REVIEWS  EFFECTIVENESS OF PHYSICAL EXERCISE AND NEUROMUSCULAR ELECTRICAL STIMULATION AFTER KNEE AND HIP ARTHROPLASTY: LESSONS FROM CONTROLLED CLINICAL TRIALS Free

European Journal of Physical and Rehabilitation Medicine 2013 December;49(6):909-20

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Neuromuscular electrical stimulation after total joint arthroplasty: a critical review of recent controlled studies

Kittelson A. J. ¹, Stackhouse S. K. ², Stevens-Lapsley J. E. ¹ ✉

¹ Physical Therapy Program Department of Physical Medicine and Rehabilitation University of Colorado, Aurora, CO, USA; ² Department of Physical Therapy Arcadia University, Glenside, PA, USA

Since 2009, four randomized controlled trials have investigated the use of Neuromuscular Electrical Stimulation (NMES) as a treatment modality following total knee arthroplasty (TKA). Two of these studies demonstrated a treatment effect of NMES for improving physical function, while another study failed to find additional benefit of NMES relative to a progressive exercise intervention. The fourth study demonstrated non-inferiority of NMES compared supervised physical therapy. These studies differed substantially in their methodology, including the timing, duration, treatment volume and intensity of NMES interventions. The purpose of this review is to examine and discuss variations between these recent trials to synthesize the current state of evidence for NMES in post-TKA rehabilitation. When comparing intervention parameters across recent studies, it appears that high intensity NMES performed regularly during the immediate postoperative phase helped to attenuate dramatic losses in quadriceps strength following TKA, thereby resulting in overall improvements in strength and function.