Neuromuscular Electrical Stimulation after Anterior Cruciate Ligament Reconstruction

Area of Science:

• Orthopedics and Sports Medicine
• Rehabilitation Science
• Biomedical Engineering

Background:

• Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
• Post-operative rehabilitation is crucial for restoring function.
• Quadriceps muscle weakness is a persistent issue after ACL reconstruction.

Purpose of the Study:

• To evaluate the efficacy of adding neuromuscular electrical stimulation (NMES) to standard rehabilitation exercise.
• To assess the impact on quadriceps muscle strength and secondary functional outcomes.
• To compare outcomes between rehabilitation exercise alone (RE) and rehabilitation exercise with NMES (RE+NMES).

Main Methods:

• Randomized controlled trial with 24 male participants post-ACL reconstruction.
• Intervention groups: RE alone vs. RE+NMES.
• Standardized range of motion and progressive strengthening exercises over 9 weeks.
• Outcomes measured: isokinetic muscle function, patient-reported scores (Lysholm, IKDC), balance tests, and muscle morphology.

Main Results:

• Both groups showed improvements, but RE+NMES demonstrated larger effect sizes for isokinetic strength.
• RE+NMES led to greater improvements in IKDC scores and balance under both stable and unstable conditions.
• Significant increases in quadriceps cross-sectional area and thickness were observed in the RE+NMES group.
• Biomarker responses also indicated a more pronounced effect with NMES addition.

Conclusions:

• Neuromuscular electrical stimulation (NMES) as an adjunct to rehabilitation exercise yields favorable outcomes post-ACL reconstruction.
• NMES enhances quadriceps muscle strength, functional recovery, and muscle morphology.
• This combined therapy offers a promising strategy for improving rehabilitation efficacy.