Quadriceps Exercise Beneficial After Knee Replacement

No added benefits observed with combined exercise and neuromuscular electrical stimulation

09 feb 2009-- In patients who undergo primary, unilateral total knee arthroplasty, progressive quadriceps strengthening with or without neuromuscular electrical stimulation leads to functional improvements that nearly approach the functional level of healthy older adults, according to a report published in the Feb. 15 issue of Arthritis Care & Research.

Stephanie C. Petterson, Ph.D., of the University of Delaware in Newark, Del., and colleagues randomly assigned 200 patients to receive six weeks of outpatient physical therapy consisting of either strength training or strength training combined with neuromuscular electrical stimulation, and compared their scores on the Medical Outcomes Study Short Form 36 and Knee Outcome Survey with those of 41 patients in a standard-of-care group.

At three and 12 months, the researchers found that the strength training and the strength training-neuromuscular electrical stimulation groups had similar scores for strength, activation and function. They also found that the standard-of-care group had significantly lower scores than either of the intervention groups.

"We predicted that the addition of neuromuscular electrical stimulation would result in better quadriceps strength, activation and function than a progressive exercise program alone, but this hypothesis was not supported," the authors write. "Both programs resulted in improved activation, and consequently strength improved over time, translating to better function."

Abstract
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