xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05971095</url>
    </required_header>
    <id_info>
      <org_study_id>20121994</org_study_id>
      <nct_id>NCT05971095</nct_id>
    </id_info>
    <brief_title>Comparison Between Percutaneous Femoral Nerve Neuromodulation Associated With Femoral Nerve Block and Standard Clinical Practice in Patients Undergoing Knee Arthroplasty.</brief_title>
    <acronym>NEPFAR</acronym>
    <official_title>Percutaneous Femoral Nerve Neuromodulation for Postoperative Analgesia and Functional Recovery Following Knee Arthroplasty.</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Hospital General Universitario de Valencia</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
    </sponsors>
    <source>Hospital General Universitario de Valencia</source>
    <oversight_info>
      <has_dmc>No</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
      <is_us_export>No</is_us_export>
    </oversight_info>
    <brief_summary>
      <textblock>
        The goal of this clinical trial is to compare the maximum isometric contraction force&#xD;
        differential of the quadriceps in the postoperative period after the use of a peripheral&#xD;
        nerve neuromodulation program in patients undergoing knee arthroplasty. The main questions it&#xD;
        aims to answer are if the combination of a peripheral neuromodulation program in the&#xD;
        perioperative period improves analgesic quality and short-term functional recovery in&#xD;
        patients undergoing knee arthroplasty,&#xD;
  &#xD;
        Participants will be asked to reach a maximum knee extension prior to neurostimulation&#xD;
        Patients will have the electrodes inserted under direct ultrasound vision and placed near the&#xD;
        femoral nerve.&#xD;
  &#xD;
        Researchers will compare whether there is a difference in both quadriceps contraction force&#xD;
        and analgesia between the stimulated group and the control group.&#xD;
      </textblock>
    </brief_summary>
    <overall_status>Recruiting</overall_status>
    <start_date type="Actual">June 1, 2023</start_date>
    <completion_date type="Anticipated">May 1, 2024</completion_date>
    <primary_completion_date type="Anticipated">January 1, 2024</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <intervention_model_description>This is an analytical study (with hypothesis testing) of a single-center, unblinded, randomized clinical trial. The patients will be separated between the intervention group and the control group.&#xD;
  To carry out the assignment of interventions, a methodology by blocks of 2 without stratification will be used. To obtain the sequence of random numbers, the official Clinical Trial Randomization Tool of the National Cancer Institute (USA) will be used.</intervention_model_description>
      <primary_purpose>Treatment</primary_purpose>
      <masking>None (Open Label)</masking>
    </study_design_info>
    <primary_outcome>
      <measure>Quadriceps maximal isometric contraction force differential after the use of a peripheral nerve neuromodulation program with direct current at low frequency combined with high frequency</measure>
      <time_frame>Before neuromodulation, immediately after the first phase of the program, and 24 hours after it.</time_frame>
      <description>To compare (analyze) the differential of the maximum isometric contraction force of the quadriceps in the postoperative period after the use of a peripheral nerve neuromodulation program with direct current at low frequency combined with high frequency compared to the usual practice.</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>VAS score and Opioid use</measure>
      <time_frame>In the immediate postoperative period in the PACU and at 24 hours</time_frame>
      <description>To compare the analgesic efficacy with the use of the described neuromodulation program versus the usual practice, in which it is not performed, in patients undergoing knee arthroplasty.</description>
    </secondary_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Anticipated">64</enrollment>
    <condition>Acute Pain</condition>
    <arm_group>
      <arm_group_label>Neuromodulation group</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>The maximum isometric contraction force of the quadriceps will be measured prior to the neuromodulation program using a hand dynamometer.&#xD;
  The percutaneous neuromodulation program will begin using the EPTE® Bipolar System device. The two stimulation protocols will be applied consecutively. Firstly, the high-frequency protocol (HFS) will be applied using the pulsed square waveform and 5 bursts of stimulation lasting 5 seconds at a frequency of 100 Hz separated by 55 s interval between bursts.&#xD;
  The low-frequency protocol (LFS) with stimulation at 2 Hz for 16 min with an intensity of 1000μA will subsequently be switched to.&#xD;
  The surgical intervention will be carried out by subarachnoid block with local anesthetic in accordance with the usual practice.&#xD;
  After its completion, a single injection block of the femoral nerve will be performed with a long-acting local anesthetic , a regional anesthesia technique included in routine clinical practice.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Control group</arm_group_label>
      <arm_group_type>No Intervention</arm_group_type>
      <description>The neuromodulation program will not be carried out. Only the maximum contraction force of the quadriceps prior to subarachnoid block will be measured. After the intervention, the femoral nerve block will be performed following the usual clinical practice.</description>
    </arm_group>
    <intervention>
      <intervention_type>Device</intervention_type>
      <intervention_name>Percutaneous neuromodulation using the EPTE® Bipolar System device</intervention_name>
      <description>The two stimulation protocols will be applied consecutively. Firstly, the high-frequency protocol (HFS) will be applied in order to produce potentiation of the non-nociceptive pathway, using the pulsed square waveform and 5 bursts of stimulation lasting 5 seconds at a frequency of 100 Hz separated by 55 s interval between bursts. Adjustments to amplitude and pulse width are made until the patient experiences paresthesias at a perceptible but not painful intensity, and the intensity will be set 200 μA above the detection threshold for each subject.&#xD;
  In order to depress the nociceptive pathway, the low-frequency protocol (LFS) with stimulation at 2 Hz for 16 min with an intensity of 1000μA will subsequently be switched to. To ensure the recruitment of higher threshold type C nociceptive fibers, the intensity level will be programmed at the pain threshold for each subject.</description>
      <arm_group_label>Neuromodulation group</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  Over 18 years&#xD;
  &#xD;
            -  Those who sign the informed consent&#xD;
  &#xD;
            -  Not pregnant&#xD;
  &#xD;
            -  Cognitive capacity that allows subjective postoperative evaluations.&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Under 18 years old&#xD;
  &#xD;
            -  IC rejection or withdrawal&#xD;
  &#xD;
            -  Pregnancy&#xD;
  &#xD;
            -  Cognitive impairment&#xD;
  &#xD;
            -  Contraindication for Regional Anesthesia&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>18 Years</minimum_age>
      <maximum_age>N/A</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>JOSE DE ANDRES IBAÑEZ, FEA</last_name>
      <role>Study Director</role>
      <affiliation>CONSORCIO HOSPITAL GENERAL DE VALENCIA</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>FERRAN MARQUES PEIRO, MD</last_name>
      <phone>34671364792</phone>
      <email>fermarpei@gmail.com</email>
    </overall_contact>
    <overall_contact_backup>
      <last_name>CARLOS DELGADO NAVARRO, FEA</last_name>
      <phone>34622523552</phone>
      <email>cardelna@gmail.com</email>
    </overall_contact_backup>
    <location>
      <facility>
        <name>Hospital General Universitario de Valencia</name>
        <address>
          <city>Valencia</city>
          <zip>46020</zip>
          <country>Spain</country>
        </address>
      </facility>
      <status>Recruiting</status>
      <contact>
        <last_name>Ferran Marques Peiro</last_name>
        <phone>671364792</phone>
        <email>fermarpei@gmail.com</email>
      </contact>
    </location>
    <location_countries>
      <country>Spain</country>
    </location_countries>
    <reference>
      <citation>Ripolles-Melchor J, Abad-Motos A, Diez-Remesal Y, Aseguinolaza-Pagola M, Padin-Barreiro L, Sanchez-Martin R, Logrono-Egea M, Catala-Bauset JC, Garcia-Orallo S, Bisbe E, Martin N, Suarez-de-la-Rica A, Cuellar-Martinez AB, Gil-Trujillo S, Estupinan-Jimenez JC, Villanova-Baraza M, Gil-Lapetra C, Perez-Sanchez P, Rodriguez-Garcia N, Ramiro-Ruiz A, Farre-Tebar C, Martinez-Garcia A, Arauzo-Perez P, Garcia-Perez C, Abad-Gurumeta A, Minambres-Villar MA, Sanchez-Campos A, Jimenez-Lopez I, Tena-Guerrero JM, Marin-Pena O, Sanchez-Merchante M, Vicente-Gutierrez U, Cassinello-Ogea MC, Ferrando-Ortola C, Berges-Gutierrez H, Fernanz-Anton J, Gomez-Rios MA, Bordonaba-Bosque D, Ramirez-Rodriguez JM, Garcia-Erce JA, Aldecoa C; Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM). Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2). JAMA Surg. 2020 Apr 1;155(4):e196024. doi: 10.1001/jamasurg.2019.6024. Epub 2020 Apr 15.</citation>
      <PMID>32049352</PMID>
    </reference>
    <reference>
      <citation>Dos'Santos T, Thomas C, Comfort P, McMahon JJ, Jones PA. Relationships between Isometric Force-Time Characteristics and Dynamic Performance. Sports (Basel). 2017 Sep 13;5(3):68. doi: 10.3390/sports5030068.</citation>
      <PMID>29910428</PMID>
    </reference>
    <reference>
      <citation>Maffiuletti NA. Assessment of hip and knee muscle function in orthopaedic practice and research. J Bone Joint Surg Am. 2010 Jan;92(1):220-9. doi: 10.2106/JBJS.I.00305.</citation>
      <PMID>20048117</PMID>
    </reference>
    <reference>
      <citation>Rice DA, McNair PJ. Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum. 2010 Dec;40(3):250-66. doi: 10.1016/j.semarthrit.2009.10.001. Epub 2009 Dec 2.</citation>
      <PMID>19954822</PMID>
    </reference>
    <results_reference>
      <citation>Ma HH, Chou TA, Tsai SW, Chen CF, Wu PK, Chen WM. The efficacy of continuous versus single-injection femoral nerve block in Total knee Arthroplasty: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2020 Feb 24;21(1):121. doi: 10.1186/s12891-020-3148-1.</citation>
      <PMID>32093655</PMID>
    </results_reference>
    <results_reference>
      <citation>Hussain N, Ferreri TG, Prusick PJ, Banfield L, Long B, Prusick VR, Bhandari M. Adductor Canal Block Versus Femoral Canal Block for Total Knee Arthroplasty: A Meta-Analysis: What Does the Evidence Suggest? Reg Anesth Pain Med. 2016 May-Jun;41(3):314-20. doi: 10.1097/AAP.0000000000000376. No abstract available.</citation>
      <PMID>27035459</PMID>
    </results_reference>
    <results_reference>
      <citation>Angers M, Belzile EL, Vachon J, Beauchamp-Chalifour P, Pelet S. Negative Influence of femoral nerve block on quadriceps strength recovery following total knee replacement: A prospective randomized trial. Orthop Traumatol Surg Res. 2019 Jun;105(4):633-637. doi: 10.1016/j.otsr.2019.03.002. Epub 2019 Mar 28.</citation>
      <PMID>30928275</PMID>
    </results_reference>
    <results_reference>
      <citation>Gilmore C, Ilfeld B, Rosenow J, Li S, Desai M, Hunter C, Rauck R, Kapural L, Nader A, Mak J, Cohen S, Crosby N, Boggs J. Percutaneous peripheral nerve stimulation for the treatment of chronic neuropathic postamputation pain: a multicenter, randomized, placebo-controlled trial. Reg Anesth Pain Med. 2019 Jun;44(6):637-645. doi: 10.1136/rapm-2018-100109. Epub 2019 Apr 5.</citation>
      <PMID>30954936</PMID>
    </results_reference>
    <results_reference>
      <citation>Plaza-Manzano G, Gomez-Chiguano GF, Cleland JA, Arias-Buria JL, Fernandez-de-Las-Penas C, Navarro-Santana MJ. Effectiveness of percutaneous electrical nerve stimulation for musculoskeletal pain: A systematic review and meta-analysis. Eur J Pain. 2020 Jul;24(6):1023-1044. doi: 10.1002/ejp.1559. Epub 2020 Apr 4.</citation>
      <PMID>32171035</PMID>
    </results_reference>
    <results_reference>
      <citation>Strand NH, D'Souza R, Wie C, Covington S, Maita M, Freeman J, Maloney J. Mechanism of Action of Peripheral Nerve Stimulation. Curr Pain Headache Rep. 2021 May 11;25(7):47. doi: 10.1007/s11916-021-00962-3.</citation>
      <PMID>33973135</PMID>
    </results_reference>
    <results_reference>
      <citation>Klein T, Magerl W, Hopf HC, Sandkuhler J, Treede RD. Perceptual correlates of nociceptive long-term potentiation and long-term depression in humans. J Neurosci. 2004 Jan 28;24(4):964-71. doi: 10.1523/JNEUROSCI.1222-03.2004.</citation>
      <PMID>14749441</PMID>
    </results_reference>
    <results_reference>
      <citation>Beltra P, Ruiz-Del-Portal I, Ortega FJ, Valdesuso R, Delicado-Miralles M, Velasco E. Sensorimotor effects of plasticity-inducing percutaneous peripheral nerve stimulation protocols: a blinded, randomized clinical trial. Eur J Pain. 2022 May;26(5):1039-1055. doi: 10.1002/ejp.1928. Epub 2022 Mar 3.</citation>
      <PMID>35191131</PMID>
    </results_reference>
    <results_reference>
      <citation>Ilfeld BM, Plunkett A, Vijjeswarapu AM, Hackworth R, Dhanjal S, Turan A, Cohen SP, Eisenach JC, Griffith S, Hanling S, Sessler DI, Mascha EJ, Yang D, Boggs JW, Wongsarnpigoon A, Gelfand H; PAINfRE Investigators. Percutaneous Peripheral Nerve Stimulation (Neuromodulation) for Postoperative Pain: A Randomized, Sham-controlled Pilot Study. Anesthesiology. 2021 Jul 1;135(1):95-110. doi: 10.1097/ALN.0000000000003776.</citation>
      <PMID>33856424</PMID>
    </results_reference>
    <results_reference>
      <citation>Gallego-Sendarrubias GM, Arias-Buria JL, Ubeda-D'Ocasar E, Hervas-Perez JP, Rubio-Palomino MA, Fernandez-de-Las-Penas C, Valera-Calero JA. Effects of Percutaneous Electrical Nerve Stimulation on Countermovement Jump and Squat Performance Speed in Male Soccer Players: A Pilot Randomized Clinical Trial. J Clin Med. 2021 Feb 10;10(4):690. doi: 10.3390/jcm10040690.</citation>
      <PMID>33578911</PMID>
    </results_reference>
    <verification_date>July 2023</verification_date>
    <study_first_submitted>July 6, 2023</study_first_submitted>
    <study_first_submitted_qc>July 24, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 2, 2023</study_first_posted>
    <last_update_submitted>July 24, 2023</last_update_submitted>
    <last_update_submitted_qc>July 24, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 2, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>Hospital General Universitario de Valencia</investigator_affiliation>
      <investigator_full_name>FERRAN MARQUES PEIRO</investigator_full_name>
      <investigator_title>Principal Investigator</investigator_title>
    </responsible_party>
    <keyword>PENS</keyword>
    <keyword>Neuromodulation</keyword>
    <keyword>Percutaneous peripheral nere stimulation</keyword>
    <keyword>Postoperative pain</keyword>
    <keyword>Acute pain after surgery</keyword>
    <keyword>Total Knee arthtolasty</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Acute Pain</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>Undecided</sharing_ipd>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05971095
  org study id: 20121994
  nct id: NCT05971095
  lead sponsor: 
  has dmc: No
  is fda regulated drug: No
  is fda regulated device: No
  is us export: No
  The goal of this clinical trial is to compare the maximum isometric contraction force
        differential of the quadriceps in the postoperative period after the use of a peripheral
        nerve neuromodulation program in patients undergoing knee arthroplasty. The main questions it
        aims to answer are if the combination of a peripheral neuromodulation program in the
        perioperative period improves analgesic quality and short-term functional recovery in
        patients undergoing knee arthroplasty,
  
        Participants will be asked to reach a maximum knee extension prior to neurostimulation
        Patients will have the electrodes inserted under direct ultrasound vision and placed near the
        femoral nerve.
  
        Researchers will compare whether there is a difference in both quadriceps contraction force
        and analgesia between the stimulated group and the control group.
  allocation: Randomized
  intervention model: Parallel Assignment
  intervention model description: This is an analytical study (with hypothesis testing) of a single-center, unblinded, randomized clinical trial. The patients will be separated between the intervention group and the control group.
  To carry out the assignment of interventions, a methodology by blocks of 2 without stratification will be used. To obtain the sequence of random numbers, the official Clinical Trial Randomization Tool of the National Cancer Institute (USA) will be used.
  primary purpose: Treatment
  masking: None (Open Label)
  measure: Quadriceps maximal isometric contraction force differential after the use of a peripheral nerve neuromodulation program with direct current at low frequency combined with high frequency
  time frame: Before neuromodulation, immediately after the first phase of the program, and 24 hours after it.
  description: To compare (analyze) the differential of the maximum isometric contraction force of the quadriceps in the postoperative period after the use of a peripheral nerve neuromodulation program with direct current at low frequency combined with high frequency compared to the usual practice.
  measure: VAS score and Opioid use
  time frame: In the immediate postoperative period in the PACU and at 24 hours
  description: To compare the analgesic efficacy with the use of the described neuromodulation program versus the usual practice, in which it is not performed, in patients undergoing knee arthroplasty.
  arm group label: Neuromodulation group
  arm group type: Experimental
  description: The maximum isometric contraction force of the quadriceps will be measured prior to the neuromodulation program using a hand dynamometer.
  The percutaneous neuromodulation program will begin using the EPTE® Bipolar System device. The two stimulation protocols will be applied consecutively. Firstly, the high-frequency protocol (HFS) will be applied using the pulsed square waveform and 5 bursts of stimulation lasting 5 seconds at a frequency of 100 Hz separated by 55 s interval between bursts.
  The low-frequency protocol (LFS) with stimulation at 2 Hz for 16 min with an intensity of 1000μA will subsequently be switched to.
  The surgical intervention will be carried out by subarachnoid block with local anesthetic in accordance with the usual practice.
  After its completion, a single injection block of the femoral nerve will be performed with a long-acting local anesthetic , a regional anesthesia technique included in routine clinical practice.
  arm group label: Control group
  arm group type: No Intervention
  description: The neuromodulation program will not be carried out. Only the maximum contraction force of the quadriceps prior to subarachnoid block will be measured. After the intervention, the femoral nerve block will be performed following the usual clinical practice.
  intervention type: Device
  intervention name: Percutaneous neuromodulation using the EPTE® Bipolar System device
  description: The two stimulation protocols will be applied consecutively. Firstly, the high-frequency protocol (HFS) will be applied in order to produce potentiation of the non-nociceptive pathway, using the pulsed square waveform and 5 bursts of stimulation lasting 5 seconds at a frequency of 100 Hz separated by 55 s interval between bursts. Adjustments to amplitude and pulse width are made until the patient experiences paresthesias at a perceptible but not painful intensity, and the intensity will be set 200 μA above the detection threshold for each subject.
  In order to depress the nociceptive pathway, the low-frequency protocol (LFS) with stimulation at 2 Hz for 16 min with an intensity of 1000μA will subsequently be switched to. To ensure the recruitment of higher threshold type C nociceptive fibers, the intensity level will be programmed at the pain threshold for each subject.
  arm group label: Neuromodulation group
  criteria: 
  gender: All
  minimum age: 18 Years
  maximum age: N/A
  healthy volunteers: No
  last name: JOSE DE ANDRES IBAÑEZ, FEA
  role: Study Director
  affiliation: CONSORCIO HOSPITAL GENERAL DE VALENCIA
  last name: FERRAN MARQUES PEIRO, MD
  phone: 34671364792
  email: fermarpei@gmail.com
  last name: CARLOS DELGADO NAVARRO, FEA
  phone: 34622523552
  email: cardelna@gmail.com
  facility: 
  status: Recruiting
  contact: 
  country: Spain
  citation: Ripolles-Melchor J, Abad-Motos A, Diez-Remesal Y, Aseguinolaza-Pagola M, Padin-Barreiro L, Sanchez-Martin R, Logrono-Egea M, Catala-Bauset JC, Garcia-Orallo S, Bisbe E, Martin N, Suarez-de-la-Rica A, Cuellar-Martinez AB, Gil-Trujillo S, Estupinan-Jimenez JC, Villanova-Baraza M, Gil-Lapetra C, Perez-Sanchez P, Rodriguez-Garcia N, Ramiro-Ruiz A, Farre-Tebar C, Martinez-Garcia A, Arauzo-Perez P, Garcia-Perez C, Abad-Gurumeta A, Minambres-Villar MA, Sanchez-Campos A, Jimenez-Lopez I, Tena-Guerrero JM, Marin-Pena O, Sanchez-Merchante M, Vicente-Gutierrez U, Cassinello-Ogea MC, Ferrando-Ortola C, Berges-Gutierrez H, Fernanz-Anton J, Gomez-Rios MA, Bordonaba-Bosque D, Ramirez-Rodriguez JM, Garcia-Erce JA, Aldecoa C; Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM). Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2). JAMA Surg. 2020 Apr 1;155(4):e196024. doi: 10.1001/jamasurg.2019.6024. Epub 2020 Apr 15.
  PMID: 32049352
  citation: Dos'Santos T, Thomas C, Comfort P, McMahon JJ, Jones PA. Relationships between Isometric Force-Time Characteristics and Dynamic Performance. Sports (Basel). 2017 Sep 13;5(3):68. doi: 10.3390/sports5030068.
  PMID: 29910428
  citation: Maffiuletti NA. Assessment of hip and knee muscle function in orthopaedic practice and research. J Bone Joint Surg Am. 2010 Jan;92(1):220-9. doi: 10.2106/JBJS.I.00305.
  PMID: 20048117
  citation: Rice DA, McNair PJ. Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum. 2010 Dec;40(3):250-66. doi: 10.1016/j.semarthrit.2009.10.001. Epub 2009 Dec 2.
  PMID: 19954822
  citation: Ma HH, Chou TA, Tsai SW, Chen CF, Wu PK, Chen WM. The efficacy of continuous versus single-injection femoral nerve block in Total knee Arthroplasty: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2020 Feb 24;21(1):121. doi: 10.1186/s12891-020-3148-1.
  PMID: 32093655
  citation: Hussain N, Ferreri TG, Prusick PJ, Banfield L, Long B, Prusick VR, Bhandari M. Adductor Canal Block Versus Femoral Canal Block for Total Knee Arthroplasty: A Meta-Analysis: What Does the Evidence Suggest? Reg Anesth Pain Med. 2016 May-Jun;41(3):314-20. doi: 10.1097/AAP.0000000000000376. No abstract available.
  PMID: 27035459
  citation: Angers M, Belzile EL, Vachon J, Beauchamp-Chalifour P, Pelet S. Negative Influence of femoral nerve block on quadriceps strength recovery following total knee replacement: A prospective randomized trial. Orthop Traumatol Surg Res. 2019 Jun;105(4):633-637. doi: 10.1016/j.otsr.2019.03.002. Epub 2019 Mar 28.
  PMID: 30928275
  citation: Gilmore C, Ilfeld B, Rosenow J, Li S, Desai M, Hunter C, Rauck R, Kapural L, Nader A, Mak J, Cohen S, Crosby N, Boggs J. Percutaneous peripheral nerve stimulation for the treatment of chronic neuropathic postamputation pain: a multicenter, randomized, placebo-controlled trial. Reg Anesth Pain Med. 2019 Jun;44(6):637-645. doi: 10.1136/rapm-2018-100109. Epub 2019 Apr 5.
  PMID: 30954936
  citation: Plaza-Manzano G, Gomez-Chiguano GF, Cleland JA, Arias-Buria JL, Fernandez-de-Las-Penas C, Navarro-Santana MJ. Effectiveness of percutaneous electrical nerve stimulation for musculoskeletal pain: A systematic review and meta-analysis. Eur J Pain. 2020 Jul;24(6):1023-1044. doi: 10.1002/ejp.1559. Epub 2020 Apr 4.
  PMID: 32171035
  citation: Strand NH, D'Souza R, Wie C, Covington S, Maita M, Freeman J, Maloney J. Mechanism of Action of Peripheral Nerve Stimulation. Curr Pain Headache Rep. 2021 May 11;25(7):47. doi: 10.1007/s11916-021-00962-3.
  PMID: 33973135
  citation: Klein T, Magerl W, Hopf HC, Sandkuhler J, Treede RD. Perceptual correlates of nociceptive long-term potentiation and long-term depression in humans. J Neurosci. 2004 Jan 28;24(4):964-71. doi: 10.1523/JNEUROSCI.1222-03.2004.
  PMID: 14749441
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  responsible party type: Principal Investigator
  investigator affiliation: Hospital General Universitario de Valencia
  investigator full name: FERRAN MARQUES PEIRO
  investigator title: Principal Investigator
  mesh term: Acute Pain
  sharing ipd: Undecided