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The Journal of Bone and Joint Surgery, Vol 73, Issue 7 1025-1036, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Electrical stimulation of the thigh muscles after reconstruction of the anterior cruciate ligament. Effects of electrically elicited contraction of the quadriceps femoris and hamstring muscles on gait and on strength of the thigh muscles
L Snyder-Mackler, Z Ladin, AA Schepsis and JC Young
Department of Physical Therapy, Sargent College of Allied Health Professions, Boston, Massachusetts 02215.
The effects of neuromuscular electrical stimulation on the strength of the
thigh muscles and on gait were examined in ten patients after
reconstruction of the anterior cruciate ligament. The patients were
randomly assigned to one of two treatment groups: neuromuscular electrical
stimulation and volitional exercise, or volitional exercise alone. A
four-week course of electrically elicited co-contraction of the thigh
muscles resulted in significant attenuation of the characteristic loss of
strength of the quadriceps as compared with volitional exercise. There was
no significant difference between groups in any measure of performance of
the hamstring muscles. In the group that received neuromuscular electrical
stimulation, the values for cadence, walking velocity, stance time of the
involved limb, and flexion-excursion of the knee during stance were
significantly different from those of the volitional exercise group.
Flexion-excursion of the knee during stance was directly and significantly
correlated with strength of the quadriceps femoris muscle. Flexion of the
knee during stance was qualitatively different in the involved extremity as
compared with the uninvolved extremity in all patients. There is a rapid
flexion of the knee at weight acceptance that is maintained throughout
stance and probably reflects stabilization of the joint by muscular
coactivation to compensate for weakness of the quadriceps. The patients who
received neuromuscular electrical stimulation had stronger quadriceps
muscles and more normal gait patterns than those in the volitional exercise
group.
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