CORE Physical Therapy In Omaha Explains…

By Dr. Mark Rathjen PT DPT CSCS

CORE Physical Therapy Co-owner

17660 Wright St.  9/10

Omaha NE

402-933-4027

The summary of the below article is as follows…

“NMES in addition to standard physical therapy appears to significantly improve quadriceps strength and physical function in the early post-operative period compared to standard physical therapy alone.”
What does this all mean?
It means that the use of Neuro re-education Russian stimulation protocol after surgery helps to increase quad strength and activation after post op procedure. As we see a lot of ACL and knee reconstructions, this is a vital component to returning gait mechanics and weight bearing under control sooner. In turn this would also allow your patients less atrophy during the post op acute phase in the 2-4 following surgery. Also noted, this would also in theory allow certain patients to get out of the brace, or unlock a knee brace sooner that with only tradition physical therapy.
What does it do?
Stimulation protocol allows biofeedback and increase external electrical signal to the afferent nerves and subsequently need less input for a muscle contraction to occur.  Is that a mouthful or what? In short, it teach and helps the muscle re learn how to fire and override the natural protection mechanism that follow post op procedures. Your body and sub conscious brain does NOT know the difference between and traumatic accident and a surgery. As as surgery is traumatic to the body as well, just in a controlled manor. Your body does NOT know the difference.
At CORE we routinely utilize Russian stimulation protocol in this way. We have for many years. If your physical therapist isn’t using it on you with a post op procedure or condition, ask them why…Likely they don’t know the science behind the research…

At CORE Physical Therapy in Omaha, We specialize in the treatment of athletes. We have worked with athletes for a combined 30 years. CORE was established in 2015 by Dr. Mark and Dr. Claire Rathjen is family owned and operated.

We are proud to serve the greater Omaha metro area.

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Original article posted below has been quoted be CORE Physical Therapy in Omaha

. 2018 Feb;26(2):399-410.

doi: 10.1007/s00167-017-4669-5. Epub 2017 Aug 17.

Neuromuscular electrical stimulation is effective in strengthening the quadriceps muscle after anterior cruciate ligament surgery

Annette V Hauger1, M P Reiman2, J M Bjordal34, C Sheets5, L Ledbetter6, A P Goode278
Affiliations

Abstract

Purpose: Reduced ability to contract the quadriceps muscles is often found immediately following anterior cruciate ligament (ACL) surgery. This can lead to muscle atrophy and decreased function. Application of neuromuscular electrical stimulation (NMES) may be a useful adjunct intervention to ameliorate these deficits following ACL surgery. The purpose of this review was to determine whether NMES in addition to standard physical therapy is superior to standard physical therapy alone in improving quadriceps strength or physical function following ACL surgery.

Methods: A computer-assisted literature search was conducted utilizing PubMed, CINAHL, PEDro and Cochrane Library databases for randomized clinical trials where patients after ACL surgery received NMES with the outcome of muscle strength and/or physical function. Random effect models were used to pool summary estimates using standardized mean differences (SMD) for strength outcomes. Physical function outcomes were assessed qualitatively. Methodological quality was assessed from the Physiotherapy Evidence Database (PEDro)-score.

Results: Eleven studies met our inclusion criteria; results from six of these were pooled in the meta-analysis showing a statistically significant short-term effect of NMES (4-12 weeks) after surgery compared to standard physical therapy [SMD = 0.73 (95% CI 0.29, 1.16)]. Physical function also improved significantly more in the NMES groups. PEDro scores ranged from 3/10 to 7/10 points.

Conclusion: NMES in addition to standard physical therapy appears to significantly improve quadriceps strength and physical function in the early post-operative period compared to standard physical therapy alone.

Level of evidence: I.

Keywords: ACL; Muscle strength; NMES; Physical therapy; Quadriceps.

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