NMES Improves Strength After Knee Replacement Surgery

Patients who use neuromuscular electrical stimulation (NMES) following total knee arthroplasty (TKA) experience statistically significant gains in quadriceps strength compared with patients who do not receive NMES, a research team from the Cleveland Clinic reported.

NMES is effective for mitigating the loss of muscle mass following TKA in the early recovery period following surgery. The current study was designed to determine whether NMES would also be effective for helping patients increase quadriceps strength and improve function during recovery from TKA.

The researchers randomly assigned 66 patients with TKA into an NMES treatment group (n=44) or a control group (n=22) that did not use NMES. Patients adhered to therapy if they used an NMES device at home for an average of at least 200 minutes per week for 12 weeks postoperatively, beginning 1 week after TKA. 

The team recorded baseline measurements and outcomes of quadriceps strength, range of motion, resting pain, functional timed up-and-go (TUG), and stair climb test outcomes at weeks 3, 6, and 12 following TKA. They also calculated knee injury and osteoarthritis outcome scores and veterans rand 12-item health survey scores for both groups.

Patients who received NMES gained quadriceps strength from baseline at all 3 postoperative follow-up visits. These results were statistically significant compared with the results from the control group, which had quadriceps strength losses at 3 and 6 weeks. Patients treated with NMES also demonstrated significant improvements in TUG at 6 and 12 weeks.

“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,” the researchers concluded.

—Rebecca Mashaw

Reference:

Klika AK, Yakubek G, Piuzzi N, Calabrese G,  Barsoum WK, Higuera CA. Neuromuscular electrical stimulation use after total knee arthroplasty improves early return to function: a randomized trial. J Knee Surg.  Published online July 1, 2020. doi:10.1055/s-0040-1713420