From the Department of Orthopaedics, Traumatology and Rehabilitation, Orthopaedic and Trauma Centre, CTO, Hospital Città della Salute e della Scienza, Turin, Italy (AB, RF, EM, IDR, GM); University of the Studies of Turin, Turin, Italy (JZ, FA, EL, GM); and Department of Clinical and Biological Sciences, Statistics, Orbassano, Turin, Italy (PB).
Am J Phys Med Rehabil. 2018 Feb;97(2):123-130. doi: 10.1097/PHM.0000000000000847.
The aim of the study was to evaluate the efficacy of the use of the neuromuscular electrical stimulation after total knee arthroplasty.
The study used a systematic review of randomized controlled trials (MEDLINE, PubMed, Cochrane Library, and PEDro) using Patient Population or Problem, Intervention, Comparison, Outcomes, Setting approach to formulate the research question, controlled terms, and Boolean operators. Inclusion and exclusion criteria were defined in advance. "Neuromuscular electrical stimulation" and "total knee arthroplasty" were used as keywords. The overall risk of bias was determined according to the following: random sequence generation, concealment, blinding mass of participants and staff, commissioning blind assessment results, incomplete data, and loans received.
Of the 36 identified studies, six were included in the review (496 participants). In these studies, one group of patients followed a rehabilitation protocol (control group) and the other followed a rehabilitation program plus a session of neuromuscular electrical stimulation (neuromuscular electrical stimulation group). Patients of neuromuscular electrical stimulation groups got the best scores (timed up and go test, stair climbing test, and walk test). Neuromuscular electrical stimulation benefits were strong in the first postoperative weeks/months and gradually diminished.
Neuromuscular electrical stimulation allows a slightly better functional recovery after total knee arthroplasty, especially in the first period, with more evident benefits in patients with a severe lack of muscular activation. Nevertheless, there is no difference at medium-long term.
本研究旨在评估全膝关节置换术后使用神经肌肉电刺激的疗效。
本研究采用系统评价随机对照试验（MEDLINE、PubMed、Cochrane 图书馆和 PEDro），采用患者人群或问题、干预、比较、结局、设定方法来制定研究问题，使用控制术语和布尔运算符。纳入和排除标准事先定义。使用“神经肌肉电刺激”和“全膝关节置换术”作为关键词。根据以下标准确定总体偏倚风险：随机序列生成、隐匿、参与者和工作人员的盲法、委托盲法评估结果、数据不完整和贷款。
在 36 项已确定的研究中，有 6 项研究被纳入综述（496 名参与者）。在这些研究中，一组患者遵循康复方案（对照组），另一组患者遵循康复方案加一次神经肌肉电刺激（神经肌肉电刺激组）。神经肌肉电刺激组的患者获得了最佳评分（计时起立行走测试、爬楼梯测试和步行测试）。神经肌肉电刺激在术后第一周/月效果明显，且逐渐减弱。
神经肌肉电刺激可在全膝关节置换术后略微改善功能恢复，特别是在早期，对肌肉激活严重不足的患者效果更为明显。然而，在中-长期没有差异。
