Center for Knee and Foot Surgery Sports Traumatology, ATOS Clinic Centre Heidelberg, D-69115 Heidelberg, Germany.
Am J Sports Med. 2011 Jun;39(6):1238-47. doi: 10.1177/0363546510396180. Epub 2011 Feb 22.
Rehabilitation after anterior cruciate ligament reconstruction is a key determinant affecting patient return to usual activity levels. Neuromuscular electrical stimulation is a treatment that can counteract strength loss and serve as an adjunct to conventional therapy.
To compare the effect of adding traditional neuromuscular electrical stimulation (Polystim) or a novel garment-integrated neuromuscular electrical stimulation (Kneehab) to a standard postoperative rehabilitation program (control).
Randomized controlled trial; Level of evidence, 1.
Ninety-six patients, of a total enrolled cohort of 131 patients randomized to 1 of 3 intervention groups, completed a standard rehabilitation program. In addition, the 2 neuromuscular electrical stimulation groups underwent 20-minute sessions of neuromuscular electrical stimulation 3 times a day, 5 days a week, for 12 weeks, in which stimulation was superimposed on isometric volitional contractions. Outcome measures including isokinetic strength of the knee extensors of the injured and uninjured leg at 90 and 180 deg/s, along with functional tests of proprioception, were assessed at baseline and at 6 weeks, 12 weeks, and 6 months postoperatively.
The Kneehab group achieved significantly better results at each time point compared with the Polystim and control groups (P < .001). Extensor strength of the Kneehab group at speeds of 90 and 180 deg/s increased by 30.2% and 27.8%, respectively, between the preoperative measurements and the 6-month follow-up point in the injured leg. The corresponding changes for Polystim were 5.1% and 5%, whereas for the control group they were 6.6% and 6.7%, respectively. The mean single-legged hop test hop score of the Kneehab group improved by 50% between the 6-week and 6-month follow-up, whereas the corresponding changes for the Polystim and control groups were 26.3% and 26.2%, respectively. Although there was no significant difference between the groups with respect to the Tegner score and the International Knee Documentation Committee 2000 knee examination score, the Kneehab group showed a significant difference in mean improvement for the baseline corrected Lysholm score compared with the control group (P = .01; 95% confidence interval, 1.12-8.59) and with the Polystim group (P < .001; 95% confidence interval, 1.34-9.09) with no significant difference evident between Polystim and control groups (P = .97; 95% confidence interval, -4.23 to 3.51).
Intensive garment-integrated stimulation combined with standard rehabilitation is effective at accelerating recovery after knee surgery.
前交叉韧带重建术后的康复是影响患者恢复到正常活动水平的关键决定因素。神经肌肉电刺激是一种可以对抗力量损失的治疗方法，可作为常规治疗的辅助手段。
比较在标准术后康复计划（对照组）中添加传统神经肌肉电刺激（Polystim）或新型服装集成神经肌肉电刺激（Kneehab）对患者的影响。
随机对照试验；证据水平，1 级。
96 名患者，共纳入 131 名患者随机分为 3 个干预组中的 1 个，完成了标准康复计划。此外，2 个神经肌肉电刺激组每天进行 3 次、每次 20 分钟的神经肌肉电刺激，每周 5 天，在等长自主收缩时叠加刺激。在术前、术后 6 周、12 周和 6 个月时，评估受伤和未受伤腿的等速伸膝器的膝关节伸肌的等速力量以及本体感受功能测试。
与 Polystim 组和对照组相比，Kneehab 组在每个时间点的结果均显著更好（P <.001）。Kneehab 组受伤腿在术前测量和 6 个月随访点之间，90 和 180 度/秒的伸肌强度分别增加了 30.2%和 27.8%。Polystim 的相应变化分别为 5.1%和 5%，而对照组则分别为 6.6%和 6.7%。Kneehab 组单腿跳跃测试的平均跳跃得分在 6 周和 6 个月随访之间提高了 50%，而 Polystim 和对照组的相应变化分别为 26.3%和 26.2%。尽管各组之间在 Tegner 评分和国际膝关节文献委员会 2000 膝关节检查评分方面没有显著差异，但与对照组相比，Kneehab 组的基线校正 Lysholm 评分的平均改善程度存在显著差异（P =.01；95%置信区间，1.12-8.59），与 Polystim 组相比差异也有统计学意义（P <.001；95%置信区间，1.34-9.09），而 Polystim 组与对照组之间无显著差异（P =.97；95%置信区间，-4.23 至 3.51）。
强化服装集成刺激与标准康复相结合，可有效加速膝关节手术后的康复。
