Introduction: In acute phase after Total Knee Arthroplasty (TKA), physiotherapy, aims at reducing pain, local edema and muscle weakness. Among treatment techniques, cryotherapy increases pain tolerance, helping in uninhibited motor recruitment of quadriceps. Intermittent muscle fiber contraction with Neuromuscular Electrical Stimulation (NMES) improves blood flow, reduces pain and decreases quadriceps arthrogenic muscle inhibition. Exercise therapy causes muscle strengthening. Effects of perioperative cold therapy have conflicting evidences. Early NMES use, post TKA for pain and swelling reduction has shown paucity of literature. Hence, this study aims to compare the effectiveness of these techniques in improving function.
Method: Interventional study was conducted with 30 subjects randomly allocated into two groups (Group A- cryotherapy and Group B- NMES). Both received standardized exercise therapy. On 2nd postoperative day- pain (using Visual Analog Scale), Range Of Motion (using universal goniometer) and gait speed (using 4 metre walk test) was measured. Treatment was given for 5 days according to allocated group. Post-treatment outcome measures were taken.
Results: Out of 30 participants, both groups showed statistically significant (p<0.05) improvement in all outcomes. Comparing effectiveness between the groups, NMES showed statistically significant improvement for knee flexion ROM. Other outcome measures showed no statistically significant difference.
Conclusion: Rehabilitation in acute phase is essential for improving patient’s strength in long term. Along with exercise therapy, both cryotherapy and NMES showed improved function. On comparison, NMES showed better results for improvement in knee flexion ROM.
Keywords: Total Knee Arthroplasty, cryotherapy, neuromuscular electrical stimulation, exercise therapy, visual analog scale, range of motion, gait speed.
Modifiable and Nonmodifiable Predictive Factors Associated with the Outcomes of Total Knee Arthroplasty
