Effect of Quadriceps Setting Exercise Combined with TENS on Knee Osteoarthritis: A Case Report

Abstract

Background: Knee osteoarthritis is a degenerative joint disorder characterized by pain, reduced range of motion, muscle weakness, and functional limitations, particularly in older adults and individuals with obesity. Effective physiotherapy interventions are required to address these impairments and improve functional capacity.

Objective: To evaluate the clinical outcomes of quadriceps setting exercise combined with transcutaneous electrical nerve stimulation (TENS) in a patient with bilateral knee osteoarthritis.

Methods: This case report describes a 68-year-old female with bilateral knee osteoarthritis (right grade III, left grade II) with bilateral knee osteoarthritis and obesity who underwent five physiotherapy sessions (twice weekly). Interventions included quadriceps setting exercise and TENS. Outcomes were assessed using the Visual Analog Scale (VAS) for pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functional ability, a goniometer for range of motion, and Manual Muscle Testing (MMT) for muscle strength. Descriptive analysis was applied to evaluate pre–post changes. This case involved a 3-week intervention period consisting of five physiotherapy sessions.

Results: Pain during movement decreased from VAS 8 to 5 (Δ=3 points). The WOMAC score improved from 43 to 33 (Δ=10 points; ~23% improvement). Knee flexion increased (right: 100° to 110°; left: 115° to 120°), and muscle strength improved to MMT grade 4 bilaterally. No adverse events were reported.

Conclusion: Quadriceps setting exercise combined with TENS shows potential to reduce pain and improve functional outcomes in knee osteoarthritis. However, findings from a single case should be interpreted cautiously and require further investigation.