Effects of Neuromuscular Electrical Stimulation After Anterior Cruciate Ligament Reconstruction on Quadriceps Strength, Function, and Patient-Oriented Outcomes: A Systematic Review

Kyung-Min Kim, Jay Hertel, Theodore Croy, Susan A. Saliba

DOI: 10.2519/jospt.2010.3184

STUDY DESIGN: Systematic literature review. OBJECTIVE: To perform a systematic review of randomized controlled trials assessing the effects of neuromuscular electrical stimulation (NMES) on quadriceps strength, functional performance, and self-reported function after anterior cruciate ligament reconstruction. BACKGROUND: Conflicting evidence exists regarding the effectiveness of NMES following anterior cruciate ligament reconstruction. METHODS: Searches were performed for randomized controlled trials using electronic databases from 1966 through October 2008. Methodological quality was assessed using the Physiotherapy Evidence Database Scale. Between-group effect sizes and 95% confidence intervals (CIs) were calculated. RESULTS: Eight randomized controlled trials were included. The average Physiotherapy Evidence Database Scale score was 4 out of possible maximum 10. The effect sizes for quadriceps strength measures (isometric or isokinetic torque) from 7 studies ranged from –0.74 to 3.81 at approximately 6 weeks postoperatively; 6 of 11 comparisons were statistically significant, with strength benefits favoring NMES treatment. The effect sizes for functional performance measures from 1 study ranged from 0.07 to 0.64 at 6 weeks postoperatively; none of 3 comparisons were statistically significant, and the effect sizes for self-reported function measures from 1 study were 0.66 and 0.72 at 12 to 16 weeks postoperatively; both comparisons were statistically significant, with benefits favoring NMES treatment. CONCLUSION: NMES combined with exercise may be more effective in improving quadriceps strength than exercise alone, whereas its effect on functional performance and patient-oriented outcomes is inconclusive. Inconsistencies were noted in the NMES parameters and application of NMES. LEVEL OF EVIDENCE: Therapy, level 1a–.

J Orthop Sports Phys Ther 2010;40(7):383-391, Epub 15 April 2010. doi:10.2519/jospt.2010.3184

KEY WORDS: ACL, electromodality, postsurgical knee rehabilitation, randomized clinical trials

The authors aim to perform a systematic review of randomized controlled trials assessing the effects of neuromuscular electrical stimulation on quadriceps strength, functional performance, and self-reported function after anterior cruciate ligament reconstruction.

Related Slides

(Right click the link below and select Save Target As...)

July2010-LR-Kim.ppt

Click here to earn Continuing Education Credits

View Full Article