A Study of Efficacy of Neuromuscular Electrical Stimulation in Post Anterior Cruciate Ligament Reconstruction

Introduction & Purpose of the Study

Surgical reconstruction with the bone patellar tendon bone graft is most commonly performed surgery for Anterior cruciate ligament(ACL) injury, patient with ACL reconstruction have been reported to demonstrate a disproportionate loss of strength of quadriceps muscle, but commonly used knee extensor muscle strengthening strategies are contraindicated initially. The purpose of this study is to study the effect of neuromuscular electric stimulation with exercise protocol in rehabilitation of post ACL reconstruction.

Material & Methods

The study design is experimental. The samples were taken from Department of Physiotherapy, PGIMER; Chandigarh .The patients with ACL reconstruction with bone patellar tendon bone graft were selected. For outcome four scales were used (Cincinnati knee rating system, Lysholm knee score, Lower extremity functional scale &Visual analogue scale). Also girth measurement, muscle power and ROM were taken to assess the progress of the patient. A number of 20 subjects, age group18-40years, were randomly selected for this study. Subjects were divided in two groups, one group (Group A) combined with neuromuscular electrical stimulation (NMES, interrupted direct current) & exercise while other (Group B) with exercise protocol only. For electrical stimulation Ionostim muscle stimulator (Physiomed electronic, Chennai, India) was used. The intensity was up to tolerable limit and surge was used. Neuromuscular electric stimulation for 15 min daily 6 days a week was given. The exercise time is of a one hour/day for six days a week. The duration of exercise was increased according to protocol with time interval. The entire patient (both groups) underwent 12 week rehabilitation program and assessed with specific scales at 8th and 12th week interval.The statistical analysis was done by using student’s t-test.

Results

Inter group analysis shows non significant result (p>0.05).

Conclusion

On the basis of the present study, it can be concluded that both the conventional treatment and conventional rehabilitation protocol with neuromuscular electrical stimulation are equally effective to regain the functional skills in post ACL reconstruction rehabilitation.