Introduction: Osteoarthritis is an age-related, degenerative, and progressive joint disease, which affects the loss of articular cartilage, bone changes, and the formation of bone growths in the synovial joints. The most common form of osteoarthritis is knee osteoarthritis, which causes pain, stiffness, and functional incapacity of the knee joint. It is often associated with the decreased activation of the quadriceps femoris muscle and, consequently, muscle weakness. The treatment includes a multidisciplinary approach focused on the patient and his needs, which includes a combination of interventions to manage pain and improve function. Although TENS is a commonly used method for pain management, its use has also followed in procedures to reduce functional impairment in knee osteoarthritis. Purpose: The purpose of this diploma thesis is to determine the impact of TENS on pain, knee muscle capacity and functional ability in people with knee osteoarthritis. Methods: The descriptive method was used. An overview of literature was carried in PubMed, Cobbis, and PEDro databases, with set criteria and chosen keywords. Results: Six randomized controlled trials were included in the review. Two studies compared the immediate effect of TENS compared to placebo TENS. One study compared the effects of TENS with focal knee joint cooling and the control group, and two studies compared the effect of TENS in combination with exercise compared with placebo TENS and a control group. Another study compared the effect of active TENS with different frequencies compared to placebo TENS. They found that TENS was no more effective than placebo or a control group without stimulation in managing pain in osteoarthritis of the knee joint, while they found an immediate effect of TENS on central activation ratio. Immediately after the first treatment, TENS effectively contributed to the excitability of the quadriceps femoris and increased muscle performance in combination with exercise after four weeks of therapy. In defining effects on functional capacity, the evidence is contradictory. Discussion and conclusion: Based on the literature review, we can conclude that TENS is effective in increasing muscle capacity and muscle activation. It also has a positive effect on walking. Further studies are needed, with larger samples of subjects, which would focus on the long-term use of TENS.
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