title: Effectiveness of electric stimulation of the vastus medialis muscle in the rehabilitation of patients after total knee arthroplasty.
abstract: OBJECTIVE
  To investigate the possible effect of electric muscle stimulation (EMS) of the vastus medialis on the walking speed, Hospital for Special Surgery (HSS) knee score, and Physiological Cost Index (PCI) of patients during rehabilitation after total knee arthroplasty (TKA).
  
  
  METHODS
  Prospective, randomized controlled trial.
  
  
  METHODS
  Various departments at a district general hospital in the United Kingdom.
  
  
  METHODS
  Thirty patients with unilateral osteoarthritis of the knee admitted for elective TKA were randomly assigned to 1 of 2 groups (15 per group): control and treatment. Both groups received standard physical therapy. The treatment group also received EMS of the vastus medialis.
  
  
  METHODS
  EMS (40Hz, 300micros) of the vastus medialis muscle for 4 hours a day, starting on postoperative day 2, over the first 6 postoperative weeks.
  
  
  METHODS
  Changes in walking speed, HSS knee score, and effort of walking as measured by the PCI.
  
  
  RESULTS
  A statistically significant increase in walking speed was observed in the treatment group in relation to the control group at both 6 weeks (P=.0002) and 12 weeks (P<.0001) postoperatively. No statistically significant difference was observed in relation to the PCI or the HSS knee score variables.
  
  
  CONCLUSIONS
  Application of EMS after TKA resulted in a statistically significant improvement in patients' walking speed. There was also a carry-over effect after the discontinuation of treatment.
authors.affiliation: Department of Orthopaedics, Salisbury District Hospital, Salisbury, Wilts SP2 8BJ, UK.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Avramidis
authors.forename: Paul W
authors.initials: PW
authors.lastname: Strike
authors.forename: Paul N
authors.initials: PN
authors.lastname: Taylor
authors.forename: Ian D
authors.initials: ID
authors.lastname: Swain
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D013848:Thigh; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology