Quick Overview
A Konkuk University Hospital team tested 24 adults after ACL reconstruction.
For 12 weeks, half added 20 minutes of EMS at 70 Hz to rehab exercise. They measured thigh circumference, quadriceps EMG, peak torque, total work and Lysholm scores.
The EMS group improved girth, activity and strength (p < 0.05 on several tests). Those results suggest extra quadriceps support in this post-surgery group.
Authors also discuss EMS in wider muscle-recovery research.
The paper is peer-reviewed in Swiss Applied Sciences and ethics-approved.
The full post has every figure, protocol and limit.
We always provide direct links to the original research at the end of every article so you can review the evidence yourself.
Electric Help for Tired Thighs: What a Korean Hospital Study Reported About EMS After ACL Surgery
A torn knee ligament can leave the quadriceps looking smaller and feeling weaker.
That is a hard fact after ACL reconstruction.
A 2023 study asked a simple question.
Could adding EMS to normal rehabilitation exercise help those thigh muscles bounce back?
That was the purpose.
Researchers wanted clearer evidence on muscle circumference, muscle activity, and muscle function.
They tested a 12-week programme in people who had just had ACL surgery.
This is not a sales pitch.
It is a write-up of a published paper.
The work appeared in Applied Sciences, a peer-reviewed journal from MDPI in Switzerland.
Switzerland has a long record of careful scientific publishing.
The trial ran at Konkuk University Hospital in Seoul, Republic of Korea.
Korea has strong sports-medicine and hospital research centres.
The same hospital’s ethics board approved the study.
The code was KUH1060126.
The team followed the Declaration of Helsinki.
Named authors came from Konkuk University, Eulji University, Gachon University, Dongseo University, and Kukkiwon.
That paper trail is why this post stays close to the source.
Who took part
Thirty people were due for the same type of ACL reconstruction.
Six later dropped out of follow-up.
Twenty-four finished and were analysed.
Each group had 12 people.
Ages averaged about 29 to 30 years.
Most were men.
Body mass index sat in a normal range.
Activity scores sat around recreational sport, not elite level.
Elite athletes were left out on purpose.
So were people who still had full basic strength from a chronic injury.
What they actually did
Both groups trained twice a week for 12 weeks.
Each session lasted 60 minutes.
The control group did the rehabilitation exercise programme only.
The EMS group did about 40 minutes of the same exercise.
Then they added 20 minutes of electro muscle stimulation on the thighs.
The device was a Kneehab unit.
Frequency was set at 70 Hz.
Pulse width sat between 300 and 400 microseconds.
The muscle worked for 10 seconds.
Then it rested for 50 seconds.
That cycle ran for 20 minutes.
EMS started on the second day after surgery.
Staff measured the same things before and after the 12 weeks.
They used the Lysholm score and the IKDC score.
They taped thigh circumference at 5 cm and 15 cm above the kneecap.
They recorded EMG from vastus medialis, vastus lateralis, and rectus femoris.
They tested isokinetic peak torque and total work on a Biodex dynamometer.
What the numbers showed
Time mattered for several scores.
The Lysholm score rose with a time effect of p = 0.018.
The effect size was η² = 0.228.
In the EMS group, the rise reached p = 0.049.
Thigh circumference at 5 cm showed a time effect of p = 0.049.
In the EMS group that gain hit p = 0.001.
At 15 cm, groups and time interacted at p = 0.010.
The EMS group’s 15 cm gain was p = 0.013.
Muscle activity told a similar story.
Vastus medialis during isokinetic work showed an interaction of p = 0.028.
The EMS group’s vastus medialis rise was p = 0.001.
Vastus lateralis and rectus femoris rose during isometric work in the EMS group.
Both of those post-hoc tests were p = 0.015.
Strength data lined up with the size and activity data.
Peak torque showed an interaction of p = 0.012.
The EMS group’s peak torque gain was p = 0.002.
Total work had a time effect of p = 0.008.
The EMS group’s total work gain was p = 0.019.
The exercise-only group did improve on the IKDC score.
That change was p = 0.026.
The extra EMS block was where more of the muscle measures moved.
The bright side the authors stressed
Adding EMS to exercise was linked with bigger changes in circumference, activation, and isokinetic function.
The paper calls that pairing an effective rehabilitation strategy in this setting.
The extra stimulation sat on top of movement, not instead of it.
That is the useful picture: exercise plus EMS, not EMS alone.
Who this study speaks to
On the evidence here, the clear group is people after ACL reconstruction.
They were adults in a hospital sports-medicine programme.
They were not elite athletes.
They could walk and contract the quadriceps before surgery.
They attended twice weekly for three months.
The authors do not claim EMS repairs the ligament.
They report muscle size, muscle signals, and muscle output.
That is the limit of this trial.
Other papers they cite look at EMS in different weak-muscle settings.
Those include older adults and some sports rehab work.
Those extra papers are not this trial.
This trial’s hard data stay with post-ACL quadriceps recovery.
What this post is not
This is not medical advice.
It is not a product claim.
It does not say EMS treats, cures, or replaces surgery or physiotherapy.
Anyone with a knee injury should follow their own clinician.
Devices sold in Australia must stay inside the rules that apply to them.
The scientists also listed limits.
The sample was small.
Follow-up stopped at 12 weeks.
Tape measure is not the same as an MRI of muscle.
Motivation may have differed between groups.
Still, the story inside the paper is easy to hold.
After ACL surgery the quadriceps often shrink and quieten.
A structured rehab plan helped.
Adding timed EMS on the thigh was tied to extra gains in girth, EMG, peak torque, and total work.
That is what the Konkuk team measured.
That is what Applied Sciences published in March 2023.
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Research Summary
| Detail | Information |
|---|---|
| Paper title | Effects of a Rehabilitation Exercise Program Using Electro Muscle Stimulation following Anterior Cruciate Ligament Reconstruction on the Circumference, Activity, and Function of the Quadriceps Muscle |
| Original study link | https://doi.org/10.3390/app13074153 |
| Open-access publisher page | https://www.mdpi.com/2076-3417/13/7/4153 |
| Journal, year and publisher | Applied Sciences, 2023, volume 13, article 4153; MDPI, Basel, Switzerland |
| Authors and equal-contribution note | Seung-Ik Cho, Jeong-Weon Kim, Sang-Seok Nam, Hwang-Woon Moon and Won-Sang Jung; Moon and Jung contributed equally |
| Research centres | Konkuk University Medical Center and Konkuk University, Gachon University, Kukkiwon, Eulji University and Dongseo University, Republic of Korea |
| Ethics and consent | Approved by Konkuk University Hospital IRB (KUH1060126); Declaration of Helsinki; informed consent obtained |
| Study purpose | Compare standard rehabilitation exercise with the same programme plus EMS after ACL reconstruction, focusing on quadriceps circumference, activity and function |
| Design and sample | Randomised two-group trial; 30 enrolled, 24 analysed after 6 lost to follow-up; 12 exercise-only (CONG) and 12 EMS plus exercise (EMSG) |
| Who was included and excluded | Adults after autograft ACL reconstruction at one centre; elite athletes, people without basic strength loss from chronic injury, and cartilage-suture cases were excluded |
| Programme dose | Both groups: 60-minute sessions, twice a week, for 12 weeks; EMSG did about 40 minutes of exercise plus 20 minutes of EMS |
| EMS settings | Kneehab device; 70 Hz; pulse width 300–400 µs; 10 s contraction and 50 s rest; started on day 2 after surgery |
| What was measured | Lysholm and IKDC scores; thigh circumference at 5 cm and 15 cm above the patella; EMG of vastus medialis, vastus lateralis and rectus femoris; isokinetic peak torque (60°/s) and total work (180°/s) |
| Circumference findings | Time effect at 5 cm (p = 0.049); interaction at 15 cm (p = 0.010); EMSG gains at 5 cm (p = 0.001) and 15 cm (p = 0.013) |
| Muscle-activity findings | VM isokinetic interaction (p = 0.028); EMSG VM isokinetic rise (p = 0.001); EMSG VL and RF isometric rises (both p = 0.015) |
| Strength and score findings | Peak-torque interaction (p = 0.012); EMSG peak torque (p = 0.002) and total work (p = 0.019); EMSG Lysholm (p = 0.049); CONG IKDC (p = 0.026) |
| Authors’ conclusion | Adding EMS to the rehabilitation programme was linked with greater gains in muscle circumference, activation and isokinetic function than exercise alone in this ACL-reconstruction sample |
| Stated limits | Small sample; 12-week follow-up only; tape measure is not MRI or ultrasound; possible motivation differences; long-term effect not tested |
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