Neuromuscular Electrical Stimulation for Quadriceps Muscle Strengthening After Bilateral Total Knee Arthroplasty: A Case Series

2004 ◽  
Author(s):  
Jennifer E. Stevens
Keyword(s):  
Total Knee Arthroplasty ◽  
Electrical Stimulation ◽  
Knee Arthroplasty ◽  
Neuromuscular Electrical Stimulation ◽  
Case Series ◽  
Quadriceps Muscle ◽  
Bilateral Total Knee Arthroplasty ◽  
Muscle Strengthening ◽  
Total Knee

scholarly journals Relationship Between Intensity of Quadriceps Muscle Neuromuscular Electrical Stimulation and Strength Recovery After Total Knee Arthroplasty

2012 ◽  
Vol 92 (9) ◽  
pp. 1187-1196 ◽  
Author(s):  
Jennifer E. Stevens-Lapsley ◽  
Jaclyn E. Balter ◽  
Pamela Wolfe ◽  
Donald G. Eckhoff ◽  
Robert S. Schwartz ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Electrical Stimulation ◽  
Muscle Strength ◽  
Muscle Fatigue ◽  
Knee Arthroplasty ◽  
Neuromuscular Electrical Stimulation ◽  
Quadriceps Muscle ◽  
Training Intensity ◽  
Quadriceps Muscle Strength ◽  
Total Knee

BackgroundNeuromuscular electrical stimulation (NMES) can facilitate the recovery of quadriceps muscle strength after total knee arthroplasty (TKA), yet the optimal intensity (dosage) of NMES and its effect on strength after TKA have yet to be determined.ObjectiveThe primary objective of this study was to determine whether the intensity of NMES application was related to the recovery of quadriceps muscle strength early after TKA. A secondary objective was to quantify quadriceps muscle fatigue and activation immediately after NMES to guide decisions about the timing of NMES during rehabilitation sessions.DesignThis study was an observational experimental investigation.MethodsData were collected from 30 people who were 50 to 85 years of age and who received NMES after TKA. These people participated in a randomized controlled trial in which they received either standard rehabilitation or standard rehabilitation plus NMES to the quadriceps muscle to mitigate strength loss. For the NMES intervention group, NMES was applied 2 times per day at the maximal tolerable intensity for 15 contractions beginning 48 hours after surgery over the first 6 weeks after TKA. Neuromuscular electrical stimulation training intensity and quadriceps muscle strength and activation were assessed before surgery and 3.5 and 6.5 weeks after TKA.ResultsAt 3.5 weeks, there was a significant association between NMES training intensity and a change in quadriceps muscle strength (R2=.68) and activation (R2=.22). At 6.5 weeks, NMES training intensity was related to a change in strength (R2=.25) but not to a change in activation (R2=.00). Furthermore, quadriceps muscle fatigue occurred during NMES sessions at 3.5 and 6.5 weeks, whereas quadriceps muscle activation did not change.LimitationsSome participants reached the maximal stimulator output during at least 1 treatment session and might have tolerated more stimulation.ConclusionsHigher NMES training intensities were associated with greater quadriceps muscle strength and activation after TKA.

Neuromuscular Electrical Stimulation Use after Total Knee Arthroplasty Improves Early Return to Function: A Randomized Trial

2020 ◽  
Author(s):  
Alison K. Klika ◽  
George Yakubek ◽  
Nicholas Piuzzi ◽  
Gary Calabrese ◽  
Wael K. Barsoum ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Electrical Stimulation ◽  
Knee Arthroplasty ◽  
Academic Medical Center ◽  
Recovery Period ◽  
Neuromuscular Electrical Stimulation ◽  
Quadriceps Strength ◽  
Randomized Controlled ◽  
Early Return ◽  
Total Knee

AbstractNeuromuscular electrical stimulation (NMES) has been reported as an effective method for quadriceps strengthening which could attenuate muscle loss in the early total knee arthroplasty (TKA) postoperative recovery period. The purpose of this randomized controlled trial was to test whether postoperative use of NMES on TKA patients results in increased quadriceps strength and ultimately improved functional outcomes. This randomized controlled clinical trial of 66 primary TKA patients was conducted at a large academic medical center. Patients were randomized 2:1 into treatment (NMES use, n = 44) or control arm (no NMES, n = 22). Patients who used the device for an average of 200 minutes/week or more (starting 1 week postoperative and continuing through week 12) were considered compliant. Baseline measurements and outcomes were recorded at 3, 6, and 12 weeks postoperatively, and included quadriceps strength, range of motion (ROM), resting pain, functional timed up and go (TUG), stair climb test, and knee injury and osteoarthritis outcome score (KOOS) and veterans rand 12-item health survey (VR-12) scores. Patients in the treatment arm (NMES use) experienced quadriceps strength gains over baseline at 3, 6, and 12 weeks following surgery, which were statistically significant compared with controls with quadriceps strength losses at 3 (p = 0.050) and 6 weeks (p = 0.015). The TUG improvements for patients treated with NMES showed significant improvements at 6 (p = 0.018) and 12 weeks (p = 0.003) postoperatively. Use of a home-based application-controlled NMES therapy system added to standard of care treatment showed statistically significant improvements in quadriceps strength and TUG following TKA, supporting a quicker return to function.

scholarly journals Comparison of Effectiveness of Cryotherapy and Neuromuscular Electrical Stimulation (NMES) on Pain, Range of Motion and Gait Speed in Early Post-Operative Phase in Subjects with Unilateral Total Knee Arthroplasty

2021 ◽  
Vol 8 (6) ◽  
pp. 245-259
Author(s):  
Jyotsna Amod Thosar ◽  
Miti Parikh ◽  
Mohan Madhav Desai
Keyword(s):  
Total Knee Arthroplasty ◽  
Electrical Stimulation ◽  
Range Of Motion ◽  
Exercise Therapy ◽  
Knee Arthroplasty ◽  
Gait Speed ◽  
Neuromuscular Electrical Stimulation ◽  
Analog Scale ◽  
Scale Range ◽  
Total Knee

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.

scholarly journals Femoral quadriceps neuromuscular electrical stimulation after total knee arthroplasty: a systematic review

2015 ◽  
Vol 14 (1) ◽  
pp. 77-98 ◽  
Author(s):  
Helena Bruna Bettoni Volpato ◽  
Paulo Szego ◽  
Mario Lenza ◽  
Silvia Lefone Milan ◽  
Claudia Talerman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Electrical Stimulation ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Randomized Clinical Trials ◽  
Neuromuscular Electrical Stimulation ◽  
Cochrane Library ◽  
Significant Difference ◽  
Total Knee

Abstract The purpose of this study was to evaluate the effects of neuromuscular electrical stimulation in patients submitted to total knee arthroplasty. This was a systematic review with no language or publication status restriction. Our search was made in Cochrane Library, MEDLINE, Embase and LILACS. Randomized or quasi-randomized clinical trials evaluating neuromuscular electrical stimulation after total knee arthroplasty were included. Four studies with moderate risk of bias and low statistical power were included, totalizing 376 participants. There was no statistically significant difference in knee function, pain and range of motion during 12 month follow-up. This review concluded that neuromuscular electrical stimulation was less effective than traditional rehabilitation in function, muscular strength and range of motion. However, this technique was useful for quadriceps activation during the first days after surgery.

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