Sun Hangxing, Wu Dan, Lou Chao, Ying Jinhe, Zhang Tao
Department of Orthopedic Surgery, NO.2 People's Hospital of Yuhang Distract, Hangzhou, 311100, China.
Department of Medical Examination Center, Qingyuan County People's Hospital Medical Examination Center, Qingyuan 323800, Zhejiang, China.
Iran J Public Health. 2025 May;54(5):928-938. doi: 10.18502/ijph.v54i5.18628.
We aimed to comprehensively evaluate the impact of neuromuscular electrical stimulation (NMES) on rehabilitation outcomes in patients following joint replacement surgery.
The systematic review and meta-analysis performed a computerized search of six databases-PubMed, Wiley Library, EMBASE, Web of Science, Cochrane Central, and PEDro-from 2009-2024, for relevant randomized controlled trials (RCTs). Two independent reviewers screened the literature, extracted data, and assessed the risk of bias according to predefined criteria. The primary outcome measures included range of Motion (ROM), pain scores, muscle strength, and functional recovery scores.
Ten RCTs involving 549 participants were included in the analysis, all of which met the inclusion criteria and had a moderate to low risk of bias. NMES significantly reduced pain scores in patients following joint replacement surgery (Standardized mean differences, with high heterogeneity (I = 82%). NMES had no significant effect on flexion range of motion (I = 33%) and a limited impact on extension range of motion (=0.04). NMES positively affected quadriceps strength (I = 95%). For the Timed Up and Go (TUG) test, NMES had a small positive effect ( < 0.01), but after standardizing TUG test scores based on baseline levels, NMES had a significant positive effect ( < 0.01). NMES had a significant positive effect on the stairs climb test ( < 0.01) and on function score ( = 0.01).
NMES is an effective adjunctive therapy for improving joint range of motion, reducing pain, and enhancing functional recovery after joint replacement surgery, but further high-quality RCTs are needed to confirm these findings.
我们旨在全面评估神经肌肉电刺激（NMES）对关节置换术后患者康复结局的影响。
本系统评价和荟萃分析对2009年至2024年期间的六个数据库——PubMed、Wiley Library、EMBASE、Web of Science、Cochrane Central和PEDro进行了计算机检索，以查找相关的随机对照试验（RCT）。两名独立的审阅者筛选文献、提取数据，并根据预定义标准评估偏倚风险。主要结局指标包括关节活动范围（ROM）、疼痛评分、肌肉力量和功能恢复评分。
分析纳入了10项涉及549名参与者的RCT，所有这些研究均符合纳入标准，且偏倚风险为中到低。NMES显著降低了关节置换术后患者的疼痛评分（标准化均数差，异质性高（I² = 82%））。NMES对屈曲活动范围没有显著影响（I² = 33%），对伸展活动范围的影响有限（I² = 0.04）。NMES对股四头肌力量有积极影响（I² = 95%）。对于计时起立行走（TUG）测试，NMES有较小的积极影响（P < 0.01），但在根据基线水平对TUG测试分数进行标准化后，NMES有显著的积极影响（P < 0.01）。NMES对爬楼梯测试有显著的积极影响（P < 0.01），对功能评分也有显著影响（P = 0.01）。
NMES是一种有效的辅助治疗方法，可改善关节置换术后的关节活动范围、减轻疼痛并促进功能恢复，但需要进一步的高质量RCT来证实这些发现。
