title: Acute effects of multipath electrical stimulation in patients with total knee arthroplasty.
abstract: OBJECTIVE
  To compare maximal evoked torque, discomfort, and fatigue-related outcomes between multipath neuromuscular electrical stimulation (NMES) and conventional NMES of the quadriceps muscle in patients with total knee arthroplasty (TKA).
  
  
  METHODS
  Randomized, single-blind, crossover study with 2 experimental sessions (multipath NMES, conventional NMES).
  
  
  METHODS
  Research laboratory.
  
  
  METHODS
  Patients (N=20; mean age, 68y) 6 to 12 months after TKA surgery.
  
  
  METHODS
  None.
  
  
  METHODS
  We quantified NMES-evoked knee extension torque at the maximally tolerated current intensity, self-reported discomfort, and fatigue induced by NMES intermittent contractions in both conditions.
  
  
  RESULTS
  Compared with conventional NMES, multipath NMES resulted in higher evoked torque (33%, P<.001), lower discomfort scores (-39%, P<.001), and less quadriceps muscle fatigue (P=.034).
  
  
  CONCLUSIONS
  The use of multiple current pathways distributed to large electrodes allowed multipath NMES to generate stronger contractions and reduce discomfort and fatigue compared with conventional NMES. Therefore, multipath NMES has the potential to be more effective than conventional NMES.
authors.affiliation: Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland.
authors.forename: Claudia
authors.initials: C
authors.lastname: Morf
authors.affiliation: Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Wellauer
authors.affiliation: Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland.
authors.forename: Nicola C
authors.initials: NC
authors.lastname: Casartelli
authors.affiliation: Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland. Electronic address: Nicola.Maffiuletti@kws.ch.
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Maffiuletti
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D018592:Cross-Over Studies; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D018763:Muscle Fatigue / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation; D010147:Pain Measurement; D016037:Single-Blind Method; D019415:Torque; D016896:Treatment Outcome
keywords: Electric stimulation; Muscle fatigue; Rehabilitation; Torque