Lieber R L, Silva P D, Daniel D M
Department of Orthopaedics, University of California, San Diego, USA.
J Orthop Res. 1996 Jan;14(1):131-8. doi: 10.1002/jor.1100140121.
Neuromuscular electrical stimulation and voluntary muscle contraction are two exercise modes widely used in rehabilitation to strengthen skeletal muscle. Since there is no debate as to which mode is most effective, we compared electrical stimulation with voluntary contraction performed at matched intensities following reconstructive surgery of the anterior cruciate ligament. Forty men and women, aged 15-44, were randomly assigned to either an electrical stimulation or a voluntary contraction group. None of the subjects had a previous history of neuromuscular injury. The subjects received treatment for 30 minutes a day, 5 days a week, for 4 weeks. Knee extension torque was monitored during treatment to try to match the absolute muscular tensions (quantified as "activity") achieved during therapy. To match the activity of the subjects in the electrical stimulation group, who were treated at the highest stimulation intensity they could tolerate, the subjects in the voluntary contraction group were paced at progressively increasing intensities corresponding to 15, 25, 35, and 45% of the injured limb's maximum voluntary torque during weeks 1, 2, 3, and 4, respectively. We found no significant difference between the groups in terms of maximum voluntary knee extension torque throughout the study period. In addition, 1 year after surgery, there was still no significant difference between groups with regard to knee extension torque (p > 0.4). These data suggest that neuromuscular electrical stimulation and voluntary muscle contraction treatments, when performed at the same intensity, are equally effective in strengthening skeletal muscle that has been weakened by surgical repair of the anterior cruciate ligament.
神经肌肉电刺激和自主肌肉收缩是康复治疗中广泛用于增强骨骼肌力量的两种运动模式。由于对于哪种模式最有效尚无争议，我们在前交叉韧带重建手术后，将电刺激与以匹配强度进行的自主收缩进行了比较。40名年龄在15至44岁之间的男性和女性被随机分为电刺激组或自主收缩组。所有受试者既往均无神经肌肉损伤史。受试者每天接受30分钟治疗，每周5天，共治疗4周。治疗期间监测膝关节伸展扭矩，以试图使治疗期间达到的绝对肌肉张力（量化为“活动量”）相匹配。为了使电刺激组中以其能耐受的最高刺激强度接受治疗的受试者的活动量相匹配，自主收缩组的受试者在第1、2、3和4周分别以逐渐增加的强度进行训练，强度分别相当于受伤肢体最大自主扭矩的15%、25%、35%和45%。在整个研究期间，我们发现两组之间在最大自主膝关节伸展扭矩方面没有显著差异。此外，术后1年，两组在膝关节伸展扭矩方面仍无显著差异（p>0.4）。这些数据表明，当以相同强度进行时，神经肌肉电刺激和自主肌肉收缩治疗在增强因前交叉韧带手术修复而减弱的骨骼肌方面同样有效。
