ArticlesNeuromuscular stimulation of the quadriceps muscle after hip fracture: A randomized controlled trial☆,☆☆,★,★★,♢,♢♢,♦
Section snippets
Design
The study was an exploratory trial with stratified randomization and double blinding. It was conducted at the John Radcliffe Hospital Trauma Service, Oxford, UK, and was approved by the local research ethics committee. Informed, written consent was obtained from all participants.
Participants
Three women did not complete the study. One developed myasthenia gravis and another had a severe chest infection. Both required hospitalization, which prevented re-examination in our study. Another woman withdrew her consent to participate a few days after commencing stimulation. Twenty-four women completed the study and were included in the analysis.
The women's characteristics are shown in table 1.Empty Cell Placebo Stimulation (n=12) PNMS
Discussion
Improving the safety and efficiency of mobility is the primary goal of physical therapy in the postoperative management of patients with hip fracture. Our results suggest that neuromuscular stimulation is a feasible home intervention and is potentially an effective method of speeding up the early restoration of mobility after hip fracture. Although gait speed at 13 weeks was significantly lower than would be expected in healthy women of similar age (.97m/s23), the improvements in walking speed
Conclusion
This study suggests that it is possible to speed the early recovery of mobility, but it is premature to suggest that PNMS is the optimal method and should be adopted for routine clinical use. Although we found statistically significant faster recovery rates, the confidence intervals for the treatment effect were wide.
Acknowledgements
We thank the staff of the Trauma Service at the John Radcliffe Hospital, Oxford. We also thank the anonymous referees for their helpful comments on the manuscript.
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Molecular and neural adaptations to neuromuscular electrical stimulation; Implications for ageing muscle
2021, Mechanisms of Ageing and DevelopmentCitation Excerpt :Immobilisation often occurs in the elderly as the decline in their functional capacity increases propensity for falls and fracture (Dirks et al., 2014; Marks, 2011). NMES applied to support the functional recovery of elderly women after hip fracture surgery resulted in a faster recovery of indoor mobility (Lamb et al., 2002). Moreover, the follow-up assessment after an additional six weeks found that NMES induced a longer-term effect on functional rehabilitation, showing an improvement in walking speed, as well as postural stability and muscle power.
Gait analysis and muscle weight analysis after lower extremity fractures in a small animal model
2020, Gait and PostureCitation Excerpt :This pattern of muscle atrophy is also demonstrated in literature [5]. It is stated that the influence of this muscle atrophy goes beyond the direct effect on fracture healing, because it can impair gait patterns and general remobilization, thereby prolonging the rehabilitation process and even decreasing the functional outcome and quality of life of these patients [4,28–30]. Overall, the CatWalk system adequately analyses and clinically reflects the gait pattern development in small animal models of fracture healing.
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2009, Archives of Physical Medicine and RehabilitationCitation Excerpt :Intensive OT and/or PT exercises6-8 and postoperative care from a geriatrician (among patients with mild to moderate dementia)22 in an acute care setting were associated with decreased LOS and a more favorable discharge destination, while SNFs59 and OT and PT on a rehabilitation ward34 were related to increased LOS. Improved balance outcomes were related to OT and PT on a rehabilitation ward,35,36 inpatient PT plus quadriceps training,37 and inpatient PT plus neuromuscular stimulation of the quadriceps44; outpatient programs with a progressive home-based PT component39 as well as those consisting of combined aerobic and progressive resistance training41 were also related to improvements in balance. Finally, early supported discharge14 and OT and PT on a rehabilitation ward35 were associated with increased falls self-efficacy, while PT plus quadriceps training37 was related to improved power, and a home care rehabilitation setting55 was related to increased rates of rehospitalization.
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Supported by grants from Research into Ageing and the PPP Healthcare Charitable Trust.
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Reprint requests to Sarah E. Lamb, DPhil, Schl of Health and Social Sciences, Coventry University, Priory St, Coventry CV1 5FB, UK, e-mail: [email protected].
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