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Shi H, Li F, Zhang F, Wei X, Liu C, Duan R. An electrical stimulation intervention protocol to prevent disuse atrophy and muscle strength decline: an experimental study in rat. J Neuroeng Rehabil 2023; 20:84. [PMID: 37386493 PMCID: PMC10311794 DOI: 10.1186/s12984-023-01208-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 06/19/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Skeletal muscle is negatively impacted by conditions such as spaceflight or prolonged bed rest, resulting in a dramatic decline in muscle mass, maximum contractile force, and muscular endurance. Electrical stimulation (ES) is an essential tool in neurophysiotherapy and an effective means of preventing skeletal muscle atrophy and dysfunction. Historically, ES treatment protocols have used either low or high frequency electrical stimulation (LFES/HFES). However, our study tests the use of a combination of different frequencies in a single electrical stimulation intervention in order to determine a more effective protocol for improving both skeletal muscle strength and endurance. METHODS An adult male SD rat model of muscle atrophy was established through 4 weeks of tail suspension (TS). To investigate the effects of different frequency combinations, the experimental animals were treated with low (20 Hz) or high (100 Hz) frequency before TS for 6 weeks, and during TS for 4weeks. The maximum contraction force and fatigue resistance of skeletal muscle were then assessed before the animals were sacrificed. The muscle mass, fiber cross-sectional area (CSA), fiber type and related protein expression were examined and analyzed to gain insights into the mechanisms by which the ES intervention protocol used in this study regulates muscle strength and endurance. RESULTS After 4 weeks of unloading, the soleus muscle mass and fiber CSA decreased by 39% and 58% respectively, while the number of glycolytic muscle fibers increased by 21%. The gastrocnemius muscle fibers showed a 51% decrease in CSA, with a 44% decrease in single contractility and a 39% decrease in fatigue resistance. The number of glycolytic muscle fibers in the gastrocnemius also increased by 29%. However, the application of HFES either prior to or during unloading showed an improvement in muscle mass, fiber CSA, and oxidative muscle fibers. In the pre-unloading group, the soleus muscle mass increased by 62%, while the number of oxidative muscle fibers increased by 18%. In the during unloading group, the soleus muscle mass increased by 29% and the number of oxidative muscle fibers increased by 15%. In the gastrocnemius, the pre-unloading group showed a 38% increase in single contractile force and a 19% increase in fatigue resistance, while in the during unloading group, a 21% increase in single contractile force and a 29% increase in fatigue resistance was observed, along with a 37% and 26% increase in the number of oxidative muscle fibers, respectively. The combination of HFES before unloading and LFES during unloading resulted in a significant elevation of the soleus mass by 49% and CSA by 90%, with a 40% increase in the number of oxidative muscle fibers in the gastrocnemius. This combination also resulted in a 66% increase in single contractility and a 38% increase in fatigue resistance. CONCLUSION Our results indicated that using HFES before unloading can reduce the harmful effects of muscle unloading on the soleus and gastrocnemius muscles. Furthermore, we found that combining HFES before unloading with LFES during unloading was more effective in preventing muscle atrophy in the soleus and preserving the contractile function of the gastrocnemius muscle.
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Affiliation(s)
- Haiwang Shi
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Fan Li
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Fulong Zhang
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Xiaobei Wei
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Chengyi Liu
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Rui Duan
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China.
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Ogrodzka-Ciechanowicz K, Głąb G, Ślusarski J, Gądek A. Quadriceps muscle strength recovery with the use of high tone power therapy after anterior cruciate ligament reconstruction: a randomized controlled trial. BMC Musculoskelet Disord 2021; 22:975. [PMID: 34814896 PMCID: PMC8609762 DOI: 10.1186/s12891-021-04862-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/11/2021] [Indexed: 11/21/2022] Open
Abstract
Background There are no scientific reports clearly describing the effectiveness of the High Tone Power Therapy in patients after ACL reconstruction. This caused that in own research an attempt was made to present the possibilities of using the selected method of electrical stimulation in the treatment of an orthopaedic patient. The aim was to assess the effectiveness of electro stimulation of the quadriceps muscle in patients after ACL reconstruction, with the use of High Tone Power Therapy. Methods In randomized controlled trial took part thirty-five men, aged 21–50, after ACL reconstruction. The tests were carried prior to and 6 months following the ACL reconstruction. After the surgery, the patients were randomly divided into experimental group (17 patients) with the High Tone Power Therapy in rehabilitation and control group (18 patients) without the High Tone Power Therapy. Patients were subjected to 6-month rehabilitation. Research tools included the measurement of muscle strength torque, ROM, knee and thigh circumference measurements, the Lysholm and the VAS scale. Results After applying HiToP, the analysis showed a statistically significant improvement of muscle torque (p = 0.041, Es = 3.71), knee circumference (p = 0.039, Es = 1.65), thigh circumference (p = 0.049, Es = 1.26), knee extension (p < 0.001, Es = 2.20) in Experimental group compared to the control group. Only the results of the VAS scale did not differ statistically significantly both within a given group and between groups. Conclusions The results confirm the hypothesis that the use of HiToP in patients after ACLr have a beneficial effect on muscle strength, reduction of joint effusion, muscle mass gain and joint function. The assumption that HiToP significantly reduces pain levels is not supported - the results in both groups are statistically insignificant. Trial registration The research project was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR). Date of first registration 11.10.2016. Registration number: ACTRN12616001416482.
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Affiliation(s)
- Katarzyna Ogrodzka-Ciechanowicz
- Institute of Clinical Rehabilitation, Faculty of Motor Rehabilitation, University of Physical Education in Krakow, Al. Jana Pawla II 78, 31-571, Krakow, Poland.
| | - Grzegorz Głąb
- Institute of Clinical Rehabilitation, Faculty of Motor Rehabilitation, University of Physical Education in Krakow, Al. Jana Pawla II 78, 31-571, Krakow, Poland
| | - Jakub Ślusarski
- Trauma and Orthopaedics Clinical Department, University Hospital in Krakow, Krakow, Poland
| | - Artur Gądek
- Trauma and Orthopaedics Clinical Department, University Hospital in Krakow, Krakow, Poland.,Department of Orthopaedics and Physiotherapy at Jagiellonian University Collegium Medicum, Krakow, Poland
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Sherman DA, Rush JL, Glaviano NR, Norte GE. Hamstrings Muscle Morphology After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis. Sports Med 2021; 51:1733-50. [PMID: 33638795 DOI: 10.1007/s40279-021-01431-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hamstrings muscle morphology is determinant of muscle function (i.e. strength). Among individuals with ACL reconstruction (ACLR), less cross-sectional area (CSA) and volume in the ACLR-limb are associated with muscle weakness, and may contribute to lower rates of return to preinjury activity level and an increased risk for long-term sequelae. OBJECTIVES To effectively treat muscular impairments, an accurate understanding of differences in hamstrings morphology following ACLR is needed. A systematic review and meta-analysis were undertaken to describe the morphology of the hamstring muscle complex after ACLR. METHODS We searched five databases for studies evaluating the difference between hamstrings size and architecture in individuals with ACLR. Two independent reviewers assessed each paper for inclusion and quality. Means and standard deviations were extracted from each included study to allow fixed-effect size meta-analysis calculations for comparison of results. RESULTS Twenty-four studies were included for final review. Eight categories of morphological outcomes were identified, and studies were grouped accordingly: (1) volume, (2) cross-sectional area (CSA), (3) muscle length, (4) muscle thickness, (5) fascicle length, (6) pennation angle, (7) fiber area, and (8) fiber type. Meta-analysis demonstrated lower hamstrings volume in the ACLR-limb in both contralateral and control group comparisons, and lower CSA, length, and thickness in the ACLR-limb in contralateral comparisons. The semitendinosus and gracilis were most profoundly impacted. Limited moderate evidence demonstrated greater biceps femoris pennation angle in the ACLR-limb. CONCLUSIONS Individuals with ACLR demonstrated large deficits in semitendinosus and gracilis muscle CSA and volume in the ACLR-limb compared contralaterally, with no differences observed in the biceps femoris or semimembranosus. Clinical implications regarding assessment and treatment of individuals with ACLR are discussed.
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Conley CEW, Mattacola CG, Jochimsen KN, Dressler EV, Lattermann C, Howard JS. A Comparison of Neuromuscular Electrical Stimulation Parameters for Postoperative Quadriceps Strength in Patients After Knee Surgery: A Systematic Review. Sports Health 2021; 13:116-127. [PMID: 33428557 DOI: 10.1177/1941738120964817] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
CONTEXT Postoperative quadriceps strength weakness after knee surgery is a persistent issue patients and health care providers encounter. OBJECTIVE To investigate the effect of neuromuscular electrical stimulation (NMES) parameters on quadriceps strength after knee surgery. DATA SOURCES CINAHL, MEDLINE, SPORTDiscus, and PubMed were systematically searched in December 2018. STUDY SELECTION Studies were excluded if they did not assess quadriceps strength or if they failed to report the NMES parameters or quadriceps strength values. Additionally, studies that applied NMES to numerous muscle groups or simultaneously with other modalities/treatments were excluded. Study quality was assessed with the Physiotherapy Evidence Database (PEDro) scale for randomized controlled trials. STUDY DESIGN Systematic review. LEVEL OF EVIDENCE Level 1. DATA EXTRACTION Treatment parameters for each NMES treatment was extracted for comparison. Quadriceps strength means and standard deviations were extracted and utilized to calculate Hedge g effect sizes with 95% CIs. RESULTS Eight RCTs were included with an average Physiotherapy Evidence Database scale score of 5 ± 2. Hedge g effect sizes ranged from small (-0.37; 95% CI, -1.00 to 0.25) to large (1.13; 95% CI, 0.49 to 1.77). Based on the Strength of Recommendation Taxonomy Quality of Evidence table, the majority of the studies included were low quality RCTs categorized as level 2: limited quality patient-oriented evidence. CONCLUSION Because of inconsistent evidence among studies, grade B evidence exists to support the use of NMES to aid in the recovery of quadriceps strength after knee surgery. Based on the parameters utilized by studies demonstrating optimal treatment effects, it is recommended to implement NMES treatment during the first 2 postoperative weeks at a frequency of ≥50 Hz, at maximum tolerable intensity, with a biphasic current, with large electrodes and a duty cycle ratio of 1:2 to 1:3 (2- to 3-second ramp).
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Affiliation(s)
- Caitlin E W Conley
- Department of Orthopaedic Surgery and Sports Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Carl G Mattacola
- College of Health and Human Sciences, The University of North Carolina Greensboro, Greensboro, North Carolina
| | - Kate N Jochimsen
- Division of Athletic Training, School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Emily V Dressler
- Department of Biostatistics and Data Science, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Christian Lattermann
- Department of Orthopedic Surgery, Center for Cartilage Repair and Sports Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jennifer S Howard
- Department of Health and Exercise Science, Beaver College of Health Sciences, Appalachian State University, Boone, North Carolina
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Charles D, White R, Reyes C, Palmer D. A SYSTEMATIC REVIEW OF THE EFFECTS OF BLOOD FLOW RESTRICTION TRAINING ON QUADRICEPS MUSCLE ATROPHY AND CIRCUMFERENCE POST ACL RECONSTRUCTION. Int J Sports Phys Ther 2020; 15:882-91. [PMID: 33344004 DOI: 10.26603/ijspt20200882] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background ACL reconstruction often results in an extended period of muscle atrophy and weakness. Blood flow restriction (BFR) training is a technique that has been shown to decrease muscle atrophy in a variety of populations. Purpose The purpose of this systematic review was to analyze the research presented on the effect of blood flow restriction training on quadriceps muscle atrophy and circumference post ACL reconstruction. Study Design Systematic Review. Methods Articles were reviewed using the databases Google Scholar, PubMed, and EBSCO. Keywords included blood flow restriction training, ACL reconstruction, and quadriceps. Inclusion criteria included English language, peer-reviewed journals; randomized control trials; and articles including blood flow restriction and measurement of quadriceps atrophy and circumference post ACL reconstruction. Exclusion criteria included non-English language publications; studies without a control group; and articles without sufficient data to evaluate the methodology. Four studies met the selection criteria and were assessed using the GRADE scale, which analyzes the strength of a study based on study limitations, precision, consistency, directness, and publication bias. After a GRADE designation was assigned, the following information was extracted from and compared across the studies: participant demographics, cuff used, graft used during ACL reconstruction, tool used to assess muscle atrophy, protocol used, and conclusions. Results Three out of four studies showed some amount of an increase in femoral muscle cross sectional area after the use of BFR combined with low-intensity resistance training (LIRT). The strength of all four studies was moderate when assessed using the GRADE scale. Conclusion This review of the available evidence yields promising results regarding the use of BFR and LIRT in the remediation of femoral muscle atrophy after an ACL reconstruction. Further research is necessary before BFR can be recommended for use in clinical settings. Level of evidence 3a.
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Mancinelli R, Toniolo L, Di Filippo ES, Doria C, Marrone M, Maroni CR, Verratti V, Bondi D, Maccatrozzo L, Pietrangelo T, Fulle S. Neuromuscular Electrical Stimulation Induces Skeletal Muscle Fiber Remodeling and Specific Gene Expression Profile in Healthy Elderly. Front Physiol 2019; 10:1459. [PMID: 31827446 PMCID: PMC6890722 DOI: 10.3389/fphys.2019.01459] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/12/2019] [Indexed: 01/08/2023] Open
Abstract
Skeletal muscle aging is a multifactorial process strictly related to progressive weakness. One of the results that were focused on was the fiber phenotype modification and their loss. The physiological muscle recruitment to contraction, basically prosecuted under volitional control, can also be engaged by means of Neuromuscular Electrical Stimulation (NMES). Knowing that the NMES is effective in improving muscle strength in active healthy elderly, the aim was to investigate which physiological modifications were able to produce in the Vastus lateralis muscle and the pathways involved. It was found that NMES increased the cross sectional area and the isometric strength of type II myofibers together with the activated myogenic pathway in order to shift glycolytic toward the oxidative phenotype II myofibers, at a molecular level and with an increase of maximal voluntary contraction (MVC) at a functional level. Using the TaqMan low density array on 48 different genes, we found that NMES specific gene regulation highlighted: (i) increased protein synthesis with respect to protein degradation; (ii) the activation of an apoptotic pathway involved in the differentiation process; (iii) increased regeneration signals; (iv) oxidative enzyme regulation. These pathways were validated via confirmatory RT-PCR for genes involved in the regeneration process as well as Myosin isoforms. We also investigated the oxidative stress status analyzing superoxide anion levels, the protein expression of two different superoxide dismutase and the activity of both catalase and superoxide anion dismutase, being two main antioxidant enzymes. In conclusion, data demonstrates that NMES is effective in producing physiological adaptation on Vastus Lateralis of active healthy elderly as well as providing new insights for further research on elderly who experienced muscle detriment for periodic or permanent immobility.
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Affiliation(s)
- Rosa Mancinelli
- Department of Neuroscience Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.,Interuniversity Institute of Myology, Rome, Italy.,Laboratory of Functional Evaluation, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Luana Toniolo
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Ester Sara Di Filippo
- Department of Neuroscience Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.,Interuniversity Institute of Myology, Rome, Italy.,Laboratory of Functional Evaluation, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Christian Doria
- Department of Neuroscience Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.,Laboratory of Functional Evaluation, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Mariangela Marrone
- Department of Neuroscience Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.,Interuniversity Institute of Myology, Rome, Italy.,Laboratory of Functional Evaluation, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Camilla Reina Maroni
- Department of Neuroscience Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.,Interuniversity Institute of Myology, Rome, Italy
| | - Vittore Verratti
- Laboratory of Functional Evaluation, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.,Department of Psychological, Health and Territorial Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Danilo Bondi
- Department of Neuroscience Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.,Laboratory of Functional Evaluation, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Lisa Maccatrozzo
- Department of Comparative Biomedicine and Food Science, University of Padova, Padua, Italy
| | - Tiziana Pietrangelo
- Department of Neuroscience Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.,Interuniversity Institute of Myology, Rome, Italy.,Laboratory of Functional Evaluation, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Stefania Fulle
- Department of Neuroscience Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.,Interuniversity Institute of Myology, Rome, Italy.,Laboratory of Functional Evaluation, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
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McGee TG, Cosgarea AJ, McLaughlin K, Tanaka M, Johnson K. Rehabilitation After Medial Patellofemoral Ligament Reconstruction. Sports Med Arthrosc Rev 2017; 25:105-13. [PMID: 28459754 DOI: 10.1097/JSA.0000000000000147] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patellar instability resulting from subluxation or dislocation is a painful and commonly recurring condition. Retinacular restraints control patellar tracking, limiting the movement of the patella in the trochlear groove. The medial patellofemoral ligament (MPFL) is considered the main soft tissue stabilizer against lateral displacement. Few studies of patellar instability discuss rehabilitation after MPFL reconstruction. In this review, we discuss the phases of rehabilitation after MPFL reconstruction, typical interventions by rehabilitation specialists, and patient-specific guidelines for return to prior level of function. The Musculoskeletal Institute at The Johns Hopkins Hospital (a collaboration of orthopedic surgeons, primary care sports medicine physicians, and clinicians from the Department of Physical Medicine and Rehabilitation) presents its rehabilitation protocol with phase-specific guidelines for progression after MPFL reconstruction. This evidence-based protocol is a generalized approach that is customized for each patient's needs.
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Nussbaum EL, Houghton P, Anthony J, Rennie S, Shay BL, Hoens AM. Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice. Physiother Can 2017; 69:1-76. [PMID: 29162949 PMCID: PMC5683854 DOI: 10.3138/ptc.2015-88] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose: In response to requests from physiotherapists for guidance on optimal stimulation of muscle using neuromuscular electrical stimulation (NMES), a review, synthesis, and extraction of key data from the literature was undertaken by six Canadian physical therapy (PT) educators, clinicians, and researchers in the field of electrophysical agents. The objective was to identify commonly treated conditions for which there was a substantial body of literature from which to draw conclusions regarding the effectiveness of NMES. Included studies had to apply NMES with visible and tetanic muscle contractions. Method: Four electronic databases (CINAHL, Embase, PUBMED, and SCOPUS) were searched for relevant literature published between database inceptions until May 2015. Additional articles were identified from bibliographies of the systematic reviews and from personal collections. Results: The extracted data were synthesized using a consensus process among the authors to provide recommendations for optimal stimulation parameters and application techniques to address muscle impairments associated with the following conditions: stroke (upper or lower extremity; both acute and chronic), anterior cruciate ligament reconstruction, patellofemoral pain syndrome, knee osteoarthritis, and total knee arthroplasty as well as critical illness and advanced disease states. Summaries of key details from each study incorporated into the review were also developed. The final sections of the article outline the recommended terminology for describing practice using electrical currents and provide tips for safe and effective clinical practice using NMES. Conclusion: This article provides physiotherapists with a resource to enable evidence-informed, effective use of NMES for PT practice.
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Affiliation(s)
- Ethne L. Nussbaum
- Department of Physical Therapy, University of Toronto
- Toronto Rehab, University Health Network, Toronto, Ontario
| | - Pamela Houghton
- School of Physical Therapy, University of Western Ontario, London
| | - Joseph Anthony
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia
| | - Sandy Rennie
- Department of Physical Therapy, University of Toronto
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia
| | - Barbara L. Shay
- Department of Physical Therapy, University of Manitoba, Winnipeg, Manitoba
| | - Alison M. Hoens
- School of Physical Therapy, University of Western Ontario, London
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Gatewood CT, Tran AA, Dragoo JL. The efficacy of post-operative devices following knee arthroscopic surgery: a systematic review. Knee Surg Sports Traumatol Arthrosc 2017; 25:501-16. [PMID: 27695905 DOI: 10.1007/s00167-016-4326-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 09/07/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE There is a wide array of device modalities available for post-operative treatment following arthroscopic knee surgery; however, it remains unclear which types and duration of modality are the most effective. This systematic review aimed to investigate the efficacy of device modalities used following arthroscopic knee surgery. METHODS A systematic search of the literature was performed on: PubMed; Scopus; MEDLINE; EMBASE; PEDro; SportDiscus; and CINAHL databases (1995-2015) for clinical trials using device modalities following arthroscopic knee surgery: cryotherapy, continuous passive motion (CPM), neuromuscular electrical stimulation (NMES), surface electromyographic (sEMG) biofeedback and shockwave therapy (ESWT). Only level 1 and 2 studies were included and the methodological quality of studies was evaluated using Physiotherapy Evidence Database (PEDro) scores. Outcome measures included: muscle strength, range of motion, swelling, blood loss, pain relief, narcotic use, knee function evaluation and scores, patient satisfaction and length of hospital stay. RESULTS Twenty-five studies were included in this systematic review, nineteen of which found a significant difference in outcomes. For alleviating pain and decreasing narcotic consumption following arthroscopic knee surgery, cryocompression devices are more effective than traditional icing alone, though not more than compression alone. CPM does not affect post-operative outcomes. sEMG biofeedback and NMES improve quadriceps strength and overall knee functional outcomes following knee surgery. There is limited evidence regarding the effects of ESWT. CONCLUSION Cryotherapy, NMES and sEMG are recommended for inclusion into rehabilitation protocols following arthroscopic knee surgery to assist with pain relief, recovery of muscle strength and knee function, which are all essential to accelerate recovery. CPM is not warranted in post-operative protocols following arthroscopic knee surgery because of its limited effectiveness in returning knee range of motion, and additional studies are required to investigate the effects of ESWT. LEVEL OF EVIDENCE II.
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Takano Y, Matsuse H, Tsukada Y, Omoto M, Hashida R, Shiba N. A New Training for Older Adults Using Combined Neuromuscular Electrical Stimulation and Volitional Contraction: A Pilot Study. Kurume Med J 2016; 62:73-81. [PMID: 27237936 DOI: 10.2739/kurumemedj.ms66001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The hybrid training system (HTS) resists the motion of a volitionally contracting agonist muscle using force generated by its electrically stimulated antagonist. We have developed a new training method using the principle of HTS. This study was designed to evaluate the effect of HTS with electrical stimulation on muscle strength and physical function by comparing it against training without electrical stimulation in older adults. 16 subjects were randomly divided into two groups: the squat and single leg lift training (control, CTR) group, and the CTR with HTS training group. Some electrical stimulation was applied to the quadriceps and hamstring muscles in the HTS group. The subjects performed training for 25 min per session 3 times a week for 12 weeks. At points before and after the research maximal isokinetic torque, knee-flexors (KFT) and knee-extensors (KET), a one-leg standing test (OLT), a functional reach test (FRT), a 10-meter maximal gait time (10MGT) and Timed up & go test (TUG) were conducted. None of the subjects had any injuries during the study period. TUG significantly improved after the training period in both the HTS group (7.15 sec to 6.01 sec P = 0.01) and in the CTR.
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Affiliation(s)
- Yoshio Takano
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare
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Behringer M, Grützner S, Montag J, McCourt M, Ring M, Mester J. Effects of stimulation frequency, amplitude, and impulse width on muscle fatigue. Muscle Nerve 2015; 53:608-16. [PMID: 26335028 DOI: 10.1002/mus.24893] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 08/28/2015] [Accepted: 09/01/2015] [Indexed: 11/10/2022]
Abstract
INTRODUCTION We investigated the effect of stimulation intensity (in percent of maximal tolerated stimulation current, mTSC), frequency, and impulse width on muscle fatigue. METHODS Using a randomized crossover design, 6 parameter combinations (80% mTSC, 80 Hz, 400 μs; 60% mTSC, 80 Hz, 400 μs; 80% mTSC, 20 Hz, 400 μs; 60% mTSC, 20 Hz, 400 μs; 80% mTSC, 80 Hz, 150 μs; 60% mTSC, 80 Hz, 150 μs) were tested in both legs of 13 athletic men (age 26 ± 2.3). The slope of the linear regression line over all tetani (FIS) and the number of tetani whose force was above 50% of the initial tetanus (FIN) were used to quantify fatigue. RESULTS FIS and FIN were significantly lower in high-frequency protocols. No effects on FIS and FIN were found for intensity and impulse width. CONCLUSIONS Stimulation frequency, but not impulse width or intensity, affected fatigue kinetics.
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Affiliation(s)
- Michael Behringer
- Institute for Training Science and Sport Informatics, German Sport University Cologne, Am Sportpark Müngersdorf, 50933, Cologne, Germany
| | - Sebastian Grützner
- Institute for Training Science and Sport Informatics, German Sport University Cologne, Am Sportpark Müngersdorf, 50933, Cologne, Germany
| | - Johannes Montag
- Institute for Training Science and Sport Informatics, German Sport University Cologne, Am Sportpark Müngersdorf, 50933, Cologne, Germany
| | - Molly McCourt
- Institute for Training Science and Sport Informatics, German Sport University Cologne, Am Sportpark Müngersdorf, 50933, Cologne, Germany
| | - Matthias Ring
- Digital Sports Group, Pattern Recognition Lab, Friedrich-Alexander University Erlangen-Nuremberg, Germany
| | - Joachim Mester
- Institute for Training Science and Sport Informatics, German Sport University Cologne, Am Sportpark Müngersdorf, 50933, Cologne, Germany
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Wright RW, Haas AK, Anderson J, Calabrese G, Cavanaugh J, Hewett TE, Lorring D, McKenzie C, Preston E, Williams G. Anterior Cruciate Ligament Reconstruction Rehabilitation: MOON Guidelines. Sports Health 2015; 7:239-43. [PMID: 26131301 PMCID: PMC4482298 DOI: 10.1177/1941738113517855] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Context: Anterior cruciate ligament (ACL) reconstruction rehabilitation has evolved over the past 20 years. This evolution has been driven by a variety of level 1 and level 2 studies. Evidence Acquisition: The MOON Group is a collection of orthopaedic surgeons who have developed a prospective longitudinal cohort of the ACL reconstruction patients. To standardize the management of these patients, we developed, in conjunction with our physical therapy committee, an evidence-based rehabilitation guideline. Study Design: Clinical review. Level of Evidence: Level 2. Results: This review was based on 2 systematic reviews of level 1 and level 2 studies. Recently, the guideline was updated by a new review. Continuous passive motion did not improve ultimate motion. Early weightbearing decreases patellofemoral pain. Postoperative rehabilitative bracing did not improve swelling, pain range of motion, or safety. Open chain quadriceps activity can begin at 6 weeks. Conclusion: High-level evidence exists to determine appropriate ACL rehabilitation guidelines. Utilizing this protocol follows the best available evidence.
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Affiliation(s)
- Rick W Wright
- Washington University in Saint Louis, St Louis, Missouri
| | - Amanda K Haas
- Washington University in Saint Louis, St Louis, Missouri
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Sillen MJ, Franssen FM, Gosker HR, Wouters EF, Spruit MA. Metabolic and structural changes in lower-limb skeletal muscle following neuromuscular electrical stimulation: a systematic review. PLoS One 2013; 8:e69391. [PMID: 24019860 DOI: 10.1371/journal.pone.0069391] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 06/13/2013] [Indexed: 01/01/2023] Open
Abstract
Background Transcutaneous neuromuscular electrical stimulation (NMES) can be applied as a complementary intervention to regular exercise training programs. A distinction can be made between high-frequency (HF) NMES and low-frequency (LF) NMES. In order to increase understanding of the mechanisms of functional improvements following NMES, the purpose of this study was to systematically review changes in enzyme activity, muscle fiber type composition and muscle fiber size in human lower-limb skeletal muscles following only NMES. Methods Trials were collected up to march 2012 and were identified by searching the Medline/PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL and The Physical Therapy Evidence Database (PEDro) databases and reference lists. 18 trials were reviewed in detail: 8 trials studied changes in enzyme activities, 7 trials studied changes in muscle fiber type composition and 14 trials studied changes in muscle fiber size following NMES. Results The methodological quality generally was poor, and the heterogeneity in study design, study population, NMES features and outcome parameters prohibited the use of meta-analysis. Most of the LF-NMES studies reported significant increases in oxidative enzyme activity, while the results concerning changes in muscle fiber composition and muscle size were conflicting. HF-NMES significantly increased muscle size in 50% of the studies. Conclusion NMES seems to be a training modality resulting in changes in oxidative enzyme activity, skeletal muscle fiber type and skeletal muscle fiber size. However, considering the small sample sizes, the variance in study populations, the non-randomized controlled study designs, the variance in primary outcomes, and the large heterogeneity in NMES protocols, it is difficult to draw definitive conclusions about the effects of stimulation frequencies on muscular changes.
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Imoto AM, Peccin S, Almeida GJM, Saconato H, Atallah ÁN. Effectiveness of electrical stimulation on rehabilitation after ligament and meniscal injuries: a systematic review. SAO PAULO MED J 2011; 129:414-23. [PMID: 22249798 PMCID: PMC10868930 DOI: 10.1590/s1516-31802011000600008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 05/09/2011] [Accepted: 05/23/2011] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Electrical stimulation (ES) is widely used to strengthen muscles following ligament and meniscal injuries. The aim of this study was to evaluate the effectiveness of ES for rehabilitation after soft tissue injuries of the knee treated surgically or conservatively. DESIGN AND SETTING Systematic review at the Brazilian Cochrane Center. METHODS We searched the Cochrane Central Register of Controlled Trials (2010, Issue 12), Medline (Medical Analysis and Retrieval System Online) via PubMed (1966 to December 2010), Embase (Excerpta Medica database, 1980 to December 2010), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde, 1982 to December 2010), and PEDro (Physiotherapy Evidence Database, 1929 to December 2010). The studies included were randomized controlled trials using ES to increase muscle strength for rehabilitation of patients with soft tissue injuries of the knee. Two authors independently evaluated studies for inclusion and performed data extraction and methodological quality assessment. RESULTS Seventeen studies evaluating ES after anterior cruciate ligament reconstruction and two studies evaluating ES after meniscectomy were included. There was a statistically significant improvement in quadriceps strength through ES (mean difference, MD: -32.7; 95% confidence interval, CI: -39.92 to -25.48; n = 56) and in functional outcomes (MD -7; -12.78 to -1.22; n = 43) six to eight weeks after surgical reconstruction of the anterior cruciate ligament. CONCLUSION There is evidence that ES coupled with conventional rehabilitation exercises may be effective in improving muscle strength and function two months after surgery.
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Affiliation(s)
- Aline Mizusaki Imoto
- PhD. Postgraduate Program on Internal Medicine and Therapeutics, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.
| | - Stella Peccin
- PhD. Supervising Professor of the Postgraduate Program on Internal Medicine and Therapeutics, Universidade Federal de São Paulo (Unifesp), São Paulo; and Head of the Department of Movement Sciences, Universidade Federal de São Paulo, Campus Baixada Santista, São Paulo, Brazil.
| | | | - Humberto Saconato
- PhD, Adjunct Professor, Department of Clinical Medicine, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil.
| | - Álvaro Nagib Atallah
- PhD. Titular Professor, Department of Internal Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.
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Hasegawa S, Kobayashi M, Arai R, Tamaki A, Nakamura T, Moritani T. Effect of early implementation of electrical muscle stimulation to prevent muscle atrophy and weakness in patients after anterior cruciate ligament reconstruction. J Electromyogr Kinesiol 2011; 21:622-30. [PMID: 21334221 DOI: 10.1016/j.jelekin.2011.01.005] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 01/25/2011] [Accepted: 01/25/2011] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Following anterior cruciate ligament (ACL) reconstruction, restricted weight bearing and immobilization results in thigh and calf muscle atrophy and weakness. The purpose of this study was to assess the effect of electrical muscle stimulation (EMS) on prevention of muscle atrophy in patients during the early rehabilitation stage after ACL reconstruction. METHODS Twenty patients with acute ACL tears were divided into two groups randomly. The control group (CON group) participated in only the usual rehabilitation program. In addition to this protocol, the electrical muscle stimulation group (EMS group) received EMS training using the wave form of 20 Hz exponential pulse from the 2nd post-operative day to 4 weeks after the surgery. RESULTS Muscle thickness of vastus lateralis and calf increased significantly 4 weeks after surgery in the EMS group, while it decreased significantly in the CON group. The decline of knee extension strength was significantly less in the EMS group than in the CON group at 4 weeks after the surgery, and the EMS group showed greater recovery of knee extension strength at 3 months after surgery. CONCLUSIONS EMS implemented during the early rehabilitation stage is effective in maintaining and increasing muscle thickness and strength in the operated limb.
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Affiliation(s)
- Satoshi Hasegawa
- Graduate School of Human and Environmental Studies, Kyoto University, Japan
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16
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Kim KM, Croy T, Hertel J, Saliba S. Effects of neuromuscular electrical stimulation after anterior cruciate ligament reconstruction on quadriceps strength, function, and patient-oriented outcomes: a systematic review. J Orthop Sports Phys Ther 2010; 40:383-91. [PMID: 20592480 DOI: 10.2519/jospt.2010.3184] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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-.
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Takano Y, Haneda Y, Maeda T, Sakai Y, Matsuse H, Kawaguchi T, Tagawa Y, Shiba N. Increasing Muscle Strength and Mass of Thigh in Elderly People with the Hybrid-Training Method of Electrical Stimulation and Volitional Contraction. TOHOKU J EXP MED 2010; 221:77-85. [PMID: 20453461 DOI: 10.1620/tjem.221.77] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yoshio Takano
- Division of Rehabilitation, Kurume University Hospital
- Department of Physical Therapy Faculty of Medical Technology, Teikyo University Fukuoka
| | - Yoshihiro Haneda
- Department of Physical Therapy Faculty of Medical Technology, Teikyo University Fukuoka
| | - Takashi Maeda
- Division of Rehabilitation, Kurume University Hospital
| | - Yutaka Sakai
- Department of Physical Therapy Faculty of Medical Technology, Teikyo University Fukuoka
| | | | - Takumi Kawaguchi
- Department of Digestive Disease Information & Research, Kurume University School of Medicine
| | - Yoshihiko Tagawa
- Department of Mechanical and Control Engineering, Kyushu Institute of Technology
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital
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Wright RW, Preston E, Fleming BC, Amendola A, Andrish JT, Bergfeld JA, Dunn WR, Kaeding C, Kuhn JE, Marx RG, McCarty EC, Parker RC, Spindler KP, Wolcott M, Wolf BR, Williams GN. A systematic review of anterior cruciate ligament reconstruction rehabilitation: part II: open versus closed kinetic chain exercises, neuromuscular electrical stimulation, accelerated rehabilitation, and miscellaneous topics. J Knee Surg 2008. [PMID: 18686485 DOI: 10.1055/s-0030-124782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Anterior cruciate ligament (ACL) reconstruction is a common surgical knee procedure that requires intensive postoperative rehabilitation by the patient. A variety of randomized controlled trials have investigated aspects of ACL reconstruction rehabilitation. A systematic review of English language level 1 and 2 studies identified 54 appropriate randomized controlled trials of ACL rehabilitation. This part of the article discusses open versus closed kinetic chain exercises, neuromuscular electrical stimulation, accelerated rehabilitation, and miscellaneous topics.
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Affiliation(s)
- Rick W Wright
- Department of Orthopedic Surgery, Washington University School of Medicine at Barnes-Jewish Hospital, St Louis, MO, USA
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Wright RW, Preston E, Fleming BC, Amendola A, Andrish JT, Bergfeld JA, Dunn WR, Kaeding C, Kuhn JE, Marx RG, McCarty EC, Parker RC, Spindler KP, Wolcott M, Wolf BR, Williams GN. A systematic review of anterior cruciate ligament reconstruction rehabilitation: part II: open versus closed kinetic chain exercises, neuromuscular electrical stimulation, accelerated rehabilitation, and miscellaneous topics. J Knee Surg 2008; 21:225-34. [PMID: 18686485 PMCID: PMC3692368 DOI: 10.1055/s-0030-1247823] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Anterior cruciate ligament (ACL) reconstruction is a common surgical knee procedure that requires intensive postoperative rehabilitation by the patient. A variety of randomized controlled trials have investigated aspects of ACL reconstruction rehabilitation. A systematic review of English language level 1 and 2 studies identified 54 appropriate randomized controlled trials of ACL rehabilitation. This part of the article discusses open versus closed kinetic chain exercises, neuromuscular electrical stimulation, accelerated rehabilitation, and miscellaneous topics.
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Affiliation(s)
- Rick W. Wright
- Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO
| | | | - Braden C. Fleming
- Department of Orthopaedic Surgery, Brown Medical School, Providence, RI
| | | | | | | | | | | | - John E. Kuhn
- Vanderbilt Sports Medicine Center, Nashville, TN
| | | | - Eric C. McCarty
- Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver, CO
| | | | | | - Michelle Wolcott
- Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver, CO
| | - Brian R. Wolf
- University of Iowa Hospitals and Clinics, Iowa City, Iowa
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Abstract
Electromyostimulation (EMS) and voluntary muscle contraction (VC) constitute different modes of muscle activation and induce different acute physiological effects on the neuromuscular system. Long-term application of each mode of muscle activation can produce different muscle adaptations. It seems theoretically possible to completely or partially cumulate the muscle adaptations induced by each mode of muscle activation applied separately. This work consisted of examining the literature concerning the muscle adaptations induced by long-term application of the combined technique (CT) [i.e. EMS is combined with VC - non-simultaneously] compared with VC and/or EMS alone in healthy subjects and/or athletes and in post-operative knee-injured subjects. In general, CT induced greater muscular adaptations than VC whether in sports training or rehabilitation. This efficiency would be due to the fact that CT can facilitate cumulative effects of training completely or partially induced by VC and EMS practiced alone. CT also provides a greater improvement of the performance of complex dynamic movements than VC. However, EMS cannot improve coordination between different agonistic and antagonistic muscles and thus does not facilitate learning the specific coordination of complex movements. Hence, EMS should be combined with specific sport training to generate neuromuscular adaptations, but also allow the adjustment of motor control during a voluntary movement. Likewise, in a therapeutic context, CT was particularly efficient to accelerate recovery of muscle contractility during a rehabilitation programme. Strength loss and atrophy inherent in a traumatism and/or a surgical operation would be more efficiently compensated with CT than with VC. Furthermore, CT also restored more functional abilities than VC. Finally, in a rehabilitation context, EMS is complementary to voluntary exercise because in the early phase of rehabilitation it elicits a strength increase, which is necessary to perform voluntary training during the later rehabilitation sessions.
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Affiliation(s)
- Thierry Paillard
- Laboratoire d'Analyse de la Performance Sportive, Département STAPS, Université de Pau et des Pays de l'Adour, Tarbes, France.
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Pua YH, Bryant AL, Steele JR, Newton RU, Wrigley TV. Isokinetic Dynamometry in Anterior Cruciate Ligament Injury and Reconstruction. Ann Acad Med Singap 2008. [DOI: 10.47102/annals-acadmedsg.v37n4p330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The use of isokinetic dynamometry has often been criticised based on the face-validity argument that isokinetic movements poorly resemble the everyday multi-segmented, dynamic activities of human movements. In the anterior cruciate ligament (ACL) reconstruction or deficiency population where muscle deficits are ubiquitous, this review paper has made a case for using isokinetic dynamometry to isolate and quantify these deficits in a safe and controlled manner. More importantly, the usefulness of isokinetic dynamometry, as applied in individuals with ACL reconstruction or deficiency, is attested by its established known-group and convergent validity. Known-group validity is demonstrated by the extent to which a given isokinetic measure is able to identify individuals who could and could not resume pre-morbid athletic or strenuous activities with minimal functional limitations following an ACL injury. Convergent validity is demonstrated by the extent to which a given isokinetic measure closely associates with self-report measures of knee function in individuals with ACL reconstruction. A basic understanding of the measurement properties of isokinetic dynamometry will guide the clinicians in providing reasoned interventions and advancing the clinical care of their clients.
Key words: Biomechanics, Knee, Validity
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Paillard T, Noé F, Edeline O. Effets neuromusculaires de l'électrostimulation transcutanée surimposée et combinée à l'activité volontaire : une revue. ACTA ACUST UNITED AC 2005; 48:126-37. [PMID: 15833260 DOI: 10.1016/j.annrmp.2004.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2004] [Accepted: 10/07/2004] [Indexed: 11/28/2022]
Abstract
With voluntary muscular contraction (VOL), small motor units (MUs) are recruited before large MUs are (a submaximal muscular contraction recruits only small MUs), whereas electrical stimulation (ES) tends to reverse the recruitment order. On the basis of this observation, some authors have tested the physiological effects of ES superimposed simultaneously with VOL (superimposed technique [ST]) or separately (combined technique [CT]). With healthy subjects, ST does not recruit more MUs than VOL, except with eccentric contractions. After health subjects undergo training programs, ST appears to be as efficient as VOL in enhancing subjects' neuromuscular qualities. Nevertheless, the use of CT seems more effective than VOL. In postsurgical rehabilitation, both ST and CT are more effective than VOL. Actually, following knee surgery, ST and CT compensate for volume and muscle strength deficits with more efficiency than does VOL.
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Affiliation(s)
- T Paillard
- Laboratoire d'analyse de la performance sportive, université de Pau et des pays de l'Adour, département STAPS de Tarbes, 55, avenue d'Azereix, 65000 Tarbes, France.
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Arna Risberg M, Lewek M, Snyder-Mackler L. A systematic review of evidence for anterior cruciate ligament rehabilitation: how much and what type? Phys Ther Sport 2004. [DOI: 10.1016/j.ptsp.2004.02.003] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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