School of Engineering & Informatics, Electrical & Electronic Engineering, NUI Galway, University Road, Galway, Ireland.
Med Eng Phys. 2011 Jan;33(1):56-61. doi: 10.1016/j.medengphy.2010.09.003.
Neuromuscular electrical stimulation (NMES) may help reduce the incidence of deep vein thrombosis (DVT) in the postoperative total hip and knee arthroplasty patient. However, discomfort associated with stimulus may reduce patient acceptance of NMES as therapy. The aim of this study was to determine if patient comfort and tolerance of NMES was affected by applying stimulation in proximity to an orthopaedic implant. There was a concern that this may cause a concentration of current around the metal which could result in hypersensitivity of NMES and reduce its effectiveness. Twenty patients took part in this study, 10 total hip and 10 total knee arthroplasty patients. Each patient was at least 3 weeks post surgery. NMES was applied to the calf muscles of each leg using skin surface electrodes. Four excitatory levels were recorded, which were: sensory threshold, motor threshold, pain threshold and pain tolerance. Following this, patients underwent a 5 min stimulation session and indicated their overall comfort level on a visual analogue scale. Measurements of peak venous velocity, mean velocity and volume flow were recorded by duplex scanning from the popliteal vein at rest and in response to NMES elicited contractions during this session. Finally, patients completed a short verbal interview detailing their experience with the NMES treatment. The blood flow results showed increases in peak venous velocities, mean velocities and volume flow produced by NMES of 200%, 60% and 60% respectively when compared to resting blood flow. Comfort assessment indicated that the presence of a metallic implant did not give rise to hypersensitivity due to NMES. Patients found the application of calf muscle NMES comfortable and acceptable as a treatment. We conclude that the use of NMES on postoperative orthopaedic patients can be safely administered as a DVT prevention method.
神经肌肉电刺激（NMES）可能有助于减少全髋关节和膝关节置换术后深静脉血栓形成（DVT）的发生率。然而，与刺激相关的不适可能会降低患者对 NMES 治疗的接受程度。本研究旨在确定在靠近骨科植入物的地方施加刺激是否会影响 NMES 的患者舒适度和耐受性。有人担心这可能会导致电流在金属周围集中，从而导致 NMES 过敏和降低其有效性。这项研究共有 20 名患者参与，其中 10 名为全髋关节置换术患者，10 名为全膝关节置换术患者。每位患者术后至少 3 周。使用皮肤表面电极将 NMES 施加到每条腿的小腿肌肉上。记录了四个兴奋性水平，分别为：感觉阈值、运动阈值、疼痛阈值和疼痛耐受。在此之后，患者接受了 5 分钟的刺激治疗，并在视觉模拟量表上对整体舒适度进行了评估。通过从腘静脉在休息时和在该治疗期间 NMES 诱发收缩时进行的双功能超声扫描记录峰值静脉速度、平均速度和体积流量的测量值。最后，患者完成了简短的口头访谈，详细描述了他们对 NMES 治疗的体验。血流结果显示，与静息血流相比，NMES 产生的峰值静脉速度、平均速度和体积流量分别增加了 200%、60%和 60%。舒适度评估表明，金属植入物的存在不会因 NMES 而引起过敏。患者发现小腿肌肉 NMES 的应用舒适且可接受，是一种治疗方法。我们得出结论，NMES 可安全地用于术后骨科患者，作为 DVT 预防方法。
