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

Eur J Phys Rehabil Med. 2013 Dec;49(6):909-20. Epub 2013 Nov 28.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Arthroplasty, Replacement, Knee / rehabilitation*
  • Electric Stimulation Therapy*
  • Humans
  • Muscle Weakness / rehabilitation*
  • Patient Selection
  • Quadriceps Muscle / physiology*
  • Quadriceps Muscle / physiopathology
  • Randomized Controlled Trials as Topic