Klika Alison K, Yakubek George, Piuzzi Nicholas, Calabrese Gary, Barsoum Wael K, Higuera Carlos A
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
Cleveland Clinic Florida, Weston, Florida.
J Knee Surg. 2022 Jan;35(1):104-111. doi: 10.1055/s-0040-1713420. Epub 2020 Jul 1.
Neuromuscular electrical stimulation (NMES) has been reported as an effective method for quadriceps strengthening which could attenuate muscle loss in the early total knee arthroplasty (TKA) postoperative recovery period. The purpose of this randomized controlled trial was to test whether postoperative use of NMES on TKA patients results in increased quadriceps strength and ultimately improved functional outcomes. This randomized controlled clinical trial of 66 primary TKA patients was conducted at a large academic medical center. Patients were randomized 2:1 into treatment (NMES use, = 44) or control arm (no NMES, = 22). Patients who used the device for an average of 200 minutes/week or more (starting 1 week postoperative and continuing through week 12) were considered compliant. Baseline measurements and outcomes were recorded at 3, 6, and 12 weeks postoperatively, and included quadriceps strength, range of motion (ROM), resting pain, functional timed up and go (TUG), stair climb test, and knee injury and osteoarthritis outcome score (KOOS) and veterans rand 12-item health survey (VR-12) scores. Patients in the treatment arm (NMES use) experienced quadriceps strength gains over baseline at 3, 6, and 12 weeks following surgery, which were statistically significant compared with controls with quadriceps strength losses at 3 ( = 0.050) and 6 weeks ( = 0.015). The TUG improvements for patients treated with NMES showed significant improvements at 6 ( = 0.018) and 12 weeks ( = 0.003) postoperatively. Use of a home-based application-controlled NMES therapy system added to standard of care treatment showed statistically significant improvements in quadriceps strength and TUG following TKA, supporting a quicker return to function.
神经肌肉电刺激（NMES）已被报道为一种有效的股四头肌强化方法，可在全膝关节置换术（TKA）术后早期恢复阶段减轻肌肉损失。这项随机对照试验的目的是测试TKA患者术后使用NMES是否能增强股四头肌力量并最终改善功能结果。这项针对66例初次TKA患者的随机对照临床试验在一家大型学术医疗中心进行。患者按2:1随机分为治疗组（使用NMES，n = 44）或对照组（不使用NMES，n = 22）。平均每周使用该设备200分钟或更长时间（术后1周开始并持续至第12周）的患者被视为依从性良好。在术后3、6和12周记录基线测量值和结果，包括股四头肌力量、活动范围（ROM）、静息疼痛、功能性计时起立行走测试（TUG）、爬楼梯测试以及膝关节损伤和骨关节炎结局评分（KOOS）和退伍军人12项健康调查（VR - 12）评分。治疗组（使用NMES）的患者在术后3、6和12周时股四头肌力量相对于基线有所增加，与在3周（P = 0.050）和6周时股四头肌力量下降的对照组相比，差异具有统计学意义（P = 0.015）。接受NMES治疗的患者在术后6周（P = 0.018）和12周（P = 0.003）时TUG有显著改善。在标准护理治疗基础上增加使用家庭应用控制的NMES治疗系统，显示TKA术后股四头肌力量和TUG有统计学意义的改善，支持更快恢复功能。
