title: The use of electrical stimulation to increase quadriceps femoris muscle force in an elderly patient following a total knee arthroplasty.
abstract: OBJECTIVE
  Persistent residual quadriceps femoris muscle force deficits after total knee arthroplasty (TKA) are commonly reported and can prevent patients from returning quickly and fully to functional activities. Neuromuscular electrical stimulation offers a potentially more effective means of increasing muscle force than current rehabilitation protocols.
  
  
  METHODS
  The patient was a 66-year-old man. Neuromuscular electrical stimulation for increasing quadriceps femoris muscle force was initiated 3 weeks after TKA for 11 sessions to supplement stretching exercises and a high-intensity volitional strengthening program.
  
  
  RESULTS
  The patient's isometric quadriceps femoris muscle force increased from 50% (involved/uninvolved) at 3 weeks after surgery to 86% at 8 weeks after surgery. A concurrent increase in his uninvolved quadriceps femoris muscle force concealed the patient's true increase in his involved quadriceps femoris muscle force in a side-to-side comparison. The patient's final involved quadriceps femoris muscle force (10 weeks after surgery) was 93% of the initial uninvolved quadriceps femoris muscle force.
  
  
  CONCLUSIONS
  Our patient was able to return to independent activities of daily living and recreational activities, with force gains that surpassed those reported in the literature.
authors.affiliation: Department of Biomechanics and Movement Science, University of Delaware, Newark 19711, USA. mlewek@udel.edu
authors.forename: M
authors.initials: M
authors.lastname: Lewek
authors.forename: J
authors.initials: J
authors.lastname: Stevens
authors.forename: L
authors.initials: L
authors.lastname: Snyder-Mackler
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005081:Exercise Therapy; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D013848:Thigh; D004561:Transcutaneous Electric Nerve Stimulation