Article

Neuromuscular electrical stimulation (NMES) can facilitate the
recovery of quadriceps muscle strength after total knee arthroplasty (TKA), yet
the optimal intensity (dosage) of NMES and its effect on strength after TKA have
yet to be determined. OBJECTIVE: The primary objective of this study was to
determine whether the intensity of NMES application was related to the recovery
of quadriceps muscle strength early after TKA. A secondary objective was to
quantify quadriceps muscle fatigue and activation immediately after NMES to guide
decisions about the timing of NMES during rehabilitation sessions. DESIGN: This
study was an observational experimental investigation. METHODS: Data were
collected from 30 people who were 50 to 85 years of age and who received NMES
after TKA. These people participated in a randomized controlled trial in which
they received either standard rehabilitation or standard rehabilitation plus NMES
to the quadriceps muscle to mitigate strength loss. For the NMES intervention
group, NMES was applied 2 times per day at the maximal tolerable intensity for 15
contractions beginning 48 hours after surgery over the first 6 weeks after TKA.
Neuromuscular electrical stimulation training intensity and quadriceps muscle
strength and activation were assessed before surgery and 3.5 and 6.5 weeks after
TKA. RESULTS: At 3.5 weeks, there was a significant association between NMES
training intensity and a change in quadriceps muscle strength (R(2)=.68) and
activation (R(2)=.22). At 6.5 weeks, NMES training intensity was related to a
change in strength (R(2)=.25) but not to a change in activation (R(2)=.00).
Furthermore, quadriceps muscle fatigue occurred during NMES sessions at 3.5 and
6.5 weeks, whereas quadriceps muscle activation did not change. LIMITATIONS: Some
participants reached the maximal stimulator output during at least 1 treatment
session and might have tolerated more stimulation. CONCLUSIONS: Higher NMES
training intensities were associated with greater quadriceps muscle strength and
activation after TKA.

Langue : ANGLAIS