Electrical stimulation effect on extensor lag and length of hospital stay after total knee arthroplasty

Gotlin, Robert S.; Hershkowitz, Sid; Juris, Paul M.; Gonzalez, Erwin G.; Scott, W. Norman; Insall, John N.

doi:10.1016/0003-9993(94)90671-8

Cited by 42 publications

(32 citation statements)

References 10 publications

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“…However, resection of the anterior cruciate ligaments during the knee arthroplasty procedure is considered to decrease the number of afferent receptors eventually resulting in limited knee extension. Furthermore, one suggested that this mechanism is associated with a reflex inhibitory response, and that earlier functional improvements might be obtained by NMES through the inhibition of this mechanism 26 ) . The degree of flexion at baseline is a significant predictor of the degree of postoperative knee flexion.…”

Section: Discussionmentioning

confidence: 99%

The effect of neuromuscular electrical stimulation on functional status and quality of life after knee arthroplasty: a randomized controlled study

Demircioğlu

Paker²,

Erbil³

et al. 2015

J Phys Ther Sci

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[Purpose] The aim of this study was to investigate the effect of the addition of NMES to the post-TKA rehabilitation protocol on the functional status and quality of life of the patients. [Subjects and Methods] Patients were randomized into an exercise (control) and electrical stimulation (NMES) group. A home exercise program was prescribed for the control group. For the neuromuscular stimulation group 30 minute electrical stimulation applied to the vastus medialis muscle 5 days a week for 4 to 6 weeks. VAS, the timed up and go test, WOMAC and SF-36 scores were evaluated preoperatively and postoperatively at the first month and the third month of the follow-up period. [Results] Both the NMES group had 30 patients each, with 2 and 1 male patients respectively. The comparisons of WOMAC results at month 1 revealed that pain, stiffness, and total scores of the NMES group was significantly better than those of control group at the first and third months. Significantly better physical function and SF-36 subscales, except mental health, were found for the NMES group at the first month of follow-up. [Conclusion] The inclusion of the neuromuscular electrical stimulation program after knee arthroplasty was more effective at providing rapid improvements in knee pain, walking distance and quality of life.

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Section: Discussionmentioning

confidence: 99%

The effect of neuromuscular electrical stimulation on functional status and quality of life after knee arthroplasty: a randomized controlled study

Demircioğlu

Paker²,

Erbil³

et al. 2015

J Phys Ther Sci

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“…NMES is also used to address quads weakness after total hip arthroplasty. 143,[149][150][151][152][153][154] Recommendation is to position electrodes in line with the orientation of the muscle fibres. 124,125 Limb position: sitting; knee flexed 60-90 143,[152][153][154] NMES waveform: low-frequency biphasic PC [149][150][151][153][154][155][156] or 2500 Hz burst-modulated AC 143,152 Frequency: 50 Hz PC (range 40-75 Hz) or AC @ 50 Hz burst rate…”

Section: D Total Joint Replacementmentioning

confidence: 99%

“…Pulse duration: 250-400 ms 149,150,153,[155][156][157] Current amplitude: individual max tolerated intensity (use large electrodes for better comfort and to reach more motor units) 143,[149][150][151][152][153][154][155]157 Work-rest cycle: ON:OFF 5-10:8-80 s. Ratio of 1:2 or 1:3 recommended when using 10-50 Hz PC. 153,154 Ratio of 1-8 recommended when using 2500 Hz AC.…”

Section: D Total Joint Replacementmentioning

confidence: 99%

“…143,152,153 For increased function, 1-2 h/d, 5d/wk, for 6 wk. [149][150][151] Indication: Use combined with (not simultaneously with) supervised active Ex, resisted Ex, or both.…”

Section: D Total Joint Replacementmentioning

confidence: 99%

“…4 However, even functional outcomes appear limited using this type of protocol. [149][150][151]154 For example, investigators applied an endurance-type NMES protocol during continuous passive motion and reported benefits for knee extensor lag, 14 less than CON, and LOS a half-day shorter than CON; it is not clear whether these are clinically important differences. 151 In summary, our recommendations are to use a protocol targeting strength and function, combining low reps with rest periods that prevent muscle fatigue.…”

Section: D Total Joint Replacementmentioning

confidence: 99%

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Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice

Nussbaum

Houghton

Anthony

et al. 2017

Physiotherapy Canada

126

109

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In response to requests from physiotherapists for guidance on optimal stimulation of muscle using neuromuscular electrical stimulation (NMES), a review, synthesis, and extraction of key data from the literature was undertaken by six Canadian physical therapy (PT) educators, clinicians, and researchers in the field of electrophysical agents. The objective was to identify commonly treated conditions for which there was a substantial body of literature from which to draw conclusions regarding the effectiveness of NMES. Included studies had to apply NMES with visible and tetanic muscle contractions. Four electronic databases (CINAHL, Embase, PUBMED, and SCOPUS) were searched for relevant literature published between database inceptions until May 2015. Additional articles were identified from bibliographies of the systematic reviews and from personal collections. The extracted data were synthesized using a consensus process among the authors to provide recommendations for optimal stimulation parameters and application techniques to address muscle impairments associated with the following conditions: stroke (upper or lower extremity; both acute and chronic), anterior cruciate ligament reconstruction, patellofemoral pain syndrome, knee osteoarthritis, and total knee arthroplasty as well as critical illness and advanced disease states. Summaries of key details from each study incorporated into the review were also developed. The final sections of the article outline the recommended terminology for describing practice using electrical currents and provide tips for safe and effective clinical practice using NMES. This article provides physiotherapists with a resource to enable evidence-informed, effective use of NMES for PT practice.

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Effect of Outpatient Rehabilitation on Functional Mobility After Single Total Knee Arthroplasty

et al. 2020

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Key Points Question Are there short-term clinically significant rehabilitation outcome differences following total knee arthroplasty among patients in a standard rehabilitation care group and patients in any of 3 intervention groups using different types of equipment? Findings This randomized clinical trial compared post–total knee arthroplasty functional mobility on discharge from outpatient rehabilitation among 363 patients who were randomly assigned to 1 of 4 groups using different types of equipment (ie, a recumbent bike, a body weight–adjustable treadmill, a patterned electrical neuromuscular stimulation device, and a combination of a body weight–adjustable treadmill and a patterned electrical neuromuscular stimulation device). The Activity Measure for Post-Acute Care scores (measuring functional mobility) and ambulatory distances (measuring functional capacity) at discharge were not statistically different across groups. Meaning This randomized clinical trial found no statistically significant differences in functional outcomes on discharge based on the type of equipment used during patients’ post–total knee arthroplasty outpatient rehabilitation.

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Electrical stimulation effect on extensor lag and length of hospital stay after total knee arthroplasty

Cited by 42 publications

References 10 publications

The effect of neuromuscular electrical stimulation on functional status and quality of life after knee arthroplasty: a randomized controlled study

The effect of neuromuscular electrical stimulation on functional status and quality of life after knee arthroplasty: a randomized controlled study

Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice

Effect of Outpatient Rehabilitation on Functional Mobility After Single Total Knee Arthroplasty

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