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Effects of electrical stimulation of vastus medialis obliquus muscle in patients with patellofemoral pain syndrome: an electromyographic analysis

BACKGROUND: The use of surface electromyography (SEMG) has been considered a tool for quantitative assessment of patellofemoral pain syndrome (PFPS). Conservative treatments aim to improve patellar alignment, and electrical stimulation of the vastus medialis obliquus (VMO) muscle has been considered effective because it is selective and does not cause joint irritation. OBJECTIVE: This study aims to investigate the efficiency of a muscle strengthening program with electrical stimulation of the VMO muscle in PFPS by SEMG. METHODS: A group of ten young women (age: 23.1±4.9 years; body mass: 66.8±14.0 kg; height: 1.63±6.9 cm; BMI: 25.1±5.6 kg/m²) with unilateral PFPS participated in the study. They performed the functional test of stair stepping to capture the electromyographic (EMG) activity of the VMO and vastus lateralis (VL) muscles, before and after a program of electrical stimulation of the VMO muscle. The electrical stimulation was performed three times per week for six weeks. For analysis between the VMO and VL muscles, we considered the variables: ratio of time of onset to peak of activation, ratio of the integrals of the signals (t-test for dependent samples), and difference between onsets of activation (Wilcoxon test), with significance level of p<0.05. RESULTS: The results only showed change in behavior in the EMG signal for the ratio of the integrals of the signals, indicating that changes occurred in the force-generating capacity of the muscle after the training. CONCLUSION: The use of electrical stimulation should be considered to complement the conservative therapeutic approach in patients with PFPS, and the analysis of the ratio of the integrals of the SEMG signals should be considered as an instrument of evaluation. Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under number ACTRN 12609000079246.

electromyography; transcutaneous electrical nerve stimulation; patellofemoral pain syndrome


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