36 patients with tibiofemoral osteoarthritis were randomized into three groups to assess the efficacy and compare transcutaneous electrical nerve stimulation in combination with therapeutic exercise to a placebo and control group. TENS treatment has been proposed to improve muscle activation which could provide benefits for this population which often suffers from quadriceps activation failure. The results from this study indicated that at varying time points throughout the intervention the TENS groups demonstrated improved central activation and maximal voluntary contractions, though this did not translate into significant differences in WOMAC scores between groups.