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Low-Frequency Electric Muscle Stimulation Combined With Physical Therapy After Total Hip Arthroplasty for Hip Osteoarthritis in Elderly Patients: A Randomized Controlled Trial

      Abstract

      Gremeaux V, Renault J, Pardon L, Deley G, Lepers R, Casillas J-M. Low-frequency electric muscle stimulation combined with physical therapy after total hip arthroplasty for hip osteoarthritis in elderly patients: a randomized controlled trial.

      Objective

      To assess the effects of low-frequency electric muscle stimulation associated with usual physiotherapy on functional outcome after total hip arthroplasty (THA) for hip osteoarthritis (OA) in elderly subjects.

      Design

      Randomized controlled trial; pre- and posttreatment measurements.

      Setting

      Hospital rehabilitation department.

      Participants

      Subjects (N=29) referred to the rehabilitation department after THA for hip OA.

      Interventions

      The intervention group (n=16; 78±8y) received simultaneous low-frequency electric muscle stimulation of bilateral quadriceps and calf muscles (highest tolerated intensity, 1h session, 5 d/wk, for 5 weeks) associated with conventional physical therapy including resistance training. The control group (n=13; 76±10y) received conventional physical therapy alone (25 sessions).

      Main Outcome Measures

      Maximal isometric strength of knee extensors, FIM instrument, before and after; a six-minute walk test and a 200m fast walk test, after; length of stay (LOS).

      Results

      Low-frequency electric muscle stimulation was well tolerated. It resulted in a greater improvement in strength of knee extensors on the operated side (77% vs 23%; P<.01), leading to a better balance of muscle strength between the operated and nonoperated limb. The low-frequency electric muscle stimulation group also showed a greater improvement in FIM scores, though improvements in the walk tests were similar for the 2 groups, as was LOS.

      Conclusions

      Low-frequency electric muscle stimulation is a safe, well-tolerated therapy after THA for hip OA. It improves knee extensor strength, which is one of the factors leading to greater functional independence after THA.

      Key Words

      List of Abbreviations:

      ANOVA (analysis of variance), LOS (length of stay), OA (osteoarthritis), PT (physical therapy), ROM (range of motion), 200mFWT (200-meter fast walk test), 6MWT (six-minute walk test), THA (total hip arthroplasty)
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