STRONG RECOMMENDATION Two high quality (Stevens-Lapsley 2012, Feil 2011) and one moderate quality (Skowron 2019) study were reviewed. The two high quality studies showed improved function for Neuromuscular electrical stimulation (NMES) over standard of care, and one high quality study also showed improved function over Transcutaneous electrical nerve stimulation (TENS). The single moderate quality study showed decreased ROM and no change on QOL outcomes for NMES compared to standard treatment. Two studies (one high and one moderate quality) showed no changes in pain.
Benefits/Harms of Implementation
No studies reported adverse events and this technology is in widespread use. Risks appear to be low.
Cost Effectiveness/Resource Utilization
NEMS units are economical and may have low resource utilization in the hospital setting.
Feasibility
Intervention has been used extensively and is clearly feasible.
Future Research
Inconsistent results highlight the need for larger studies with an emphasis on heterogenous treatment effects. Further research into the effect of this intervention on opioid use and pain are needed, as well as cost effectiveness studies.
- Stevens-Lapsley, J. E., Balter, J. E., Wolfe, P., Eckhoff, D. G., Kohrt, W. M. Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial. Phys Ther 2012; 2: 210-26
- Skowron, M., Kociuga, J., Domzalski, M. Electrostimulation has a positive effect on the knee function after knee arthroscopic surgery: A randomized trial. J Back Musculoskelet Rehabil 2019; 0:
- Feil, S., Newell, J., Minogue, C., Paessler, H. H. The effectiveness of supplementing a standard rehabilitation program with superimposed neuromuscular electrical stimulation after anterior cruciate ligament reconstruction: a prospective, randomized, single-blind study. Am J Sports Med 2011; 6: 1238-47