after and 7 d after the single intervention. In addition, perceived pain during the intervention was also assessed. RESULTS Both groups were comparable at baseline as no significant differences were found for age, height, weight, body mass index, PPTs or SAKPP. No adverse events were reported during or after the interventions. A significant decrease in SAKPP (both HIPE and LIPE, P < 0.01) and increased patellar tendon PPT (all, P < 0.001) were found, with no differences between the groups (VAS: F = 0.30; η 2 = 0.05; P > 0.05; tendon PPT immediate effects: F = 0.15; η 2 = 0.02; P > 0.05 and tendon PPT 7-d effects: F = 0.67; η 2 = 0.10; P > 0.05). A significant PPT increase in rectus femoris MTrP was found at follow-up in both the HIPE and LIPE groups (both, P < 0.001) with no differences between the groups (immediate effects: F= 1.55; η 2 = 0.20; P > 0.05 and 7-d effects: F = 0.71; η 2 = 0.10; P > 0.05). Both HIPE and LIPE interventions were considered less painful compared with DN (F = 8.52; η 2 = 0.587; P < 0.01). CONCLUSION HIPE and LIPE induce PPT changes in MTrPs and patellar tendon and improvements in SAKPP, and seem to produce less pain during the intervention compa...

Endogenous Pain Modulation in Response to a Single Session of Percutaneous Electrolysis in Healthy Population: A Double-Blinded Randomized Clinical Trial

“…In fact, no significant differences were found between low- and high-intensity groups. Those results are coherent with the pilot study conducted by Valera-Calero et al [ 45 ], which is the only one to date (to the best of our knowledge) comparing two PE protocols in humans. They found no differences between protocols in sensitivity and pain in patients with patellofemoral pain syndrome.…”

Efficacy of percutaneous needle electrolysis versus dry needling in musculoskeletal pain: A systematic review and meta-analysis

“…The full article was then accessed and three articles were removed as two of them had no final results [24,38] and one [39] used pulsed current. Finally, a total of six articles were included in the qualitative and quantitative analysis of our review [22,23,25,[40][41][42]. The study selection flow diagram is shown in Fig.…”

“…The included studies were highly heterogeneous as they studied different musculoskeletal conditions. These were tendinopathy of the supraspinatus [43], lateral epicondylalgia [41] temporomandibular pain [40], plantar pain [23], patellar tendinopathy [25], and patellar pain syndrome [42].…”

“…The most common bias recorded were blinding of patients and blinding of therapists. Only one study (16.66%) succeeded in blinding therapists and patients [42]. Table 5 lists the final score of the PEDro scale for each clinical study included in our systematic review/meta-analysis.…”

Efficacy of different intensities of percutaneous electrolysis for musculoskeletal pain: A systematic review and meta-analysis

“…As mentioned above, the choice of the dosage of administration of PE therapy is poorly supported by scientific evidence. To the best of our knowledge, only a pilot study has compared two PE protocols in patients, finding no differences between them in sensitivity and pain associated with patellofemoral pain syndrome ( 42 ). In this case, the two protocols presented little variation in the intensity parameter (0.220 mA for 30 s and 0.660 mA for 10 s) and both would belong to the low-intensity modality.…”