Comparison of the Efficacy of Transcutaneous Electrical Nerve Stimulation, Interferential Currents, and Shortwave Diathermy in Knee Osteoarthritis: A Double-Blind, Randomized, Controlled, Multicenter Study

Abstract Atamaz FC, Durmaz B, Baydar M, Demircioglu OY, Iyiyapici A, Kuran B, Oncel S, Sendur OF. Comparison of the efficacy of transcutaneous electrical nerve stimulation, interferential currents, and shortwave diathermy in knee osteoarthritis: a double-blind, randomized, controlled, multicenter study. Objective To compare the effectiveness of transcutaneous electrical nerve stimulation (TENS), interferential currents (IFCs), and shortwave diathermy (SWD) against each other and sham intervention with exercise training and education as a multimodal package. Design A double-blind, randomized, controlled, multicenter trial. Setting Departments of physical medicine and rehabilitation in 4 centers. Participants Patients (N=203) with knee osteoarthritis (OA). Interventions The patients were randomized by the principal center into the following 6 treatment groups: TENS sham, TENS, IFCs sham, IFCs, SWD sham, and SWD. All interventions were applied 5 times a week for 3 weeks. In addition, exercises and an education program were given. The exercises were carried out as part of a home-based training program after 3 weeks' supervised group exercise. Main Outcome Measures Primary outcome was a visual analog scale (0–100mm) to assess knee pain. Other outcome measures were time to walk a distance of 15m, range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Nottingham Health Profile, and paracetamol intake (in grams). Results We found a significant decrease in all assessment parameters ( P