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

Publication date: Available online 10 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Yosuke Yoshida, Koki Ikuno, Koji Shomoto
ObjectiveTo compare sensory-level neuromuscular electrical stimulation (sNMES) and conventional motor- level neuromuscular electrical stimulation (mNMSE ) in patients after total knee arthroplasty (TKA).DesignA prospective randomized single-blind trial.SettingA hospital total arthroplasty center: inpatients.ParticipantsPatients 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.InterventionsEach type of NMES was applied in 45 minute sessions, 5days/week, for 2 weeks.Main Outcome MeasuresData 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.ResultsThe 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.ConclusionThe 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.



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