Quadriceps Muscle Neuromuscular Electrical Stimulation & Strength Recovery Discussion
Quadriceps Muscle Neuromuscular Electrical Stimulation & Strength Recovery Discussion
Relationship Between Intensity of Quadriceps Muscle Neuromuscular Electrical Stimulation and Strength Recovery After Total Knee Arthroplasty
Research Report
Purpose and Significance
There is no question that the article aids in our understanding of different approaches available for muscle recovery. With this in mind, the purpose of the article is to determine the relationship between the intensity of neuromuscular electrical stimulation (NMES) and the recovery of quadriceps muscle strength after total knee arthroplasty (TKA). The authors aimed to determine the importance of NMES training intensity generally. Consequently, the said study hypothesized that quadriceps muscle activation would improve through NMES. Further, the study is important for the reason that it proves the effectiveness of NMES in terms of muscle strength improvement, pain reduction, as well as contractures. Through the study’s findings, the health community is able to perceive NMES as an effective approach for quadriceps muscle mitigation after TKA.
Research Methods
In terms of methods and procedures, the investigation utilized an observational substudy of data that was controlled, randomized, and paralleled. Through a randomized controlled trial, 30 people aged 50-85 years old were given the opportunity to receive (1) standard rehabilitation or (2) standard rehabilitation and NMES. The participants underwent a similar tricompartmental cemented TKA with a medial parapatellar surgical approach. It is also worthy to note that all of the participants have already received NMES after TKA. Moreover, exclusion criteria included uncontrolled hypertension, diabetes, body mass index, impairments, and osteoarthritis. To further advance the said study, the researchers assessed the participants quadriceps muscle strength and activation before surgery.
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Findings
Their findings have shown that neuromuscular electrical stimulation is an effective approach when it comes to the mitigation of quadriceps muscle central activation after TKA. To be more specific, their data analysis suggests that there is a significant relationship between NMES training intensity and quadriceps muscle strength and activation. Although NMES is a beneficial procedure, the authors have identified a few limitations: muscle fatigue and the recruitment of nerve fibers. In other words, this relates to patient tolerance for NMES application. Hence, the authors recommended that NMES application requires familiarization before surgery. In addition, the authors have concluded that additional investigation is necessary to establish a threshold for NMES application as a whole.
Strengths and Weaknesses
Similar to most studies, this article held its strengths and weaknesses. To start off with its strengths, the study conducted an NMES intervention. Hence, the authors were able to determine strength activation, muscle retrains that aided in the study’s outcomes. Further, the study itself was supported by the National Institute on Aging. Thus, sufficient resources were accessible and enabled the study to be more reliable and accurate in terms of their discussions. On the other hand, one of its weaknesses is using an observational study approach–this becomes an avenue for bias and confounding to take place. In addition, the authors and their findings also had limitations in line with not being able to determine a minimum threshold for NMES application.
Clinical Implications
A clinical implication from this research is that NMES treatment resulted in improvements in quadriceps muscle strength and activation. This particular evidence found by the authors aid in the provision of knowledge in relation to leg movements. Essentially, the research conveyed a message that quadriceps muscle strength plays a significant key role in nearly all of our leg movements, making individuals resistant to weakness including osteoarthritis and knee cartilage loss. Another clinical implication taken from this study is that the authors mentioned how most NMES-related studies focus on healthy individuals rather than those who struggle with muscle function. With that being said, this evidence is imperative primarily because it makes NMES-related studies more inclusive and accessible. Consequently, both of these clinical implications can be applied in real-time situations.
Research Application
Undoubtedly, therapeutic exercises play a vital role for patients recovering from total knee arthroplasty. Therapeutic exercises assist people in their overall body improvement. The findings of this research suggested that NMES is a significant and effective approach towards recovery. With this in mind, the research becomes a positive avenue for patients to have access to information and alternatives in terms of functional recovery, ROM deficit reduction, and motor control improvements. Additionally, the findings of this research is accommodating of patients recovering from TKA to a high extent. Hence, the participants were given the chance to improve their muscle strength through an organized procedure and rehabilitation–a situation that should be applied in reality.
References
Stevens-Lapsley, Jennifer, et al. “Relationship Between Intensity of Quadriceps Muscle Neuromuscular Electrical Stimulation and Strength Recovery After Total Knee Arthroplasty.” Research Report: Physical Therapy, Volume 92.
