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Neuromuscular electrical stimulation therapy to restore quadriceps muscle function in patients after orthopaedic surgery

Journal of Bone and Joint Surgery - American Volume, ISSN: 1535-1386, Vol: 98, Issue: 23, Page: 2017-2024
2016
  • 39
    Citations
  • 0
    Usage
  • 144
    Captures
  • 0
    Mentions
  • 12
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    39
  • Captures
    144
  • Social Media
    12
    • Shares, Likes & Comments
      12
      • Facebook
        12

Review Description

▸ Despite evidence supporting the use of neuromuscular electrical stimulation (NMES) as an adjunct exercise modality to improve voluntary activation, muscle strength, and functional recovery after knee surgery, NMES therapy remains a clinically underutilized modality. ▸ We propose a criteria-based treatment algorithm aimed at optimizing and simplifying the clinical application of NMES therapy following knee surgery. ▸ The suggested algorithm includes a short preoperative phase for patient education (1 visit) and familiarization with NMES, followed by 2 home-based treatment phases (each lasting 3 weeks): (1) a high-intensity, high-volume phase initiated within the first few days following surgery, and (2) a high-intensity, low-volume phase. ▸ Two evaluation sessions are also incorporated, with the first following 1 week of treatment to assess the responsiveness to NMES and the second after 3 weeks of treatment to assess whether voluntary activation failure has resolved. ▸ Practical guidelines for maximizing muscle response while minimizing discomfort and fatigue, including optimal pulse characteristics, electrode size and location, knee joint position, and patient instructions, are provided.

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