Comparison of the effect of sensory-level and conventional motor-level neuromuscular electrical stimulation on quadriceps strength after total knee arthroplasty: a prospective randomized single-blind trial

• Published in: Archives of physical medicine and rehabilitation
• Main Authors: Yoshida, Yosuke, MSc, Ikuno, Koki, PhD, Shomoto, Koji, PhD
• Format: Journal Article
• Language: English
• Published: 2017
• Subjects: Physical Medicine and Rehabilitation; Body Mass Index; Timed Up and Go test; LSMM; MVIC; TUG; muscle strength training; Visual Analog Scale; Leg Skeletal Muscle Mass; NMES; VAS; TKA; Bioelectrical Impedance Analysis; Neuromuscular Electrical Stimulation; 2MWT; 2 Minute Walk Test; sensory-level neuromuscular electrical stimulation; total knee arthroplasty; ROM; Maximum Voluntary Isometric Contraction; OA; BIA; Osteoarthritis; BMI; Range of Motion
• ISSN: 0003-9993
• DOI: 10.1016/j.apmr.2017.05.005

Abstract Objective To compare sensory-level neuromuscular electrical stimulation (sNMES) and conventional motor - level neuromuscular electrical stimulation (mNMSE ) in patients after total knee arthroplasty (TKA). Design A prospective randomized single-blind trial. Setting A hospital total arthroplasty center: inpatients. Participants Patients with osteoarthritis (N=66, 85% women, mean age 73.5±6.3y) were randomized to receive either sNMES applied to the quadriceps (the sNMES group), mNMES (the mNMES 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, 5days/week, for 2 weeks. Main Outcome Measures Data for the quadriceps maximum voluntary isometric contraction (MVIC), the leg skeletal muscle mass determined using multiple frequency bioelectrical impedance analysis, the Timed Up and Go test, the 2-Minute Walk Test (2MWT), the visual analogue scale, and the range-of-motion of the knee were measured preoperative and at 2 and 4 weeks after TKA. Results The mNMES ( P = 0.001) and sNMES groups ( P = 0.028) achieved better MVIC results than the Control group. The mNMES ( P = 0.003) and sNMES groups ( P = 0.046) achieved better 2MWT results than the Control group. Some patients in the mNMES group dropped out of the experiment due to discomfort. Conclusion The mNMES significantly improved the muscle strength and functional performance more than the standard program alone. The mNMES was uncomfortable for some patients. The sNMES was comfortable and improved muscle strength and functional performance more than the standard program alone.