Lab-based feasibility and acceptability of neuromuscular electrical stimulation in hip osteoarthritis rehabilitation.

Louise C Burgess,Paul Taylor,Ian D Swain,Thomas W Wainwright

doi:10.1177/2055668320980613

Abstract

IntroductionNeuromuscular electrical stimulation (NMES) could provide an alternative or adjunct treatment modality to induce muscle hypertrophy in the hip osteoarthritis population. This preliminary study evaluates the feasibility and acceptability of NMES to evoke involuntary muscle contractions in adults with advanced hip osteoarthritis.MethodsThirteen adults with moderate-to-severe hip osteoarthritis and fifteen healthy, older adults were invited to a lab-based testing session. NMES was applied unilaterally to the knee extensors and hip abductors for one continuous, five-minute testing session. Data were collected on device acceptability, tolerability and muscle contractile force, and compared between groups.ResultsElectrical stimulation of the knee extensors elicited a visible muscular contraction in 11 participants (85%) with hip osteoarthritis and 15 controls (100%) at an intensity acceptable to the participant. Electrical stimulation of the hip abductors elicited a muscular contraction in eight participants (62%) with osteoarthritis, and ten controls (67%). Muscle contractile force, pain, discomfort and acceptability did not differ between groups, however NMES of the knee extensors was favoured across all measures of assessment when compared to the hip abductors.ConclusionsElectrical stimulation of the knee extensors may be a feasible and acceptable treatment modality to address muscle atrophy in adults with advanced hip osteoarthritis.

Highlights

Neuromuscular electrical stimulation (NMES) could provide an alternative or adjunct treatment modality to induce muscle hypertrophy in the hip osteoarthritis population
Neuromuscular electrical stimulation of the knee extensors elicited a visible muscular contraction in 11 participants (85%) in the hip osteoarthritis group and 15 participants (100%) in the control group, at a stimulation intensity acceptable to the participant
Muscle contractile force, pain, discomfort and acceptability did not differ between groups, electrical stimulation of the knee extensors was favoured across all measures of assessment when compared to the hip abductors in both groups

Summary

Introduction

Neuromuscular electrical stimulation (NMES) could provide an alternative or adjunct treatment modality to induce muscle hypertrophy in the hip osteoarthritis population. This preliminary study evaluates the feasibility and acceptability of NMES to evoke involuntary muscle contractions in adults with advanced hip osteoarthritis. Muscle contractile force, pain, discomfort and acceptability did not differ between groups, NMES of the knee extensors was favoured across all measures of assessment when compared to the hip abductors. Conclusions: Electrical stimulation of the knee extensors may be a feasible and acceptable treatment modality to address muscle atrophy in adults with advanced hip osteoarthritis. Local muscle strengthening and aerobic exercise are recommended irrespective of age, comorbidity, pain severity or disability.[9,10,11,12] Likewise, when progression of the disease leads to consideration for total hip replacement surgery, preoperative exercise programmes are proposed as a potential method to expedite recovery time.[13,14,15] some patients choose to avoid traditional exercise due to fear of causing joint damage or exacerbating pain,[16,17,18,19,20] and the evidence supporting physiotherapy prior to hip replacement for improving function is equivocal.[13]

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