Welcome back to the Oriems Fit Research Digest!
We simplify new research to help you discover ways to support your wellness journey.

Today’s spotlight: a study on using electrical muscle stimulation (EMS) to strengthen thigh muscles before and after knee replacement surgery.

Study Title:
Surface Neuromuscular Electrical Stimulation for Quadriceps Strengthening Pre and Post Total Knee Replacement
By Brenda Monaghan, Brian Caulfield, and Donal P. O'Mathuna.
(Full link to the original study is at the end—for research lovers and collectors!)

Who Did This Research and When?

This research was conducted in 2010 by a team from Our Lady's Hospital in Navan, Ireland, and Dublin City University. These researchers are well-respected for their work in physiotherapy and rehabilitation, especially for issues like knee replacements. Published by the Cochrane Library—a highly trusted source for health studies—this research provides valuable insights into EMS applications.

What Is This Study About?

The study looked into how neuromuscular electrical stimulation—a type of EMS—could help strengthen the quadriceps muscles (the large muscles on the front of the thigh) for people preparing for or recovering from total knee replacement surgery. This surgery is often done to help people with severe knee pain from conditions like osteoarthritis.

After knee surgery, people sometimes experience weakened thigh muscles, making it harder to do daily tasks like standing up from a chair or climbing stairs. This research reviewed the effects of using NMES to help these muscles regain strength.

Who Was This Study Conducted On?

This study reviewed the results from two smaller studies on adults who either had knee replacement surgery or were scheduled to have it due to osteoarthritis.

How Was the Study Done?

Researchers used randomized controlled trials to examine whether Neuromuscular ES helped improve muscle strength better than regular physical exercises alone.

What Did the Study Find?

📊 What Did the Researchers Discover?

Two studies were examined in this review to explore how surface Neuromuscular Electrical Stimulation  might affect quadriceps strength, muscle activation, and function before or after total knee replacement.

🟦 Study 1: Stevens 2002 (Post-Surgery – Neuromuscular ES+ Exercise vs. Exercise Only)

• Total Participants: 34

  • Neuromuscular ES+ Exercise Group: 16

  • Exercise Only Group: 18

• Neuromuscular ESDosage: Stimulated contractions at 29% to 69% of the participant’s maximum voluntary isometric contraction (MVIC)

• Time Points Assessed: 3rd, 9th, and 12th week after surgery

• Assessment Tools:

  • Quadriceps activation

  • Quadriceps strength

  • Timed Up and Go test

  • Health questionnaires

🔍 Notable Observations:

• At Week 6, the NMES + exercise group showed statistically better quadriceps activation than the group doing exercise alone.

• By Week 12, this advantage was no longer measurable, but early gains may be meaningful in certain recovery stages.

• Neuromuscular ES contractions were calibrated using a physiologically matched protocol, offering controlled muscle work at sub-maximal levels — between 29–69% of MVIC.

• Functional gains (e.g. walking speed, balance) followed similar patterns in both groups, with slight advantages mid-program for NMES users.

🟦 Study 2: Oldham 1995 (Pre-Surgery – Neuromuscular ES vs. Sham)

• Total Participants: 30, median age 69

• Groups Compared:

  • Patterned Neuromuscular ES

  • Random Neuromuscular ES

  • Uniform Neuromuscular ES

  • Sham stimulation (placebo)

• Stimulation Intensity: Calibrated to create visible and palpable muscle contraction

• Training Duration: 3 hours per day for 6 weeks

• Contraction/Rest Time: 30 seconds on, 15 seconds off

🔍 What They Measured:

• Muscle strength

• Endurance

• Stride length

• Sit-to-stand time

• Quality of life scores

📈 Key Details:

• All data were reported as percentage changes from baseline

• The stimulation produced measurable changes in muscle contraction quality, but detailed values (mean strength gains or torque) were not published numerically

• The training intensity was sufficient to elicit neuromuscular activity daily over prolonged sessions

✳️ Common Patterns Across Both Studies:

• Quadriceps muscle activation improved in the NMES groups, particularly in the early stages of training

• The ability of NMES to generate strong, structured contractions between 29%–69% of MVIC offers a viable training dose for low-mobility individuals

• Functional mobility tests (Timed Up and Go, sit-to-stand) showed general improvement in both groups, with some added benefit mid-way through recovery for NMES users

🟨 What Does This Suggest?

While both studies varied in duration and participant stage (before vs. after surgery), each applied Neuromuscular ES in a structured setting and recorded positive responses in muscle activation during key recovery phases.

Neuromuscular ES provided added neuromuscular engagement, offering potential for early-stage rehab support — especially for patients with limited movement or pain that prevents full effort exercises.

Although full numerical strength gains were not published, activation improvements and structured muscle work up to 69% MVIC were achieved using NMES.

More About Osteoarthritis Hub:

• How Electrical Stimulation Improves Walking, Climbing, and Joint Stability in Hip and Knee Osteoarthritis? UK Research Reveals. Click Here
  
• How Electrical Stimulation May Help Strengthen Muscles After Knee Surgery? – Insight from Irish Research. Click Here.
• Can Electromagnetic Fields Help with Osteoarthritis? The study looked at 636 adults with osteoarthritis. Click Here 

About Oriems Fit Research Digest

The Oriems Fit Research Digest brings you interesting research discoveries, making science accessible and engaging for everyone. Our posts aim to share new findings that spark curiosity and inform our readers.

Disclaimer

This post is for informational and recreational purposes only and should not be seen as medical advice. Our blog posts are for recreational, all of our infomation are not medical advices, our team members are not medical practioners, and our products are not medical devices. Always consult a healthcare professional before beginning any new treatments. For more on our disclaimer, visit Full Disclaimer.