Download PDF
CC BY-NC-ND 4.0 · Revista Fisioterapia Invasiva / Journal of Invasive Techniques in Physical Therapy 2020; 03(01): 030-034
DOI: 10.1055/s-0040-1701431
Case Series
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Efecto de la neuromodulación percutánea ecoguiada en el nervio femoral sobre el dolor y rango de movimiento en pacientes con dolor anterior de rodilla: Estudio de caso

Article in several languages: English | español
Paula García-Bermejo
1   DINAMIA Physiotherapy Clinic, Madrid, Spain
,
Carlos Romero-Morales 
2   Facultad de Ciencias del Deporte, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
,
Blanca de-la-Cruz-Torres 
3   Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain
› Author Affiliations
Further Information

Publication History

02 November 2019

05 December 2019

Publication Date:
19 May 2020 (online)

Also available at
   Permissions and Reprints

Resumen

Introducción El dolor anterior de rodilla (DAR) es uno de los principales motivos de consulta y su tratamiento continúa siendo un reto para el fisioterapeuta. El objetivo del estudio fue evaluar los efectos de una intervención de neuromodulación percutánea ecoguiada (NMP-e) en el nervio femoral sobre el dolor y el rango de movimiento (ROM) de flexión de rodilla, en pacientes con dolor anterior de rodilla unilateral crónico.

Método Ocho pacientes recibieron una única intervención de NMP-e sobre el nervio femoral de la rodilla sintomática. El nivel de dolor y el ROM fueron medidos antes, inmediatamente después y a las 24 horas de la intervención.

Resultados Se produjo un descenso del dolor y un aumento del ROM tras la intervención y a las 24 horas. Respecto al dolor, el tamaño del efecto fue mediano (ES = 0,63 ± 0,43) tras la intervención y grande (ES = 1,73 ± 0,44) a las 24h. Respecto al ROM, el tamaño del efecto fue grande en ambos momentos (ES = -1,30 ± 1,14; -1,76 ± 0,80, respectivamente).

Conclusión Una única intervención de NMP-e sobre el nervio femoral produce una disminución del dolor y aumenta el ROM, mayor a las 24h de la estimulación.

Nivel de evidencia Nivel II-3.

Palabras Claves

dolor anterior de rodilla - nervio femoral - neuromodulación percutánea - ecografía
 

  • References

  • 1 Aglietti P, Buzzi R, Pisaneschi A. Patella pain. J Sports Trauma Rel Res. 1990; 12: 131-150
    Google Scholar
  • 2 Goldberg B. Chronic anterior knee pain in the adolescent. Pediatr Ann 1991; 20 (04) 186-187 , 190–193
    CrossrefPubMedGoogle Scholar
  • 3 Sanchis-Alfonso V, Dye SF. How to deal with anterior knee pain in the active young patient. Sports Health 2017; 9 (04) 346-351
    CrossrefPubMedGoogle Scholar
  • 4 Sanchis-Alfonso V. Holistic approach to understanding anterior knee pain. Clinical implications. Knee Surg Sports Traumatol Arthrosc 2014; 22 (10) 2275-2285
    CrossrefPubMedGoogle Scholar
  • 5 Günther KP, Thielemann F, Bottesi M. [Anterior knee pain in children and adolescents. Diagnosis and conservative treatment]. Orthopade 2003; 32 (02) 110-118
    CrossrefPubMedGoogle Scholar
  • 6 Fairbank JC, Pynsent PB, van Poortvliet JA, Phillips H. Mechanical factors in the incidence of knee pain in adolescents and young adults. J Bone Joint Surg Br 1984; 66 (05) 685-693
    PubMedGoogle Scholar
  • 7 Lin PL, Shih YF, Chen WY, Ma HL. Neurodynamic responses to the femoral slump test in patients with anterior knee pain syndrome. J Orthop Sports Phys Ther 2014; 44 (05) 350-357
    CrossrefPubMedGoogle Scholar
  • 8 de la Cruz Torres B. Strength-duration curve of radial nerve in patients with lateral elbow pain. J Sport Rehabil 2019; 18: 1-6
    Google Scholar
  • 9 Rodríguez-Fernández ÁL, Rebollo-Roldán J, Jiménez-Rejano JJ, Güeita-Rodríguez J. Strength-Duration curves of the common fibular nerve show hypoexcitability in people with functional ankle instability. PM R 2016; 8 (06) 536-544
    CrossrefPubMedGoogle Scholar
  • 10 White JC, Sweet WH. Pain and the neurosurgeon: a forty-year experience. Springfield: Thomas; 1969: 894-899
    Google Scholar
  • 11 Stuart RM, Winfree CJ. Neurostimulation techniques for painful peripheral nerve disorders. Neurosurg Clin N Am 2009; 20 (01) 111-120 , vii–viii
    CrossrefPubMedGoogle Scholar
  • 12 Valera-Garrido F, Minaya-Muñoz F. Fisioterapia Invasiva. Barcelona: Elsevier España SL; 2016
    Google Scholar
  • 13 De-la-Cruz-Torres B. Ultrasound-guided Percutaneous neuromodulation in patients with unilateral refractory lateral epicondylitis. J Manipulative Physiol Ther 2019 ; In press
    PubMedGoogle Scholar
  • 14 Rossi M, DeCarolis G, Liberatoscioli G, Iemma D, Nosella P, Nardi LF. A novel mini-invasive approach to the treatment of neuropathic pain: the PENS study. Pain Physician 2016; 19 (01) E121-E128
    PubMedGoogle Scholar
  • 15 de la Cruz-Torres B, Barrera-García-Martín I, Albornoz-Cabello M. Immediate effects of ultrasound-guided percutaneous neuromodulation versus physical exercise on performance of the flexor hallucis longus muscle in professional dancers: a randomised clinical trial. Acupunct Med 2019; 37 (02) 91-97
    CrossrefPubMedGoogle Scholar
  • 16 Recoules-Arché D, Gayet A. [L4 crural neuralgia and disc hernia of the L4-L5 intervertebral foramen]. Rev Rhum Mal Osteoartic 1986; 53 (03) 161-165
    PubMedGoogle Scholar
  • 17 Hjermstad MJ, Fayers PM, Haugen DF. , et al; European Palliative Care Research Collaborative (EPCRC). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage 2011; 41 (06) 1073-1093
    CrossrefPubMedGoogle Scholar
  • 18 Norkin C, White DJ. Goniometría, evaluación de la movilidad articular. Marban; 2007
    Google Scholar
  • 19 Brosseau L, Tousignant M, Budd J. , et al. Intratester and intertester reliability and criterion validity of the parallelogram and universal goniometers for active knee flexion in healthy subjects. Physiother Res Int 1997; 2 (03) 150-166
    CrossrefPubMedGoogle Scholar
  • 20 Hopkins WG, Marshall SW, Batterham AM, Hanin J. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc 2009; 41 (01) 3-13
    PubMedGoogle Scholar
  • 21 Suarez-Arrones L, Arenas C, López G, Requena B, Terrill O, Mendez-Villanueva A. Positional differences in match running performance and physical collisions in men rugby sevens. Int J Sports Physiol Perform 2014; 9 (02) 316-323
    CrossrefPubMedGoogle Scholar
  • 22 Ilfeld BM, Gilmore CA, Grant SA. , et al. Ultrasound-guided percutaneous peripheral nerve stimulation for analgesia following total knee arthroplasty: a prospective feasibility study. J Orthop Surg Res 2017; 12 (01) 4
    CrossrefPubMedGoogle Scholar
  • 23 Ilfeld BM, Said ET, Finneran IV JJ. , et al. Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation: Neuromodulation of the Femoral Nerve for Postoperative Analgesia Following Ambulatory Anterior Cruciate Ligament Reconstruction: A Proof of Concept Study. Neuromodulation 2019; 22 (05) 621-629
    CrossrefPubMedGoogle Scholar
  • 24 Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965; 150 (3699): 971-979
    CrossrefPubMedGoogle Scholar
  • 25 de-la-Cruz-Torres B, Barrera-García-Martín I, Romero-Morales C. Comparative Effects of One-Shot Electrical Stimulation on Performance of the Flexor Hallucis Longus Muscle in Professional Dancers: Percutaneous Versus Transcutaneous?. Neuromodulation 2019 ; In press
    PubMedGoogle Scholar
  • 26 Ilfeld BM, Grant SA, Gilmore CA. , et al. Neurostimulation for Postsurgical Analgesia: A Novel System Enabling Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation. Pain Pract 2017; 17 (07) 892-901
    CrossrefPubMedGoogle Scholar
  • 27 Álvarez-Prats D, Carvajal-Fernández O, Pérez-Mellada N, Minaya-Muñoz F. Changes in Maximal Isometric Quadriceps Strength after the Application of Ultrasound-Guided Percutaneous Neuromodulation of the Femoral Nerve: A Case Series. Rev Fisioter Invasiva 2019; 2: 39-45
    Google Scholar
  • 28 Brosseau L, Balmer S, Tousignant M. , et al. Intra- and intertester reliability and criterion validity of the parallelogram and universal goniometers for measuring maximum active knee flexion and extension of patients with knee restrictions. Arch Phys Med Rehabil 2001; 82 (03) 396-402
    CrossrefPubMedGoogle Scholar