Comparison of the Effect of Sensory-Level and Conventional Motor-Level Neuromuscular Electrical Stimulations on Quadriceps Strength After Total Knee Arthroplasty: A Prospective Randomized Single-Blind Trial

Arch Phys Med Rehabil. 2017 Dec;98(12):2364-2370. doi: 10.1016/j.apmr.2017.05.005. Epub 2017 Jun 10.

Abstract

Objective: To compare sensory-level neuromuscular electrical stimulation (NMES) and conventional motor-level NMES in patients after total knee arthroplasty.

Design: Prospective randomized single-blind trial.

Setting: Hospital total arthroplasty center: inpatients.

Participants: Patients with osteoarthritis (N=66; mean age, 73.5±6.3y; 85% women) were randomized to receive either sensory-level NMES applied to the quadriceps (the sensory-level NMES group), motor-level NMES (the motor-level NMES group), or no stimulation (the control group) in addition to a standard rehabilitation program.

Interventions: Each type of NMES was applied in 45-minute sessions, 5d/wk, for 2 weeks.

Main outcome measures: Data for the quadriceps maximum voluntary isometric contraction, the leg skeletal muscle mass determined using multiple-frequency bioelectrical impedance analysis, the timed Up and Go test, the 2-minute walk test, the visual analog scale, and the range of motion of the knee were measured preoperatively and at 2 and 4 weeks after total knee arthroplasty.

Results: The motor-level NMES (P=.001) and sensory-level NMES (P=.028) groups achieved better maximum voluntary isometric contraction results than did the control group. The motor-level NMES (P=.003) and sensory-level NMES (P=.046) groups achieved better 2-minute walk test results than did the control group. Some patients in the motor-level NMES group dropped out of the experiment because of discomfort.

Conclusions: Motor-level NMES significantly improved muscle strength and functional performance more than did the standard program alone. Motor-level NMES was uncomfortable for some patients. Sensory-level NMES was comfortable and improved muscle strength and functional performance more than did the standard program alone.

Keywords: Electric Stimulation; Knee; Muscles; Rehabilitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / rehabilitation*
  • Electric Stimulation Therapy / methods*
  • Humans
  • Isometric Contraction
  • Muscle Strength
  • Physical Therapy Modalities*
  • Prospective Studies
  • Quadriceps Muscle
  • Range of Motion, Articular
  • Single-Blind Method
  • Walking

Associated data

  • UMIN CTR/UMIN-CTR 000011884