Short-term effects of percutaneous electrical nerve stimulation on pain and muscle function in patients undergoing anterior cruciate ligament surgery: a randomized clinical trial.
Julio Caballero-López, Marcos Navarro-Santana, Jaime Almazán-Polo and 4 others
PMID 40365171WHAT IT FOUND
Adding ultrasound-guided PENS to rehabilitation reduced pain and improved quadriceps strength immediately after treatment.
However, by 12 weeks, both groups showed similar improvements. The benefit appears to be short-term, fading as standard rehabilitation continues.
Key findings
01The PENS group showed significant short-term improvements in pain intensity and active knee extension isometric strength immediately following the first intervention compared to the control group.
02At the 12-week follow-up, both groups exhibited beneficial effects on pain, pressure pain threshold, range of motion, and strength, with no significant long-term differences between groups except for knee extension ROM.
03Post-hoc analysis confirmed significant group differences in pain favoring PENS immediately after the first intervention and one week later, but these differences were not sustained in the medium-long term interaction.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study only administered two PENS sessions, which the authors acknowledge may have been insufficient to produce sustained effects over time. The 12-week follow-up period may be too short to detect long-term benefits or potential sustained neuromodulatory effects. Psychological factors such as fear-avoidance behaviors and anxiety, which can influence recovery, were not considered. The lack of a sham PENS control means the observed short-term benefits could be partly due to placebo effects or the attention received during the procedure.
Declared interests
The authors declared no financial support for the research or publication of this article.
The easy way to misread this
Do not interpret the significant post-hoc differences at early time points as evidence that PENS changes long-term recovery. The primary analysis showed no significant difference between groups overall, and by 12 weeks, the control group had caught up in pain and strength outcomes.