The effect of neuromuscular electrical stimulation during closed kinetic chain exercise on lower extremity performance following anterior cruciate ligament reconstruction*

Abstract

No studies have examined the effect of augmenting closed kinetic chain (CKCh) exercises with neuromuscular electrical stimulation (NMES) following anterior cruciate ligament (ACL) reconstruction. Therefore, the purpose of this study was to compare the effect of supplementing a CKCh training program with NMES during the initial six weeks following ACL reconstruction on anterior tibiofemoral joint laxity and the following CKCh performance activities: (1) unilateral squat, (2) 0.10 m lateral step‐up test and (3) anterior reach test. Twenty patients who underwent ACL reconstruction were randomly placed in two treatment groups post surgery: group 1 performed CKCh exercise with NMES applied to the quadriceps and hamstring musculature of the ACL reconstructed lower limb and group 2 performed CKCh exercise alone. Following five weeks of either CKCh training program, performance on the lower limb CKCh tests and knee arthrometry was compared between the two groups by multivariate analysis of variance. No significant difference was noted between the groups with respect to the non‐involved lower limb's performance. The ACL reconstructed lower limb in the combined CKCh and NMES group performed significantly better on the unilateral squat and lateral step‐up test than did the ACL reconstructed lower limb in the CKCh exercise alone group. It is concluded that augmenting CKCh training with NMES during the initial six weeks following ACL reconstruction produces a better lower limb performance effort than is attributable to a CKCh training program without NMES.