The Use of Neuromuscular Electrical Stimulation to Reverse Muscle Atrophy in Patients With Rheumatoid Arthritis



Status:Completed
Conditions:Arthritis, Rheumatoid Arthritis, Neurology
Therapuetic Areas:Neurology, Rheumatology
Healthy:No
Age Range:21 - Any
Updated:11/8/2014
Start Date:June 2009
End Date:May 2014
Contact:Samannaaz Khoja, PT, MS
Phone:312-383-6868

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Trial Summary
Trial Overview
Inclusion Criteria
This study will be a small randomized clinical trial to test the effectiveness of
neuromuscular electrical stimulation (NMES) to improve physical function and reverse muscle
atrophy in patients with rheumatoid arthritis (RA). The investigators will also determine
the mechanism by which NMES affects muscle hypertrophy and physical function. The proposed
study will be the first step in demonstrating that NMES training is an effective alternative
to highly intense volitional exercises (VE) in individuals with RA. After baseline testing,
60 individuals with RA will be randomly assigned to a 16-week NMES program or highly intense
VE program. Both programs will be applied based on the best current clinical evidence.
Subjects will be re-assessed after intervention. Groups will be compared for differences in
performance-based and self-reported lower extremity function, muscle volume, muscle
strength, proportion and area of type I and II muscle fibers, fat content, and muscle
oxidative capacity from pre- to post-intervention. Changes in physical function, muscle
volume, and muscle strength will be correlated with proportion and area of type I and II
muscle fibers, fat content, and markers of muscle oxidative capacity.


Inclusion Criteria:

- English-speaking

- Age 21 or older

- Diagnosed with RA for at least 5 years according to the criteria of the American
College of Rheumatology

- Independent ambulator

Exclusion Criteria:

- History of cardiovascular disease or uncontrolled hypertension (above 140/90 mmHg);

- History of a quadriceps tendon or patellar tendon rupture;

- History of previous adverse reaction associated with electrical stimulation
treatment;

- Surgery to the dominant lower extremities within the past 6 months.

- History of a neurological disorder that may affect lower extremity function, such as
cerebrovascular accident or neuropathy, parkinson's disease, multiple sclerosis,
etc.;

- History of muscle disease such as muscular dystrophy;

- Change in medication regimen (excluding NSAID change) during the month prior to
treatment;

- Current use of cholesterol-lowering medication;

- History of malignancy during the last 5 years, excluding skin cancers other than
melanoma;

- Current or anticipated pregnancy;

- Less than 70º of passive knee flexion;

- Are not willing to undergo needle biopsy.

- Participated in progressive resistance training or NMES training in the prior year;

- Prior adverse effects with local anesthesia.
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Physical Therapy Department
Pittsburgh, Pennsylvania 15260
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