Prospective, Double Blind Randomized Controlled Trial on the Use of Immediate Post-Operative Electrical Muscle Stimulation to Preserve Muscle Function and Volume Following Achilles Tendon Surgery

Autor: Christopher Hyer DPM, Gregory Berlet MD, James Wilgus DPT, Christy Collins PhD, Joshua Houser MD, Matthew Crill MPT, MS, MBA, Carrie Sexton, Emily Stansbury, Patrick Bull DO, Terrence Philbin DO
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Foot & Ankle Orthopaedics, Vol 2 (2017)
Druh dokumentu: article
ISSN: 2473-0114
24730114
DOI: 10.1177/2473011417S000215
Popis: Category: Ankle Introduction/Purpose: Post-surgical muscle atrophy is common after Achilles tendon repair and immobilization. Muscle atrophy takes significant rehabilitation effort and time to recover, sometimes never returning to pre-operative level. Neuromuscular stimulation has been shown to improve pain and accelerate recovery following orthopedic surgery. The mechanism of this effect has not yet been elucidated. We theorized that muscle atrophy was a critical link to positive patient outcomes and that NMES could be achieving its effect by a muscle volume preserving mechanism. It was theorized that electrical muscle stimulation used immediately after surgery and through the course of immobilization could mitigate calf muscle atrophy, improve post-operative patient reported scores, and perhaps speed functional recovery of Achilles tendon repairs. Methods: This was an IRB approved prospective, double blind randomized controlled trial with 40 patients. Pre-operative and post-operative measurements of calf circumference, Focus on Therapeutic Outcomes (FOTO) Score, and AOFAS ankle-hindfoot score were measured. All subjects had MRI scans pre-operative and at post-operative weeks 2 and 6 to measure cross sectional muscle volumes. A four lead NMES device was applied in a standardized fashion at time of surgery with both patient and surgeon blinded to activity of the device (20 active, 20 ‘sham’). All patients followed a standardized post-operative protocol. Chi-square test was used for categorical variables and two-sample t-tests for continuous variables. Linear mixed models were used to compare changes in muscle cross sectional area and clinical outcomes of interest over time between the groups. Statistical significance was set at p
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